Countries > UK for Doctors > UKMLA
The United Kingdom for Doctors. The UK's National Health Service remains one of the world's largest employers of international doctors, offering a structured training pathway from foundation years through to consultancy.
Its General Medical Council registration is globally respected and often streamlines the licensing process in other jurisdictions. For international medical graduates, the UKMLA provides a single, clearly defined licensing exam, making the route to practice predictable and well-supported by a vast ecosystem of preparation resources.
Pathway Snapshot
Every international medical graduate aiming to practise in the UK sits two exams, built to the GMC's UKMLA content standard. First you prove you know the medicine, that's the AKT. Then you prove you can actually do it in front of a patient, that's the CPSA. Clear both, and you can apply for GMC registration with a licence to practise.
Complete Journey: Medical Graduation → English Language Evidence → AKT → CPSA → GMC Registration with Licence to Practise → NHS Posts / Postgraduate Training.
Before you can book the AKT, you need to prove your English meets the GMC's standard. This isn't optional and isn't something you can submit later; it has to be approved before the booking system will even let you in.
Accepted Tests & Scores
You need one of the following, with all four parts passed in the same sitting:
| Test | Minimum Score |
|---|---|
IELTS Academic |
Overall score of 7.5, with no individual section below 7.0 |
OET Medicine |
Grade B (350 or above) in Listening, Reading, Writing, and Speaking |
Validity
Both are valid for 2 years from your test date. Time it so the certificate is still valid when you apply for GMC registration later, not just when you book the AKT.
You start by creating a GMC Online account and uploading your primary medical qualification and English test evidence (IELTS Academic or OET Medicine). Once the GMC verifies your English evidence, usually within about a week, you can book the AKT through the portal.
The AKT tests whether core medical knowledge actually holds up under pressure, across every major area a junior doctor deals with. It's a written, computer-based exam of multiple-choice questions built around real patient scenarios, not simple recall. The test covers general medicine (cardiovascular, respiratory, neurology, and more), surgery, paediatrics, obstetrics and gynaecology, psychiatry, general practice, pharmacology, medical ethics and law, microbiology, and public health.
Exam Day: 3 hours total, 180 single best answer questions, five options each.
Booking: After your GMC Online account and English evidence are verified, you can book the AKT through the GMC portal.
What we offer
Full AKT question bank mapped to the GMC content map, flashcards, self assessments, trained AI companion with you at every step, mentorship, a medical library, study groups, and more, all offered together.
Start AKT Prep →The CPSA is the practical half, this is where you're assessed hands-on. It's not just about knowing the right answer; it's about showing you can communicate it, examine safely, and behave professionally under real-time pressure. The exam is held exclusively at the GMC's Clinical Assessment Centre in Manchester and can only be booked after you pass the AKT.
Exam Day & Format
The CPSA is made up of 16 clinical stations, each built around a simulated patient (a trained actor) or a manikin for procedural skills. You'll get 8 minutes at each station, with 90 seconds beforehand outside the door to read the brief and patient information before you go in. Built into the circuit are at least 2 rest stations. All in, the exam runs about 3 hours.
How You're Marked
Every station is scored across three domains, each worth up to 4 marks, for a maximum of 12 marks per station:
Pass Mark Logic
What the Stations Cover
Across the circuit you'll be tested on history taking, clinical examination, explaining a diagnosis or procedure in plain language, prescribing, data interpretation, and practical skills like venepuncture, cannulation, or basic life support — all assessed the way a Foundation Year 2 doctor would be expected to handle them on a UK ward.
What we offer
Full CPSA station walkthroughs, video demonstrations of practical skills, flashcards, self assessments, trained AI companion with you at every step, mentorship, a medical library, study groups, and more, all offered together.
Start CPSA Prep →Up to 4 attempts per component. Your AKT pass stays valid for 3 years; you need to pass the CPSA within that window. Once you pass the CPSA, you have 2 years to get your GMC registration application approved.
Once you pass both the AKT and CPSA, you apply for GMC registration with a licence to practise. This includes getting your medical degree independently verified through ECFMG's EPIC system, which you can start any time before your final application to avoid delays.
Once GMC registration is approved, you're clear to take up NHS posts or apply for UK postgraduate training.
GMC official rates, effective 1 April 2026. The applicable fee is determined by the date you sit the exam, not when you book it.
| Item | Fee |
|---|---|
AKT (booked as PLAB 1) | £283 |
CPSA (booked as PLAB 2) | £1,036 |
Full registration with a licence to practise | £481 |
Provisional registration with a licence to practise | £26 |
Annual Retention Fee | £433 (discounted to £166 if worldwide income is under £36,000) |