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Wednesday 15 March 2023

Tips for UKMLA AKT and PLAB 1

Starting from the 2024/2025 academic year, all final year medical students in UK medical schools, including Newcastle University Medicine Malaysia (NUMed), have to take the UK Medical Licensing Assessment (UKMLA) as part of their medical degree before graduating. The UKMLA has 2 parts, the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA).

Currently, all medical graduates from non-UK medical schools, with the exception of NUMed graduates and graduates with a relevant European qualification, have to take the Professional and Linguistic Assessment Board (PLAB) in order to apply for provisional or full registration with the UK General Medical Council (GMC) and practise Medicine in UK. The PLAB has 2 parts, PLAB 1 and PLAB 2. Starting from 2024, PLAB 1 will be aligned with the UKMLA AKT while PLAB 2 will be aligned with the UKMLA CPSA.

The UKMLA AKT and PLAB 1 are in the form of a Single Best Answer (SBA) examination. I got a score of 75.5% for my final year SBA examination in 2020. I completed my MBBS course at NUMed and subsequently worked as a Teaching Fellow there. Here, I would like to share some tips on passing the UKMLA AKT and PLAB 1.

I am writing the tips based on how I revised for the exam previously. However, different individuals may have different learning styles, so you should just take this as a guide.

First, you have to start your revision no less than 2 months before the UKMLA or PLAB. I recommend studying at least 5 hours per day on weekdays and 7 hours per day on weekends and holidays. If possible, you should revise every day. To pass the exam, you should aim for a score of at least 66%.

If you do not understand any topic when doing revision, ask a lecturer or a friend for further clarification. Personally, I do not find group study helpful for the SBA examination.

All specialties will be covered in the UKMLA AKT and PLAB 1, including:
- Internal Medicine
- Obstetrics and Gynaecology
- Paediatrics
- Psychiatry
- Surgery
- Trauma and Orthopaedics
- Ophthalmology
- Dermatology

When revising, you should go specialty by specialty. Finish all topics in a particular specialty before moving on to the next specialty. Your focus when doing revision should be on risk factors, pathophysiology, diagnosis, investigations, management and complications. You should complete at least 4 full rounds of revision for all topics if possible.

Medicine should be studied mainly through understanding, not memorising. Basically, for every fact you come across in your revision, try to think "Why is this the case?" If there is an explanation, read it and make sure you understand what it says. If there is no explanation, try to come up with your own explanation based on your knowledge. Even if your explanation is wrong, it does not really matter as the exam questions will not ask for the explanation. You can also look up the internet for an explanation. The fact is that, when you actively seek an explanation for a fact, you will end up remembering the fact much better and your revision will also become more interesting. This is so much more effective than simply memorising the facts. However, do note that not everything can be studied this way. Certain facts have no possible explanation at all, so the only way to study them is by memorising.

You do not need to memorise the normal range of values for investigations as it will be provided in the questions during the UKMLA AKT or PLAB 1. You also need not memorise the doses of drugs apart from very commonly used ones.

The most important revision resource for the UKMLA AKT and PLAB 1 is the textbooks. I recommend using the following textbooks and resources for each specialty:
Internal Medicine - Oxford Handbook of Clinical Medicine (11th Edition)
Ophthalmology, ENT, Dermatology, Trauma and Orthopaedics - Oxford Handbook of Clinical Specialties (11th Edition)
Surgery - Oxford Handbook of Clinical Medicine (11th Edition) and Surgical Talk (3rd Edition) 
Psychiatry - Psychiatry by Ten Teachers (2nd Edition), Psychiatry - A Clinical Handbook and ICD-11
Obstetrics and Gynaecology - Obstetrics & Gynaecology by Lawrence Impey & Tim Child (5th Edition)
Paediatrics - Illustrated Textbook of Paediatrics (6th Edition)

These textbooks are not essential for the exam but may be helpful to refer to if you are looking for some specific information:
Davidson's Principles and Practice of Medicine, Kumar and Clark's Clinical Medicine, Apley and Solomon's Concise System of Orthopaedics and Trauma, Robbins Basic Pathology, Underwood's Pathology, Rang and Dale's Pharmacology

While Year 1 and Year 2 knowledge can be helpful at times, they are not essential for the UKMLA AKT or PLAB 1. There is no need for you to specifically revise any Year 1 or Year 2 topics.

You need to know the clinical guidelines for the more common conditions. Important guidelines are those that can be found in the textbooks, and you should look up the internet for the most up-to-date version of those guidelines. For obstetrics and gynaecology, use NICE and RCOG Green-top guidelines. For asthma, use BTS guidelines. For other conditions, use NICE guidelines. However, do not place too much emphasis on the guidelines, as it is more important that you revise the textbooks and understand the facts.

You should also do practice SBA exam questions. Go through all practice questions on the Medical Schools Council website and those provided by your lecturers. Passmedicine and Pastest have a large number of practice questions. They require paid subscription and I recommend that you subscribe to one of them. Some of the practice questions are similar in style to those in the UKMLA AKT and PLAB 1 while others are not. After finishing each practice question, check the correct answer and make sure you understand the reasoning behind every correct or wrong answer. Although doing practice questions is important, you should not prioritise it over revising the textbooks.

During the UKMLA AKT and PLAB 1, you will have a limited amount of time to answer each question. Therefore, you should always time yourself when doing the practice questions. As you are reading the question, you should already be thinking of the diagnosis so that you can get to the answer faster.

All the best in your revision! I hope you will be able to do well in the exam.

Tips for the Prescribing Safety Assessment (PSA) can be found here: