What did Medical Schools have to say about the UKMLA? Why did 59% not agree?
So, the General Medical Council have done a fair amount of work since the proposition of a nation-wide assessment that would be taken by all doctors aiming to work in the UK. This has been named the United Kingdom Medical Licensing Assessment (UKMLA), and if you want to know more about what that is, go check out my previous post.
Since the concept of the UKMLA was suggested, the GMC has done various things to refine, improve, and critique the assessment. This includes the Chair, Chief Executive, and various members of the GMC visiting all the UK medical schools, and a consultation that was open from the 13th January till the 30th April 2017. To put it in Layman’s terms, the consultation was basically a 48-page document with information about the planned proposal, with closed questions and boxes for people to type out their opinions to the questions asked. Essentially, it was a survey sent out to a wide range of people, and I’ll be condensing their findings in today’s post.
The consultation received a total of 418 responses in total, with 104 of them being from organisations, and 314 individual responses. The responses from organisations consisted of: 32 medical schools including the Medical Schools Council (MSC) (there are 34 medical schools in total within the MSC), 17 from the Royal Colleges/related bodies, and the rest from various bodies such as the NHS and those who deliver postgraduate teaching, whilst the 314 individual responses consisted of doctors, medical educators and students, and other beings. [Full details can be found on page 5 of the consultation report.]
The first, and probably the most important question that was asked in this consultation was if the UKMLA was a realistic plan: whether people supported the idea of introducing the assessment. The results showed that 64% of those who responded agreed with the proposal, whereas 14% did not (13% were unsure whilst 9% left it blank). Whilst this meant that more people agreed with the UKMLA than those who didn’t, there is still quite a substantial amount people who are unsure or do not agree with this.
One thing that was surprising was how much of a negative perspective the medical schools had on the UKMLA. Out of the 32 medical schools that responded, 13 of them supported the aim, whilst 15 of them were unsure. 3 medical schools didn’t leave an answer, and one said that they didn’t support the assessment. This meant that only 41% thought the UKMLA was a good idea; this was the lowest percentage of “yes” responses out of all the types of respondents. One of their main concerns was with regards to the second section of the assessment, that being whether a suitable test for the clinical and professional skills could be produced within within the timeframe remaining.
Another point that was made was that many did not believe that having a single clinical assessment was representative of a student’s clinical and professional skills and that a “longitudinal approach” would be more appropriate.
Both the MSC and the Scottish Deans Medical Education Group (SDMEG) support the GMC, but in slightly different ways. The MSC believe that the UKMLA would be a good idea, yet do not agree with the current format. They state that the assessment should be “of a minimum rather than a common threshold”. Essentially, this means that if a common threshold was set, then international students willing to study in the UK may be put at a disadvantage, and there would be various challenges with preparing a common clinical assessment. However, one of the potential faults with having a minimum threshold may be that the standards of the UK medical graduates may decrease. The SDMEG, whilst supporting the GMC’s views on improving patient safety and reassurance that their doctors are of a certain standard, do not think that having an assessment is a necessary procedure, as they believe that the medical schools will already be making sure that their graduates are at a certain level of capability.
Whilst it seems like the MSC and SDMEG have negative viewpoints on the UKMLA, this can’t be said for the postgraduate education bodies. The Academy of Medical Royal Colleges believes that having a single assessment would be a reliable means for everyone to have trust in a doctor’s competence and skills. They state that a nationwide assessment would address one of the issues that many Colleges have: regardless of whether you’re a UK or international graduate, there is a wide range in skills and knowledge when going into postgraduate training. Health Education England wholly supported the UKMLA, if the period where you had to register for the exam was moved to the end of medical school. They thought that it was ambitious to prepare the assessment by 2022, and whilst acknowledging that there are still a few complications that need sorting, they support the idea of introducing the nationwide assessment.
Many medical schools also asked for clarification on the details for the exam, so that they could begin preparing for the UKMLA as soon as possible, so don’t worry if your medical school hasn’t mentioned anything to you about this yet, as they’ll be busy behind the scenes to make sure that you guys will be ready by 2022, if the UKMLA becomes a set assessment by then.
Question 8 of the consultation was whether people believed that by 2022, medical schools could prepare their students to a sufficient level that will allow them to pass the assessment. The overall individual “yes” response was at 49%, whereas the organisation total was only 17%. This was quite interesting to see, as the medical students and doctors had a greater confidence that students would be able to reach the limits set by the UKMLA, with the argument that most students who make it to final year already have a high level of competence. Those who said no mainly believed that it wouldn’t be possible to change the curricula for those currently studying medicine or about to study.
Overall, it’s interesting to see the evolution of UK medicine, and the criticisms various people had with regards to the UKMLA. If anything, there seems to be a fair amount of uncertainty with how exactly the assessment will be formatted. Remember that this will be quite a big part of our* future and changes could still occur, hence I highly recommend that you sign up to the mailing list so you can stay updated on any changes implemented in the upcoming years.
*if you’re graduating in 2022 or later.
The GMC sent out a survey to multiple different groups, including medical schools, doctors, and various bodies of the UK healthcare system, with queries about the UKMLA. The results were reported in a document and the following findings are noted:
- 418 responses were received, 104 of them being organisational responses, and the other 314 being individuals.
- Overall, 64% agreed that the UKMLA was a realistic plan of action.
- When focusing on the medical school responses, only 41% agreed that this was realistic, with many other medical schools responding with a “no” or “unsure”.
- One of the main worries that people had was that the timeframe would be too short to produce a suitable assessment.
- One other issue noted was that some people didn’t agree with having one assessment to standardise all the graduates looking to study in the UK.
- Another key finding was that there was a surprising difference between the organisational and individual response to whether they believed that the medical students would be prepared to take the test by 2022, with the individuals being much more confident.
Whilst I wasn’t able to go over every single point made, I’ve tried to hone in on the key focal points and those that I found particularly interesting. The report itself is formatted clearly, with a table under each question displaying the responses categorised into groups, and some key points stated below said tables. I would highly recommend that you check out the consultation report for greater detail on any of the points mentioned above, or to see what else was said within the report.
About the author
Hi, my name’s Chang, and I’m a medical student studying at Imperial College London! If I’m not writing blog posts for UKMLAforums, you’ll find me struggling to balance my academics with a decent social life and enough sleep. So, pretty much the average life of any student.
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