PLAB MLA Mastery Programme
AKT Virtual Tutorials · CPSA Clinical Skills · AI-Powered Adaptive Learning App
Fully aligned to the GMC MLA Content Map — applicable from September 2026 onwards
The MLA has changed everything. Your preparation must change too.
From September 2026, every doctor entering UK practice — whether a UK medical school graduate or an international medical graduate — is assessed against a single, unified standard: the GMC Medical Licensing Assessment (MLA) Content Map. The PLAB examination is now fully MLA-compliant. PLAB 1 meets the requirements for the MLA Applied Knowledge Test (AKT). PLAB 2 meets the requirements for the MLA Clinical and Professional Skills Assessment (CPSA). The content, the standard, and the question bank are aligned to the same curriculum framework.
The 2026 update is not a cosmetic revision. The GMC has expanded the content map from approximately 311 to 430 core conditions, removed the restrictive mapping grid that previously limited which conditions could appear in which clinical contexts, and introduced new topics including transgender health, genetics, updated sepsis guidance, and substantially broadened women's health content. Questions are longer, more clinically detailed, and test applied reasoning rather than factual recall. The content map is explicitly described as "indicative and non-exhaustive."
Two expert-led courses. One intelligent learning platform. Total MLA readiness.
Programme 1 — Starts 1 July 2026
PLAB MLA AKT Virtual Tutorial Programme
12 live sessions · 3 hours each · 36 contact hours
Format: Fortnightly Saturday sessions via secure video platform
Faculty-led teaching targeting the content domains where live instruction yields the greatest return over self-directed learning — UK-specific clinical context, ethically complex reasoning, prescribing frameworks, and the high-yield AKT domains where IMG candidates consistently underperform.
Every session includes didactic teaching, case-based group work in breakout rooms, SBA self-assessment drawn from the MD Acumen question bank, and faculty-led reasoning walkthroughs that model how expert clinicians approach clinical vignettes.
Programme 2 — Starts 14 November 2026
PLAB MLA CPSA Clinical Skills Programme
Structured OSCE preparation · Simulated patient encounters
Format: Virtual sessions with targeted clinical skills coaching
Prepares candidates for the 16-station OSCE at the GMC Assessment Centre in Manchester. Emphasis on communication (ICE framework), safety-netting, shared decision-making, and professional behaviours assessed against GMC Good Medical Practice across the three CPSA domains: Data Gathering, Clinical Management, and Interpersonal Skills.
Detailed programme structure to be published — register your interest below.
The MD Acumen App — Launches 21 July 2026
AI-Powered Adaptive Question Bank
A purpose-built learning platform designed to complement the tutorial programme. AI-generated clinical vignettes grounded in current UK guidelines — every question verified by practising NHS clinicians. Adaptive algorithms personalise your learning journey, targeting your weakest areas and tracking your progress toward exam readiness.
Intelligent performance tracking tells you not just what you got wrong, but why — and what to study next. Built for the 2026 MLA Content Map from day one.
The preparation standard that no question bank alone can deliver
Professor-Designed, Examiner-Informed
Every element of this programme is conceived by Professor Rajesh Varma — a practising NHS GP, dual-CCT consultant, former PLAB examiner, NICE Guideline Committee member, Cambridge visiting researcher, and active publishing academic. This is not an algorithm with a medical veneer. It is a clinician with a platform.
AI-Powered, Expert-Verified
Content is generated using advanced AI trained on current UK clinical guidelines — NICE, CKS, BNF, and SIGN — then subjected to mandatory validation by registered UK clinicians. This delivers the scale of a technology platform with the clinical authority of an expert-led course.
Built for the UK System, Not Adapted from Abroad
Global platforms like AMBOSS and Osmosis offer outstanding medical education — but they are not built for UK licensing. MD Acumen is purpose-built for the GMC MLA Content Map, UK referral pathways, NHS prescribing conventions, and the specific clinical reasoning frameworks that PLAB and MRCGP examiners assess.
Teaches Reasoning, Not Just Answers
Most question banks tell you which answer is correct. MD Acumen teaches you how to arrive at the correct answer — the clinical reasoning technique that experienced UK clinicians use instinctively and that the MLA is specifically designed to assess. This is the difference between passing and mastering.
Complete AKT + CPSA Pathway
The AKT programme (from 1 July 2026) and the CPSA programme (from 14 November 2026) form a single, integrated preparation pathway — with the adaptive app connecting both components through continuous progress tracking and personalised study plans.
From PLAB to MRCGP and Beyond
MD Acumen is designed to support your entire UK medical career — not just one exam. The knowledge and reasoning skills developed through the PLAB MLA programme directly feed into MRCGP preparation, Primary Care Masterclasses, and continuing professional development. One platform, one clinical standard, one career.
