Today, we have launched a consultation on plans to develop a Medical Licensing Assessment (MLA). Here, our Chair Professor Terence Stephenson, explains why we believe the MLA is needed.

One of the reasons I chose medicine as a profession is its capacity to constantly challenge and surprise.

I’ve seen huge changes since I qualified as a doctor, but perhaps the most surprising thing is what has not changed at all: there is still no unified method of entry to the UK medical register, or a single assessment to test the skills, competence and quality of doctors seeking to practise here.

Agreeing a threshold of competence

There are 32 medical schools in the UK, and each sets its own curriculum and methods of assessment. That’s 32 slightly different ways of determining if a doctor in training is up to entering the profession.

It can’t be right that medicine marks its own homework. So how do we make sure that doctors reach an agreed threshold of competence and preparedness?

We’ve done some research [PDF] and found that not all doctors leave medical school feeling prepared for practice to the same level. Doctors in training can’t possibly be fully prepared as they go into foundation training but it’s up to us to ensure they’re as ready as possible.

Terence Stephenson speaks at GMC conference 2016
Terence Stephenson speaks at GMC conference 2016

Creating a more straightforward route to practice

Our proposal is to introduce a Medical Licensing Assessment (MLA) for all medical students, building on the work already done by the Medical Schools Council to introduce a common bank of questions for final exams.

Our aspiration is that this assessment should apply to doctors who join the medical register wherever they obtain their degree.

This would create a straightforward and transparent route to medical practice in the UK. We believe it would be fairer and more reassuring for the public for there to be a standard for entry to the register that everyone can rely on. Over time we are confident that the MLA could become an international benchmark test for entry to medicine.

We don’t want to create a one-size-fits-all system of undergraduate education – the diversity of our current medical schools can and should be cherished – but we do think all those becoming doctors in the UK should demonstrate that they have the skills and competence to practise here by passing the same assessment.

Many experts in medical schools recognise the value such an examination could bring. A Medical Licensing Assessment would promote consistency and fairness. And, the 35% of NHS doctors who qualified overseas could take the test free from claims of discrimination, as the assessment would be matched to the standards of UK doctors.

Our Education team speak to doctors and educators about the MLA proposals at GMC conference 2016
Our Education team speaks to doctors and educators about the MLA proposals at GMC conference 2016

Gathering expertise and working with partners

I am the first to admit that we do not have all the answers and it would be foolhardy to embark on such a mission without the views and support of experts. We spent the early part of 2016 visiting all medical schools to hear from as many educators as possible. A genuinely valuable MLA will take time to deliver and of course we shall have to work closely with our partners to deliver it.

In an increasingly mobile world, the setting of a clear and respected threshold for entry to UK medicine would have huge advantages for medical education and practice in this country, and for its international reputation, bringing us into line with best practice in other countries.

The GMC’s consultation is open from 31 January to 30 April 2017. To read the proposals and give your views, visit