What is UKMLA?
The UK's new single licensing assessment replacing PLAB for new candidates.
2026-27 UKMLA guide for Indian doctors
United Kingdom Medical Licensing Assessment (UKMLA) 2026-27 for Indian Doctors - Complete Guide
Last Updated: March 2026
UKMLA is the major UK licensing change replacing the old PLAB route for new entrants. This page gives you the practical 2026-27 map from English and EPIC through AKT, CPSA, GMC registration, and your first NHS job.
Key reason
UKMLA is now the core UK route for new Indian doctors entering the NHS pathway.
Key reason
The UK remains one of the strongest English-only medical migration routes in the world.
Key reason
GMC registration carries global value far beyond the NHS itself.
Key reason
The AKT is more reasoning-driven than the old PLAB 1 pattern, so preparation strategy matters more than ever.
Quick Summary
The UKMLA snapshot before you start planning seriously
Two Parts
AKT plus CPSA.
Main Fees
AKT around GBP 283, CPSA around GBP 1,036, GMC registration GBP 481.
English Requirement
IELTS Academic 7.5 overall with 7.0 each band, or OET Medicine Grade B in all components.
NHS Starting Salary
FY1 basic pay starts around GBP 36,616 yearly.
Core Advantage
Full English pathway with a globally respected GMC registration outcome.
Key Facts
The rules and numbers every UKMLA candidate should know
| Feature | Details |
|---|---|
| Exam Full Name | United Kingdom Medical Licensing Assessment (UKMLA) |
| Administered By | General Medical Council with UK medical schools |
| Replaces | PLAB for new candidates from 2026 onward |
| Parts | AKT plus CPSA |
| AKT Format | 200 SBA MCQs across two papers |
| CPSA Format | OSCE-style clinical and professional skills assessment |
| AKT Fee | About GBP 283 |
| CPSA Fee | About GBP 1,036 |
| GMC Registration Fee | GBP 481 |
| English Requirement | IELTS Academic or OET Medicine |
| EPIC Verification | Required for Indian MBBS graduates |
| Maximum Attempts | Normally 4 for AKT and 4 for CPSA |
| Pass Standard | Pass / fail; fixed public numerical mark not published by GMC |
| GMC Registration Validity | Long-term registration with annual retention and revalidation obligations |
| Best Prep Tools | MedRevisions, Pastest, Quesmed, and GMC-aligned MLA content map resources |
Timeline
What the UKMLA-to-NHS route usually looks like from India
| Phase | Month | Action | Focus |
|---|---|---|---|
| English | Month 1-2 | Prepare IELTS or OET | Get the English requirement out of the way early. |
| English | Month 2-3 | Sit IELTS or OET | Secure a valid 2-year result. |
| Documents | Month 2-5 | Start EPIC verification | Run ECFMG EPIC in parallel with other prep. |
| Documents | Month 2-5 | Gather, certify, and apostille documents | Prepare MBBS, internship, registration, and identity documents. |
| GMC | Month 4-6 | Submit GMC account and registration pathway documents | Move into the formal UKMLA route. |
| AKT Prep | Month 3-8 | Study for AKT | Use UKMLA-specific question banks and MLA content map revision. |
| AKT | Month 6-9 | Sit AKT | India-based test-centre option makes this easier logistically. |
| CPSA Prep | Month 8-11 | Prepare OSCE skills | Communication and station practice become critical. |
| CPSA | Month 10-14 | Travel to UK and sit CPSA | Requires UK visitor-visa logistics. |
| GMC + NHS Job | Month 13-18 | Complete GMC registration and apply for NHS posts | Move into Foundation, trust-grade, or specialty-track employment. |
Step By Step
The 8-step UKMLA pathway in the right order
Step 1: Clear IELTS or OET
Your UK pathway starts with English evidence acceptable to GMC.
Step 2: Start EPIC immediately
EPIC is one of the most common delay points, so begin it in parallel with language.
Step 3: Prepare your full document file
Apostilled MBBS papers, internship, registration, and identity documents should be organized early.
Step 4: Open your GMC pathway online
This is the formal start of the licensing process on the UK side.
Step 5: Prepare for and pass AKT
AKT now demands stronger clinical reasoning than the old PLAB-style mindset.