Three hours of structured, active learning — every session
| Segment | Duration | What Happens |
|---|---|---|
| Opening Orientation | 15 min | Key concepts, learning objectives, MLA content map alignment |
| Faculty-Led Teaching Block 1 | 40 min | Expert teaching with worked clinical examples and UK pathway context |
| Break | 10 min | — |
| Case-Based Group Work | 25 min | Breakout rooms — clinical scenarios with structured reasoning tasks |
| Plenary Debrief | 15 min | Groups present their reasoning; faculty provides real-time coaching |
| Faculty-Led Teaching Block 2 | 35 min | Second topic area with worked clinical examples |
| Break | 10 min | — |
| Self-Assessment SBA Block | 20 min | 10 exam-standard SBAs completed individually from the MD Acumen bank |
| Reasoning Walkthrough | 15 min | Faculty models expert clinical reasoning on selected questions |
| Closing Synthesis | 5 min | Key take-aways and directed app study for the next session |
36 contact hours · Mapped to all six MLA Content Map domains
Sessions are sequenced to build cumulatively. Sessions 1–2 establish the foundational framework for UK clinical practice. Sessions 3–9 address the core clinical and professional knowledge domains. Sessions 10–11 integrate across domains with complex multi-system vignettes. Session 12 consolidates exam technique and performance optimisation.
Foundation MLA Domain 3
How the AKT Works & How to Think Like a UK Clinician
AKT blueprint, scoring methodology, and question architecture. How the six MLA domains interact. The critical distinction between applied reasoning and factual recall. Common IMG pitfalls — over-investigating, selecting specialist interventions, missing "most appropriate next step" framing. Introduction to the MD Acumen clinical reasoning technique.
Foundation MLA Domains 1, 3
UK Primary Care — The Hidden Curriculum
The single largest knowledge gap for IMGs. NHS structure and the GP gatekeeper model. The 10-minute consultation and managing undifferentiated presentations. Multidisciplinary teams. QOF and clinical coding. Two-week-wait referral criteria (NICE NG12). Safety-netting. Fit notes, DVLA reporting, and occupational health referrals.
Ethics & Law MLA Domains 2, 3
Medical Ethics & Law — Capacity, Consent & Confidentiality
Mental Capacity Act 2005 — the five statutory principles and two-stage test. Decision-specific, time-specific capacity. Best interests decisions. Lasting Power of Attorney. Advance Decisions to Refuse Treatment. Gillick competence and Fraser guidelines. The Caldicott Principles. Confidentiality, disclosure, and GMC Good Medical Practice.
Ethics & Law MLA Domains 2, 3
Safeguarding, Professional Duties & End of Life
Non-accidental injury patterns. Safeguarding referral pathways. FGM mandatory reporting. DASH risk assessment and MARAC. Care Act 2014. Modern slavery and the National Referral Mechanism. Duty of candour. Raising concerns and whistleblowing. Fitness to practise. DNACPR decisions. Organ donation opt-out. Death certification and coroner referral.
Prescribing MLA Domains 2, 3
Prescribing, Pharmacology & Patient Safety
The BNF as the prescribing reference. High-risk prescribing: anticoagulants, opioids, methotrexate, lithium, insulin. Drug monitoring parameters and intervals. Renal and hepatic dose adjustment. Prescribing in pregnancy and breastfeeding. STOPP/START criteria and deprescribing. Controlled drugs regulations. Never events. Significant event analysis. PDSA cycles and clinical audit. LFPSE reporting. Human factors and cognitive bias.
Clinical MLA Domains 1, 3, 5, 6
Cardiovascular, Respiratory & Acute Medicine
Hypertension — NICE stepped approach including ABPM diagnostic pathway. Atrial fibrillation and CHA₂DS₂-VASc scoring. Acute coronary syndromes. Heart failure diagnosis, BNP interpretation, and primary care management. QRISK3 and statin thresholds. Asthma stepwise management (NICE/BTS). COPD GOLD classification and inhaler selection. CURB-65 and pneumonia. Pulmonary embolism — Wells score and D-dimer pathway. Pneumothorax.
Clinical MLA Domains 1, 2, 5, 6
Mental Health, Neurology & the Undifferentiated Patient
Depression — PHQ-9 and the stepped care model. Anxiety — GAD-7. Psychosis recognition in primary care. Self-harm and suicide risk assessment. Mental Health Act 1983: Sections 2, 3, 5(2), and 136. Substance misuse — AUDIT screening and opioid substitution. Headache red flags. Stroke and TIA — FAST and secondary prevention. Epilepsy, DVLA, and sodium valproate in women. Dementia diagnostic pathway.
