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Update, July 2019
In April 2019, MSC conference voted to renew their opposition to the introduction of the UKMLA (UK Medical Licensing Assessment) by the GMC. We believe that the exam presents an undue and unnecessary burden to students, and due to several major revisions to the project, medical students still only have a limited idea of what the exam that they will be facing in a few years looks like.
Since conference reconfirmed our opposition to the UKMLA, several further changes have been approved by GMC Council.
Initially, proposals for the AKT (Applied Knowledge Test) element of the exam ranged from a GMC supplied question paper on four set dates a year, to an alternative flexible model which involved universities setting their own date for students and selecting a number of questions from a GMC question bank (allowing for the AKT to be integrated into existing final examinations).
We understand that the GMC Council have settled for a middle ground approach and have approved a plan for the GMC to supply a standalone UKMLA test paper that universities will have the flexibility to deliver at any date throughout their final year. While we are content that this change allows schools to schedule the AKT to suit their own timetables, the additional exam burden to final year medical students remains. At many medical schools (including my own) students sit their final written exams in their penultimate year, allowing for a purely clinical, apprenticeship-style final year to prepare us for the day-to-day work of an FY1. Additional examination burden will only serve us with less time on the wards and more time in the library.
Due to the extra complications that this will entail, GMC Council have also approved a major change to the UKMLA timescale, pushing the start date of the UKMLA back a year to allow for an additional year of piloting. This means that the UKMLA will now be a requirement for all UK medical students starting a five year course this Autumn, or all those graduating from 2023-2024 onwards.
The GMC states “while changing from what was previously planned may be frustrating for some students, there has been value in taking extra time to refine the AKT and to make sure that they can deliver a good experience for candidates needing to sit the MLA.” This change to the timescale is welcomed by our committee and we believe indicates that the GMC is responding to feedback from medical schools and students.
We will continue to engage with the GMC to make improvements to the UKMLA and secure the developments needed for this exam so that no student is disadvantaged by its introduction.
In April 2018, student representatives from each of the UK’s thirty-three medical schools came together at MSC conference and voted overwhelmingly to oppose the implementation of the GMC UKMLA (UK Medical Licensing Assessment).
Since the motion, the BMA MSC (medical students committee) have established red lines that we believe should be met before the introduction of any new examination and have critically engaged with the GMC to ensure that the interests of students are protected in the development of the UKMLA.
We continue to fight to ensure these red lines are adhered to, and in doing so have secured assurances on behalf of our members across the UK: students will not bear the cost of any sittings of the UKMLA, GMC fees for doctors will not rise to fund the exam, practice and revision materials will be made freely available and any pilot of the exam will be on a purely voluntary basis. But there are still areas where we feel the GMC are falling short, and have failed to answer to reasonable concerns raised by students and staff.
Here is our updated guide to the UKMLA, including what we know (featuring a brand-new proposed alternative model), what we have achieved, and further concerns that the GMC must address.
What do we know?
The UKMLA is the proposed assessment for all doctors who wish to practice medicine in the UK. This will be a requirement for all those graduating from UK medical schools from 2023, and International Medical Graduates (IMG) who wish to practice in the UK1. The GMC have stated the aim of the UKMLA is to set “a common threshold for safe practice” 2.
The UKMLA will be composed of two parts- the AKT (Applied Knowledge Test) and CPSA (Clinical and Professional Skills Assessment) 1.
AKT- The knowledge component of the UKMLA. The GMC Council approved model of the AKT will be made up of 150-200 Single Best Answer questions, and sat at medical schools over four set dates throughout the year1. The GMC are exploring ways to integrate this into existing medical school structures as far as possible, but it is unclear how successfully this may be achieved.
An alternative AKT model has been proposed by the Medical Schools Council (details below).
CPSA- The practical aspect of the exam. This will not be a separate exam from medical school finals, but a quality assurance process of existing medical school practical exams (e.g. OSCEs) to confirm these fit with GMC requirements1. It can therefore be fully integrated into existing structures.
The alternative AKT model
The latest update on the UKMLA is that the Medical Schools Council have tabled a proposal for an alternative AKT model that will allow schools increased control and flexibility over the AKT’s delivery, and can realistically allow for the full integration of the exam.
The proposal would see the GMC create four ‘pools’ of standard questions, one for each quartile of the year. Universities would select their own date for students to sit the AKT, and then include a number of questions from the AKT pool for their quartile, and use these to compile their own school’s paper. The GMC would then approve the schools’ paper.
Each schools’ paper would therefore be unique, the control of what is tested in final exams would still be with each school (subject to final approval by the GMC), and the AKT could be sat at a date selected by the school, meaning it could be scheduled as part of, or instead of, an existing exam.
There have been a number of positive developments and reassurances made by the GMC in response to continued efforts by the MSC.
While we are pleased with many of the positive developments in the MLA’s structure, we remain concerned and committed to advocating for students over a number of key areas:
This year’s BMA medical students conference will be taking place in April, and students from across the UK will be voting on whether to maintain our current policy to oppose the UKMLA. We look forward to hearing the views and concerns of our grassroots members, and will use their insight to strengthen our arguments put to the GMC.
The GMC have agreed to engage with regular meetings with BMA representatives to discuss the UKMLA’s development, and have been transparent and forthcoming in providing information for this post. We look forward to these opportunities to shape an exam that will not disadvantage students.
If you want to have your say in our approach to these negotiations, please get in touch with your local rep by emailing [email protected]
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