Step 6: Prepare for and pass CPSA
CPSA is a UK-based OSCE and rewards structured communication practice.
Step 7: Apply for full GMC registration
After both exam passes, move into full registration and get your GMC number.
Step 8: Apply for NHS jobs and Skilled Worker visa
Once you have registration, your NHS career path formally opens.
Eligibility
Who can actually enter the UKMLA route
| Criteria | Requirement | Notes |
|---|---|---|
| Medical Degree | Primary Medical Qualification from a GMC-accepted, WDOMS-listed school | Most NMC-approved Indian MBBS colleges fit this. |
| Internship | 12 months of supervised clinical practice | Indian rotating internship usually qualifies. |
| NMC / State Registration | Valid and in good standing | No unresolved disciplinary issues. |
| IELTS | Academic 7.5 overall with minimum 7.0 each band | Valid for 2 years. |
| OET Medicine | Grade B in all components | Also valid for 2 years. |
| EPIC Verification | Required | Mandatory for Indian MBBS graduates. |
| AKT | Pass required | Can be sat in India. |
| CPSA | Pass required | Must be sat in the UK. |
| Maximum Attempts | Normally 4 for each part | Further attempts require special consideration. |
| NEET | Not required | UKMLA has its own eligibility logic. |
Top NHS Trusts
NHS trusts and cities Indian doctors compare most often
| # | NHS Trust / Hospital | Region | Starting Salary | Starting Salary (INR) | Advantage |
|---|---|---|---|---|---|
| 1 | King's College Hospital NHS FT | London | GBP 36,616 | Rs 38.45L / yr | Strong IMG support and a major London teaching environment |
| 2 | Guy's and St Thomas' NHS FT | London | GBP 36,616 | Rs 38.45L / yr | Very strong teaching profile and a large IMG ecosystem |
| 3 | Manchester University NHS FT | Manchester | GBP 36,616-42,008 | Rs 38.45L-Rs 44.1L | Major northern training hub with stronger affordability than London |
| 4 | University Hospitals Birmingham FT | Birmingham | GBP 36,616-42,008 | Rs 38.45L-Rs 44.1L | Strong Indian community and large tertiary-care infrastructure |
| 5 | Leeds Teaching Hospitals NHS FT | Leeds | GBP 36,616-42,008 | Rs 38.45L-Rs 44.1L | Teaching strength with better cost-of-living balance |
| 6 | Oxford University Hospitals NHS FT | Oxford | GBP 36,616-49,909 | Rs 38.45L-Rs 52.4L | High-value academic medicine route |
| 7 | Imperial College Healthcare NHS FT | London | GBP 36,616-49,909 | Rs 38.45L-Rs 52.4L | Strong central-London academic prestige |
| 8 | NHS Lothian / Edinburgh Royal Infirmary | Edinburgh | GBP 36,616-49,909 | Rs 38.45L-Rs 52.4L | Strong Scotland route with lower specialty-training competition in some tracks |
| 9 | Nottingham University Hospitals NHS FT | Nottingham | GBP 36,616-42,008 | Rs 38.45L-Rs 44.1L | Affordable city and active IMG recruitment |
| 10 | Barts Health NHS FT | London | GBP 36,616-42,008 | Rs 38.45L-Rs 44.1L | Largest NHS trust in England with broad entry opportunities |
Costs and Fees
What the UKMLA route really costs before your first NHS salary starts
| Item | GBP | INR | Notes |
|---|---|---|---|
| IELTS Academic | 230-300 | Rs 24,150-Rs 31,500 | British Council India or equivalent booking path |
| OET Medicine | 350-400 | Rs 36,750-Rs 42,000 | Alternative to IELTS |
| English prep coaching | - | Rs 10,000-Rs 50,000 | Optional coaching spend |
| EPIC verification | ~150 | Rs 15,580 | Paid in USD equivalent |
| Document apostille | - | Rs 5,000-Rs 15,000 | Depends on volume and handling |
| UKMLA AKT fee | 283 | Rs 29,715 | April 2026 fee point |
| AKT prep resources | 30-100 | Rs 3,150-Rs 10,500 | Question banks and short subscriptions |
| CPSA prep academy | 600-1,500 | Rs 63,000-Rs 1.58L | UK-based OSCE coaching |
| UK visitor visa for CPSA | 115 | Rs 12,075 | For the CPSA trip |
| India-UK travel + stay for CPSA | 1,100-2,100 | Rs 1.15L-Rs 2.20L | Flights plus short accommodation window |
| UKMLA CPSA fee | 1,036 | Rs 1.09L | April 2026 fee point |
| GMC registration fee | 481 | Rs 50,505 | Paid after passing both parts |
