UK medical schools, with the support of the Medical Schools Council (MSC), have successfully delivered the first national sitting of the Applied Knowledge Test (AKT), which forms part of the new Medical Licensing Assessment (MLA), marking a major milestone in UK medical education.
All final-year medical students across the UK are now required to pass the MLA as part of their degree before they can join the medical register. Delivered by medical schools and regulated by the General Medical Council (GMC), this landmark assessment represents one of the most significant reforms to undergraduate medical training in recent years.
Between September 2024 and August 2025, the AKT was delivered to more than 10,000 medical students across the UK, including those studying at UK medical schools’ overseas campuses. The development of the exam reflects an unprecedented level of collaboration across the medical education community.
Key highlights from the first year include:
This achievement followed a three-year pilot programme with over 15,000 students, providing crucial data to create a high-quality assessment that reflects the knowledge required for safe medical practice across the UK.
The first annual report on the MLA AKT outlines the systems and structures put in place to support delivery of the new national assessment. Medical schools worked closely to deliver the assessment, with oversight and quality assurance provided by the GMC.
The report highlights:
Bringing medical school experts together from across the UK created unique opportunities to innovate in assessment and develop novel approaches. With the primary goal of creating a reliable and robust exam, these innovations included:
The AKT also provided a platform for professional development, enhancing medical school staff skills in assessment design, item writing and exam delivery. It not only exemplifies national collaboration but also strengthens expertise across the sector, ensuring both high-quality assessment and ongoing capacity building.
The implementation of a single national knowledge assessment reflects the sector’s long-standing commitment to high standards in medical training and patient safety. It demonstrates the strength of coordination across UK medical schools and highlights the significant contributions of clinical academics, educators and professional staff who continue to support its development and delivery.
Professor Mark Gurnell, Chair of the AKT Exam Board said:
The successful delivery of the first national Applied Knowledge Test is a testament to the extraordinary collaboration between UK medical schools. I want to extend my thanks to our colleagues at the GMC for their guidance and support, our medical students for their resilience to adapt and engage with a new high-stakes assessment, and above all to the countless staff across medical schools who have generously given their time and expertise over many years to make this possible. I also want to recognise the dedication of the Medical Schools Council team, led by Dr Katie Petty-Saphon, whose leadership and hard work have been instrumental in guiding us through this process.
This has been over a decade in the making and we are proud that the public can now have even greater confidence in the quality of UK medical training and the safety of patient care. It has been a steep learning curve for everyone involved and we look forward to sharing the insights and lessons we have learned as we continue to develop and refine the assessment.Professor Mark Gurnell, Chair, AKT Exam Board
