ST EMLYN’S · MLA REVISION GUIDE
The St Emlyn’s MLA revision guide
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Using this guide
This guide is for UK medical students preparing for the Medical Licensing Assessment and for the transition into Foundation training. It brings together approaches to clinical assessment, communication, examination, practical care and prescribing, with explanations to help you understand why each step matters.
Use it alongside your placements and your medical school’s teaching. Start with the AKT and CPSA chapters, then choose a skill to practise with a colleague or supervisor. After a patient encounter, return to the relevant section to check what you recognised, what you missed and how you would explain your next steps. A useful revision session ends with a specific change to your practice, rather than another completed checklist.
St Emlyn’s has a particular interest in acute and emergency care, but the MLA covers practice across hospital and community settings. The examples here also consider children, pregnancy, mental health, frailty and long-term conditions. This is a practical companion, not a claim to cover every presentation and condition in the GMC content map. Use the map and your school’s curriculum to identify topics requiring further study.
The MLA has two components: the applied knowledge test (AKT) and the clinical and professional skills assessment (CPSA). Prescribing is an essential part of safe practice and has its own chapter here; it is not a third MLA component. The GMC’s UK student guide explains the assessment framework. School-specific instructions determine the arrangements for your sitting.
Demonstrating a skill in an assessment and being authorised to perform it on a patient are different matters. On placement, identify yourself as a student, agree your role and supervision, and obtain the patient’s consent. Newly qualified doctors also work within supervised teams. The graduate outcomes and practical skills requirements explain the expected progression.
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The people behind the guide
The original teaching was developed by Dr Trudie Pestell and adapted for the MLA with Iain Beardsell as revision guide editor. Nick Smith contributed examination infographics and videos. Medical students and recent graduates helped review the original material for relevance, and Simon Carley supported its publication through St Emlyn’s.
The contributions below record how the guide began. They remain in the authors’ own words; statements about a future MLA and the size of the earlier guide describe the original edition. Current chapters and examination information should be read separately from these historical contributions.
For additional acute-care teaching, use the St Emlyn’s undergraduate curriculum. The FRCEM guide is a separate postgraduate resource; its senior clinical responsibilities and examination arrangements do not define the MLA standard.
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Official information to keep alongside this guide
- GMC MLA content map: use the version applying to your assessment period
- GMC UK students’ guide to the MLA
- Medical Schools Council: AKT handbook and preparation
- Official AKT practice papers with explanations
- Outcomes for graduates
- Graduate practical skills and procedures
The current content map applies from September 2026 and the GMC records a further update in September 2026. Check the live page when preparing for your sitting. A source-check date describes an editorial check; it does not imply that this guide has received clinical sign-off.
Original forewords · 2021. This page was first published on 12 April 2021; Trudie’s foreword is dated January 2021. The three contributions below are preserved as written.
The MLA has since been implemented for UK graduates, from the 2024–25 academic year. For current arrangements, use Chapter 1: the Applied Knowledge Test, your medical school’s instructions and the GMC MLA framework.
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Iain’s original introduction
Historical contribution, retained from the original MLA guide.
In 2020 we published our guide to preparing for the Fellowship of Emergency Medicine (FRCEM) examination. After publishing the FRCEM Revision Guide, we decided to edit and amend it for medical students to be able to use as part of the new Medical Licensing Assessment, after all Emergency Medicine does really cover almost all of medicine so it should be of some use!
We are really grateful to Trudie Pestell and Nick Smith for the huge contributions to this project; Trudie’s work provides the main backbone of the content, with Nick’s superb inforgraphics and videos complementing it perfectly. I am also grateful to our volunteer medical student (and recent graduated medical students) for checking through the content for relevance.
In acute care (St Emlyn’s particular area of interest) there is also our ‘Undergraduate Curriculum‘, with suggestions for learning objectives and links to great FOAMed (Free Open Access Medical Education) resources
Although the full implementation of the Medical Licensing Assessment is some time away, medical schools across the UK will be using the next few sittings to adapt to the new requirements and this guide will be relevant to you if you are doing Medical School Finals.
We really hope that this guide will help you prepare for your exams. PLease do let us know about any corrections or amendments you would like to see.
All best,
Iain
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Trudie’s original foreword
Historical contribution, retained from the original MLA guide.
Often, I think, we fail to appreciate the time required to gain the breadth and depth of knowledge needed to pass the medical examinations at whatever stage we are at, and whilst everyone has different approaches to revision I found it really useful to try and gather everything in one place. There are a number of excellent resources available, I think one that attempts to gather all the information, or the links at least, in one place and focuses on the approach and technique needed to hopefully pass the exam will be a useful addition, and this is what we have aimed to do by developing this guide.
Everything you need is accessible from the interactive contents page.
Good luck!
January 2021
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Simon’s original editor’s welcome
Historical contribution, retained from the original MLA guide.
We are absolutely thrilled that Trudie has allowed us to share this incredible resource on St Emlyn’s. As you use it you will realise the huge amount of work that she has singlehandedly done to make this guide as comprehensive and usable as possible: 11 Chapters, 37 individual OSCE station guides and hundreds of links to other resources.
When Trudie first shared her draft of the FRCEM Revision Guide with us we discussed how she might like to take it forward: as a printed publication; a paid for e-book; or as #FOAMed content. Her reply was instantaneous – whatever will make sure the most people are able to access it. When we discussed amending it for undergraduates preparing for the MLA she was equally enthusiastic.
We hope you find this guide useful. Although the MLA is likely a few years away this guide will be a valuable resource for any medical school examination you are sitting.
Simon