| Skilled Worker visa | 715-1,084 | Rs 75,075-Rs 1.14L | Depends on route length and category |
| Health surcharge | 1,035 per year | Rs 1.09L per year | Applies on visa side |
| Estimated total pathway cost | 3,500-12,000 | Rs 3.68L-Rs 12.6L | Depends heavily on coaching, repeats, and relocation spend |
NHS Salary Data
How UK doctor pay looks from Foundation to Consultant level
| Role | Annual Basic Pay (GBP) | Annual (INR) | Monthly Gross (GBP) | Monthly Gross (INR) |
|---|---|---|---|---|
| Foundation Year 1 | 36,616 | Rs 38.45L | 3,051 | Rs 3.20L |
| Foundation Year 2 | 42,008 | Rs 44.11L | 3,501 | Rs 3.68L |
| Specialty Registrar ST1-ST2 | 49,909 | Rs 52.4L | 4,159 | Rs 4.37L |
| Specialty Registrar ST3+ | 61,825 | Rs 64.9L | 5,152 | Rs 5.41L |
| Specialty Doctor | 59,175-99,216 | Rs 62.1L-Rs 1.04Cr | 4,931-8,268 | Rs 5.18L-Rs 8.68L |
| Consultant | 105,504-132,000+ | Rs 1.11Cr-Rs 1.39Cr+ | 8,792-11,000 | Rs 9.23L-Rs 11.55L |
| Supplement | Amount | Applies |
|---|---|---|
| Weekend allowance | 10-20% of basic | Junior and specialty doctors with weekend work |
| Night shift supplement | 37% per hour | Night-duty periods |
| On-call supplement | 8-13% | Rota-based on-call roles |
| London weighting | GBP 2,162-5,132 yearly | Doctors working in London |
| Rural / remote incentives | Up to GBP 20,000 one-time | Some shortage or underserved placements |
Recognition
Why GMC registration is such a powerful medical credential
| Body | Meaning |
|---|---|
| GMC | The core UK medical regulator and the body issuing registration. |
| WHO / WDOMS | Your medical school must sit in the accepted international recognition framework. |
| ECFMG / FAIMER | EPIC verification confirms your source credentials for GMC. |
| AHPRA | GMC registration can strengthen later Australian routes. |
| NZMC | GMC carries strong value for New Zealand pathways too. |
| Gulf authorities | GMC registration is highly portable into Gulf licensing ecosystems. |
| NMC India | The key caveat body; UK training and GMC registration are not directly treated as Indian MD/MS equivalence. |
| HEE / local training bodies | Drive specialty-training entry and long-term NHS development. |
| Royal Colleges | Postgraduate exam route for deeper specialty progression. |
| GMC Revalidation | Five-yearly revalidation supports long-term professional credibility. |
AKT Syllabus
What UKMLA actually tests and how to structure your study
| Domain | Sub-Domains | AKT Weighting | CPSA Relevance |
|---|---|---|---|
| Clinical Medicine | Medicine, surgery, paediatrics, OBG, psychiatry, ENT, ophthalmology and more | ~60% | High across most stations |
| Prescribing Safety | Drug interactions, IV fluids, medical gases, adverse effects | ~15% | Prescribing and safe-practice stations |
| Investigations and Data Interpretation | ECG, ABG, labs, imaging | ~10% | Interpretation stations |
| Medical Ethics and Law | Consent, capacity, confidentiality, end-of-life issues | ~10% | Communication and professionalism stations |
| Professional Behaviour | Communication, MDT work, professionalism, GMC standards | ~5% | Communication-heavy stations |
| Preparation Month | Focus | Resources |
|---|---|---|
| Month 1-2 | MLA content map familiarization and early Q-bank work | MedRevisions essentials, GMC content map |
| Month 2-4 | Core clinical medicine | Full Q-bank plus Oxford Handbook Clinical Medicine and similar references |
| Month 4-5 | Prescribing, ethics, professionalism | BNF, GMC Good Medical Practice, prescribing modules |
| Month 5-6 | Data interpretation and targeted weak areas | ECG, imaging, data-interpretation banks |
| Month 6 | Full mocks and error review | Timed mock papers and wrong-answer analysis |
| Post-AKT | CPSA / OSCE preparation | UK-based OSCE academies and live station practice |
After Passing
What happens after UKMLA once you are moving into NHS practice
Next step 1
Apply for full GMC registration once AKT and CPSA are both passed.
