MLA CPSA Requirements PDF 84742729

Requirements for
the MLA Clinical and

Professional Skills
Assessment
Medical Licensing Assessment
gmc-uk.org/mla
Requirements for the Medical Licensing
Assessment Clinical and Professional Skills
Assessment
Requirements for the Medical Licensing Assessment Applied Knowledge Test is annexed to - and
forms part of – Assuring readiness for practice: a framework for the MLA.
Background
The Medical Licensing Assessment
The purpose of the Medical Licensing Assessment (MLA) is to ensure that doctors seeking
registration with a licence to practise medicine in the UK have met a common threshold for safe
practice that is appropriate to their point of entry to the medical register.
The MLA has two components: the applied knowledge test (AKT) and the clinical and professional
skills assessment (CPSA), through which candidates can demonstrate they are ready for safe
practice, able to manage uncertainty, and deliver patient centred care. These are the three
themes underpinning the MLA content map, which sets out the core knowledge, skills and
behaviours needed for UK practice.
The CPSA is a performance-based assessment * of clinical and professional skills, knowledge and
behaviours. It is set and delivered by:
 UK medical schools† for medical students in their penultimate or final year of
undergraduate education, and
 the GMC for those international medical graduates (IMGs) who wish to practise medicine
in the UK and must demonstrate their knowledge and skills through taking the MLA.
*
Irrespective of the format that each assessment provider has chosen to use (eg Objective Structured Clinical
Examination (OSCE), Objective Structured Long Examination Record (OSLER), Practical Assessment of Clinical
Examination Skills (PACES)).
†
Under section 4.4 of the Medical Act 1983 medical schools may, with GMC approval, unite or cooperate to design,
construct, and deliver the Applied Knowledge Test for UK medical students.
The GMC is a charity registered in England and Wales (1089278) and Scotland (SC037750).
You are welcome to contact us in Welsh. We will respond in Welsh, without this causing additional delay.
Joining the medical register
Before they can join the medical register with provisional registration with a licence to practise
granted by the GMC, unless transitional arrangements set out in Annex D of Assuring readiness
for practice: a framework for the MLA apply, UK medical students graduating from the academic
year 2024-25 will need to hold a medical degree awarded by a university included in the list
maintained by the GMC of bodies entitled to award a Primary Medical Qualification that includes
a pass in both parts of the MLA and the other assessments set by their medical school.
From 2024, before they can apply for registration with a licence to practise, IMGs who need to
take the MLA will need to pass both parts of the MLA and meet our other conditions, including
providing evidence demonstrating that they have an acceptable primary medical qualification,
clinical experience and the necessary knowledge of English.
Purpose of this document

This document specifies the requirements that each assessment provider’s* CPSA must meet.
By meeting these requirements, an assessment provider is demonstrating the quality,
consistency and fairness of their CPSA to a standard that the GMC requires for the CPSA to count
towards a candidate’s MLA. In identifying these requirements, we have ensured they are based
on scholarship and effective practice.
An assessment provider must submit a narrative and supporting evidence (“the submission”) to
us to show how their CPSA meets these requirements. We will then review the submission, with
the help of a panel of independent assessment experts, to decide whether their CPSA meets the
requirements.
Accompanying guidance
Further information on how to complete the submission is available in the accompanying
guidance.
*
This document refers to all medical schools and the GMC as ‘assessment providers’ and all test-takers as
‘candidates’.
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Design
Assessment strategy
1. Describe and demonstrate how the CPSA sits within the overall assessment strategy for the
final and penultimate years, eg workplace-based assessments (WPBA) and clinical procedural
skills.
CPSA design
2. Describe the rationale for the design of the CPSA. This should include:
 format
 station type
 testing time, including number and duration of stations.
Scoring
3. Describe the rationale for the approach to scoring candidate performance:
 within station (eg domain/checklist/overall global judgement)
 how results are aggregated at the level of the overall assessment
 any marks or judgements given by the simulated or real patient, and how they
contribute to the overall score.
Standard setting
4. Describe and demonstrate how standards are set for the first take and resit, as applicable,
and the underlying rationale for the chosen method(s), including:
 standard setting method at station and overall assessment level
 any additional passing criteria (eg minimum number of stations passed).
Assessing professionalism
5. Describe and demonstrate how professionalism is assessed during the CPSA and
unprofessional behaviours are captured and followed up.
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Content
Content sampling
The MLA content map is informed by Outcomes for graduates, the Foundation Programme
training outcomes, the Generic professional capabilities framework and Good medical practice.
6. Describe how the CPSA content relates to the MLA content map:
 Demonstrate that the CPSA maps to the three overarching themes:
a. Readiness for safe practice
b. Managing uncertainty
c. Delivering person-centred care
 Demonstrate how the CPSA maps to the individual domains:
a. Areas of clinical practice
b. Areas of professional knowledge
c. Clinical and professional capabilities
d. Practical skills and procedures
e. Patient presentations
f. Conditions
 Demonstrate that candidates can identify and interpret clinical findings.
Quality of CPSA content