Clinical MLA Domains 1, 3, 5, 6
Women's Health, Child Health & Obstetrics
UK antenatal care pathway (NICE NG201). Pre-eclampsia recognition. Gestational diabetes screening and management. Ectopic pregnancy and miscarriage. Contraception — full range, UKMEC categories, LARC emphasis. Cervical screening HPV-first programme. Menopause and HRT prescribing. Developmental milestones and red flags. UK immunisation schedule. The febrile child — NICE traffic light system. Childhood asthma. Safeguarding in paediatric contexts. Adolescent consent and confidentiality.
Clinical MLA Domains 1, 5, 6
Musculoskeletal, Dermatology, ENT & Ophthalmology
Acutely swollen joint — septic arthritis, gout, pseudogout. Back pain red flags and cauda equina syndrome. Osteoarthritis — NICE stepwise management. Osteoporosis and FRAX assessment. Common skin conditions — eczema, psoriasis, acne. Skin cancer ABCDE and two-week-wait referrals. Acute red eye differential. Acute glaucoma. Gradual and sudden vision loss. Otitis media and externa. Sore throat scoring (Centor/FeverPAIN). Vertigo — BPPV, vestibular neuritis, and Ménière disease differentiation.
Integration MLA Domains 2, 3
Public Health, Epidemiology & Evidence-Based Medicine
Consistently underperformed by IMG candidates. Sensitivity, specificity, PPV, NPV with worked 2×2 tables. NNT, NNH, ARR vs RRR. Odds ratios and hazard ratios. Study design hierarchy. Types of bias. Wilson-Jungner screening criteria. UK National Screening Programmes. Health inequalities — inverse care law and the Marmot review. Notifiable diseases. Vaccination programmes.
Integration All MLA Domains
Complex Multi-Domain Vignettes — Integration Session
The AKT does not test domains in isolation. This session builds the ability to manage clinical complexity and uncertainty through six faculty-led complex vignettes and six candidate-led walkthroughs — spanning polypharmacy with capacity concerns, teratogenic prescribing in pregnancy, professional duties and confidentiality, screening and statistical interpretation, multi-system acute presentations, and palliative care with family communication.
Performance Cross-cutting
Exam Technique, Mock Examination & Exam-Day Preparation
Time allocation strategy. Question reading technique — "most appropriate" vs "first" vs "immediate." Negative phrasing traps. Elimination strategy under uncertainty. Managing exam anxiety — cognitive load in practice. Physical and logistical preparation. 30-question timed mini-mock under exam conditions with immediate group debrief. Personalised revision targeting using app performance data.
Every session mapped to the MLA Content Map domains
| Session | D1 Clinical Practice | D2 Professional Knowledge | D3 Capabilities | D4–D5 Skills & Presentations | D6 Conditions |
|---|---|---|---|---|---|
| 1. AKT Framework | ★★★ | ||||
| 2. UK Primary Care | ★★★ | ★★ | |||
| 3. Ethics & Law I | ★★★ | ★★★ | |||
| 4. Ethics & Law II | ★★★ | ★★★ | |||
| 5. Prescribing | ★★★ | ★★★ | |||
| 6. CVS, Resp & Acute | ★★★ | ★★ | ★★ | ★★★ | |
| 7. Mental Health & Neuro | ★★★ | ★★ | ★★ | ★★ | ★★★ |
| 8. Women's & Child Health | ★★★ | ★★ | ★★ | ★★★ | |
| 9. MSK, Derm, ENT, Ophth | ★★★ | ★★ | ★★ | ★★★ | |
| 10. Public Health & EBM | ★★★ | ★★ | |||
| 11. Integration | ★★ | ★★ | ★★★ | ★★ | ★★ |
| 12. Exam Technique | ★★★ |
★★★ = Primary focus · ★★ = Secondary coverage
Everything you need — in one programme
36 Hours of Expert Teaching
12 live sessions led by Professor Varma with structured group work, case-based discussion, and real-time reasoning coaching.
MD Acumen App Access
Full access to the AI-powered adaptive question bank — personalised to your performance, grounded in UK guidelines, and continuously updated.
SBA Practice Questions
Exam-standard single best answer questions in every session, drawn from the MD Acumen bank and mapped to the 2026 MLA Content Map.
Progress Tracking
Personalised performance feedback identifying your strongest and weakest domains — so you know exactly where to focus your revision.
Timed Mock Examination
Full mock exam under timed conditions with immediate faculty debrief — not just correct answers, but the reasoning behind them.
Exam Readiness Certification
On achieving the mastery threshold, receive a professionally formatted MD Acumen Exam Readiness Certificate to evidence your preparation.