Next step 2
Apply for Foundation-equivalent, trust-grade, or direct NHS doctor posts.
Next step 3
Use the employer's Certificate of Sponsorship to move into the Skilled Worker visa route.
Next step 4
Begin NHS induction and complete the mandatory local training modules.
Next step 5
Apply for specialty training or build toward it through service posts and portfolio growth.
Next step 6
Progress through Royal College exams and long-term specialist pathways.
Next step 7
Apply for ILR and later British citizenship if that is part of your plan.
Living Costs
How city choice affects NHS doctor savings in the UK
| Expense | London | Manchester | Birmingham | Leeds | Edinburgh |
|---|---|---|---|---|---|
| Rent | 1,200-2,000 | 700-1,200 | 700-1,100 | 600-1,000 | 700-1,200 |
| Food | 300-500 | 250-400 | 250-400 | 250-350 | 250-400 |
| Transport | 160-300 | 80-120 | 80-120 | 70-100 | 80-120 |
| Phone + Internet | 30-60 | 25-50 | 25-50 | 25-50 | 25-50 |
| Health surcharge equivalent monthly impact | ~86 | ~86 | ~86 | ~86 | ~86 |
| Personal / leisure | 150-300 | 100-200 | 100-200 | 100-200 | 100-200 |
| Total monthly | 1,926-3,246 | 1,241-1,970 | 1,241-1,870 | 1,131-1,786 | 1,241-1,970 |
Pros and Cons
The honest UKMLA and NHS trade-off for Indian doctors
Advantages
The entire route is in English, which removes the biggest obstacle many doctors face in continental Europe.
GMC registration is one of the most portable medical credentials in the world.
The NHS remains a very strong clinical-training system with major teaching hospitals and research centers.
The timeline to first paid job is often faster than Germany for doctors who are exam-ready.
Consultant-level salary and long-term private-practice upside remain very strong.
AKT can be sat in India, reducing early logistical friction.
Disadvantages
The CPSA still requires travel to the UK, adding a real extra cost layer.
The UK is expensive, especially once rent, travel, and the immigration surcharge are factored in.
GMC registration and UK specialist training are not directly recognized as Indian MD/MS equivalence.
Competitive specialty-training routes can be very difficult even after you enter the NHS system.
The UKMLA is more reasoning-heavy than the old PLAB model and punishes superficial prep.
There are hard attempt limits, so poor strategy is costly.