7. Describe and demonstrate how stations are created and approved, and quality is maintained.
This should include:
 how station writers are trained
 the process for creating, reviewing and approving new stations, and reusing existing
stations
 how a range of appropriate stakeholders is involved in the creation and development of
stations to assure their authenticity and level of challenge
 how feedback collected on the day of the CPSA and post-exam station metrics are fed
into the writing and review process.
Security of CPSA content

8. Describe and demonstrate how the security of the assessment content is maintained.
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Preparation of and support for candidates
Familiarisation with the assessment process for candidates
9. Describe and demonstrate how candidates have been given information about the CPSA in
advance, and briefed on the day, covering:
 assessment format, including the criteria for achieving a pass
 expected standards of performance
 how the CPSA will be run on the day.
Results and feedback to candidates

10. Describe and demonstrate what results and feedback are given to candidates and how the
quality of any feedback is assured, as well as what support is given to unsuccessful
candidates.
Preparedness of examiners and patients for the CPSA

Examiners
We encourage the inclusion of multi-professional, lay and training grade examiners.
Professionally qualified examiners must be in good standing with the relevant regulatory body.
11. Describe how examiners are recruited, trained, briefed and calibrated, and demonstrate:
 criteria for becoming an examiner
 training to support examiners’ preparedness
 details of marking calibration
 details of equality, diversity and inclusion (ED&I) training.
Simulated/real patients
12. Describe how simulated/real patients are involved in the CPSA, and demonstrate how they
are recruited, trained, briefed and calibrated.
Collaboration between examiners and patients

13. Describe and demonstrate how the examiner and simulated/real patient for each station are
given the opportunity to meet and familiarise themselves with the station content.
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Feedback to examiners and simulated patients
14. Describe and demonstrate what feedback is given to examiners and simulated patients, and
how the impact of this feedback is monitored.
Policies and resources

Policies and procedures
15. Demonstrate that there are policies and procedures in place to deal with all aspects of the
CPSA.
Resources and space

16. Demonstrate that the CPSA takes place in a space appropriate for a high stakes assessment
with access to appropriate clinical resources.
Data management
Data acquisition
17. Describe and demonstrate the approach to accurate and consistent data acquisition during
the CPSA and dealing with missing data identified during the CPSA itself.
Production of results
18. Describe and demonstrate how results data are combined and checked after the CPSA to
produce results for the exam board, including:
 approach to missing data identified during production of results
 approaches to post-assessment mark-data changes.
Evaluation and quality assurance

Psychometric analysis
19. Describe and demonstrate how the assessment data are analysed and how the outcomes of
the analysis feed into post-CPSA review, evaluation and decision making. This should include:
 what analyses are conducted
 how the analysis is used to improve station quality
 how the analysis informs the development of the CPSA.
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External examiners
20. Describe and demonstrate how the external examiners contribute to the quality of the CPSA
and how the assessment provider responds to their advice.
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Email: [email protected]
Website: gmc-uk.org
Telephone: 0161 923 6602
General Medical Council, 3 Hardman Street, Manchester M3 3AW
Textphone: please dial the prefx 18001 then

0161 923 6602 to use the Text Relay service.
Join the conversation

@gmcuk facebook.com/gmcuk
linkd.in/gmcuk youtube.com/gmcuktv
To ask for this publication in another format or language, please call us

on 0161 923 6602 or email us at [email protected].
I ofyn am y cyhoeddiad hwn mewn fformat neu iaith arall, ffoniwch ni ar
0161 923 6602 neu e-bostiwch ni ar [email protected].
You are welcome to contact us in Welsh. We will respond in Welsh,

without this causing additional delay.
Mae croeso i chi gysylltu â ni yn Gymraeg. Byddwn yn ymateb yn
Gymraeg, heb i hyn achosi oedi ychwanegol.
Published September 2019, updated October 2024

© 2024 General Medical Council
The text of this document may be reproduced free of charge in

any format or medium providing it is reproduced accurately and not in
a misleading context. The material must be acknowledged as General
Medical Council copyright and the document title specified.
The General Medical Council is a charity registered in England and Wales

(1089278) and Scotland (SC037750).
Code: GMC/MLACPSA/1024

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Requirements for

the MLA Clinical and

Purpose of this document

Quality of CPSA content

Security of CPSA content

Results and feedback to candidates

Preparedness of examiners and patients for the CPSA

Collaboration between examiners and patients

Policies and resources

Resources and space

Evaluation and quality assurance

Textphone: please dial the prefx 18001 then

Join the conversation

To ask for this publication in another format or language, please call us

You are welcome to contact us in Welsh. We will respond in Welsh,

Published September 2019, updated October 2024

The text of this document may be reproduced free of charge in

The General Medical Council is a charity registered in England and Wales

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