Designed for international medical graduates preparing for UK practice
| Candidate Profile | How the Programme Helps | Primary Focus |
|---|---|---|
| Strong clinical knowledge, unfamiliar with UK systems | UK clinical context, NHS referral pathways, prescribing conventions, and the regulatory frameworks that differentiate UK practice | Sessions 2, 3, 4, 5 |
| Moderate clinical knowledge, some UK exposure | Clinical reasoning technique, high-yield domain depth, ethics and law, and structured exam preparation | Sessions 1, 6–9, 12 |
| Weaker clinical knowledge, no UK exposure | Foundation building across all domains with intensive app-based study between sessions — may benefit from early app access | Full 12-session programme + app |
| UK medical students preparing for UKMLA AKT | The AKT content is identical for UK graduates and IMGs. UK students benefit from the same structured approach, particularly in ethics, prescribing, and public health | Sessions 3–5, 10, 11 |
Your pathway to GMC registration — the MD Acumen timeline
Saturday 1 July 2026 — AKT Programme Begins
First session of the 12-session AKT Virtual Tutorial Programme. Fortnightly Saturdays through to December 2026.
Monday 21 July 2026 — MD Acumen App Launches
The AI-powered adaptive question bank goes live. All enrolled candidates receive immediate access. Active app use is a programme prerequisite.
September 2026 — Updated MLA Content Map Takes Effect
All PLAB sittings from this date are based on the updated 2026 MLA Content Map. The MD Acumen programme is aligned to this standard from day one.
Saturday 14 November 2026 — CPSA Programme Begins
The PLAB MLA CPSA Clinical Skills Programme launches — structured OSCE preparation for the 16-station assessment at the GMC Centre in Manchester.
2027 — MRCGP Preparation & Beyond
For candidates progressing to GP training, the MD Acumen platform extends into MRCGP AKT and RCA/CSA preparation, Primary Care Masterclasses, and continuing professional development modules.
Professor Rajesh Varma
Professor of Cardiovascular–Renal–Metabolic (CVRM) Medicine & Women's Health, New Vision University, Tbilisi. Visiting Researcher, Department of Public Health & Primary Care, University of Cambridge. Practising NHS GP Partner and GMC-Approved GP Trainer in Hertfordshire.
On the GMC Specialist Register (Obstetrics & Gynaecology) and the GP Register. Former PLAB Examiner. NICE Osteoporosis Guideline Committee Member. Former Consultant at Guy's & St Thomas' NHS Foundation Trust. Harvard AI in Healthcare certification. Active publishing academic — h-index 18, Scopus Author ID 8932600800.
Professor Varma brings a unique combination of clinical practice, examination experience, regulatory insight, and academic research to every element of the MD Acumen programme. He is not an advisor or a figurehead — he is the clinical architect, the content author, and the lead faculty for every session.
Essential PLAB 1 / MLA AKT information for candidates
| Component | Detail |
|---|---|
| Format | 180 Single Best Answer (SBA) questions · Computer-based |
| Duration | 3 hours (180 minutes) |
| Standard | Foundation Year 2 (FY2) level — the same standard as the UKMLA for UK graduates |
| Curriculum | GMC MLA Content Map — approximately 430 core conditions across six domains |
| Negative marking | No — attempt every question |
| Pass mark | Variable (typically around 60–65%, approximately 110–116/180) |
| Sitting frequency | Multiple sittings per year — typically February, May, August, November |
| Venues | Pearson VUE centres — UK and international (via British Council) |
| Fee (2026) | Approximately £273–283 |
| Maximum attempts | GMC recommends a maximum of 4 valid attempts |
| Validity | PLAB 1 / AKT pass is valid for 3 years for progression to PLAB 2 / CPSA |
CPSA / PLAB 2 Exam Reference
| Component | Detail |
|---|---|
| Format | 16 OSCE stations (plus rest stations) · Performance-based assessment |
| Duration per station | 8 minutes (with 1.5 minutes reading time between stations) |
| Assessment domains | Data Gathering · Clinical Management · Interpersonal Skills |
| Location | GMC Assessment Centre, Manchester (for IMGs) |
| Fee (2026) | Approximately £980–1,036 |
| Scoring | Borderline regression method · Must pass minimum number of stations |
Ready to begin?
The AKT programme starts Saturday 1 July 2026. Places are limited.
Institutional enquiries: Medical school deans, NHS education leads, and pharmaceutical partners interested in collaboration or sponsorship of educational modules are invited to contact Professor Varma directly at enquiry@mdacumen.com or via the Academic & Partnership Enquiry form.
Legal & Disclaimer · enquiry@mdacumen.com