Compare Alternatives
How UKMLA compares with the other major international doctor pathways
| Parameter | UK | USA | Germany | Australia | Canada | India |
|---|---|---|---|---|---|---|
| Exam Name | UKMLA | USMLE | FSP + KP | AMC | MCCQE pathway | NExT |
| Language | English only | English only | German B2 + medical German | English | English or French | English |
| Exam Cost | GBP 2,000-3,000 total core exam path | USD 4,000-7,000+ | EUR 3,000-7,000+ | AUD 3,000-5,000 | CAD 4,000-6,000 | Very low government exam cost |
| Time to First Paid Job | 12-18 months | 18-24 months | 18-24 months | 18-24 months | 18-30 months | Immediate after seat |
| Starting Salary | GBP 36,616 / year | USD 60,000-80,000 / year | EUR 57,600-66,000 / year | AUD 80,000-100,000 / year | CAD 90,000-120,000 / year | Rs 3.6L-Rs 7.2L / year |
| Permanent Residency | ILR after 5 years | Longer green-card route | Can be faster on Blue Card | PR after several years | Strong PR route | N/A |
| Recognition in India | Not direct | Not direct | Not direct | Not direct | Not direct | Direct |
Support and Funding
What funding and support options are actually relevant
| Program | Coverage | Eligibility | Access |
|---|---|---|---|
| Wellcome Trust fellowships | Clinical research funding | Research-oriented GMC-registered doctors | Apply through Wellcome |
| BMA grants | Hardship and support grants | BMA members in qualifying situations | Apply through BMA |
| HSBC UK overseas-doctor loan | Personal finance support | Doctors with GMC or job progress | Bank-led route |
| SBI Global Ed-Vantage | Preparation, exam, and mobility funding | Indian doctors with documentation | Apply through SBI |
| NHS relocation package | Often GBP 1,000-5,000 | Trust-specific recruitment scenarios | Negotiate during the offer stage |
| Royal College travel grants | Courses and conference support | Doctors entering College pathways | Use Royal College grant portals |
| Q-bank free trials | Short free prep access | Any user | Sign up on the provider site |
Documents
The document checklist that usually decides whether your GMC timeline stays on track
MBBS degree certificate
Academic transcripts and marksheets
Internship completion certificate
NMC or State Medical Council registration certificate
Valid passport
IELTS Academic or OET Medicine certificate
ECFMG EPIC verification confirmation
Apostilled academic documents
Good Standing Certificate from NMC India
Professional reference letters
Completed GMC online application
AKT pass proof
CPSA pass proof
Visitor-visa documents for CPSA travel
NHS employment contract and Certificate of Sponsorship
Police clearance certificate
Medical fitness certificate
Biometric photographs
GMC fee payment proof
Career Pathways
What GMC registration and NHS progression can unlock next
| Pathway | Country | Requirement |
|---|---|---|
| NHS Foundation / trust doctor | UK | GMC registration and NHS job offer |
| Specialty training | UK | Foundation-equivalent progression, portfolio, MSRA or specialty competition route |
| NHS consultant | UK | CCT and relevant Royal College progression |
| UK private practice | UK | Consultant status and private-practice setup |
| ILR | UK | 5 years on Skilled Worker route |
| British citizenship | UK | ILR plus later citizenship criteria |
| Australia / New Zealand route | Australia / NZ | Use GMC value in later registration pathways |
| Gulf route | UAE / Qatar / Gulf | Leverage GMC portability into Gulf licensing |
| USA route | USA | USMLE plus ECFMG / match pathway |
| Return to India | India | NExT and Indian recognition pathway if you want to practice there |
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FAQs
Straight answers to the UKMLA questions doctors ask most
Question 1
What is the UKMLA and has it replaced PLAB?
Yes. For new candidates, UKMLA is the main licensing route replacing the old PLAB pathway.
Question 2
Can Indian MBBS graduates sit the UKMLA?
Yes, if they hold an accepted medical degree, internship, registration, English evidence, and EPIC verification.
Question 3
What is the AKT exam format?
AKT is a 200-question SBA exam delivered across two papers and focused on clinical reasoning as much as recall.
Question 4
Why must CPSA be done in the UK?
Because CPSA is the practical OSCE-style assessment delivered only in approved UK centers.
Question 5
How long does the full UKMLA pathway take?
A realistic range is about 12-18 months from starting prep to the first NHS job.
Question 6
Do I need EPIC verification?
Yes. EPIC is not optional for Indian MBBS graduates on this route.
Question 7
Is OET better than IELTS for doctors?
Many Indian doctors find OET more intuitive because it is healthcare-contextual, but both are valid if they meet GMC standards.
Question 8
Can I sit AKT in India?
Yes. The written part can be taken without traveling to the UK.
Question 9
How expensive is the full UKMLA route?
Depending on preparation style and travel costs, the full route can range from roughly Rs 3.68 lakh to Rs 12.6 lakh.
Question 10
What is the NHS starting salary after UKMLA?
Foundation Year 1 basic pay starts around GBP 36,616 yearly before supplements.
Question 11
Is UK training recognized in India?
Not directly. Like many international PG routes, it does not automatically become Indian MD/MS equivalence.
Question 12
Can I bring my family to the UK later?
Yes, many NHS doctors on Skilled Worker visas can later use dependent routes, subject to the current UK immigration rules.