Chapter 2 – The MLA Clinical and Professional Skills Assessment

Overview of the MLA Clinical and Professional Skills Assessment (CPSA)

Unlike the AKT part of the MLA, the Clinical and Professional Assessment (CPSA) will be set locally, by medical schools, but must conform to rigorous standards set by the GMC.

The CPSA is a performance based assessment, the format of which the university can choose (e.g. Objective Structured Clinical Examination (OSCE); Objective Structured Long Examination Record (OSLER); Practical Assessment
of Clinical Examination Skills (PACES)).

The CPSA is usually formed into a circuit of stations, in which students are examined across a variety of clinical materials. Each student is allocated a starting station and then rotates to the next after the pre-determined length of time has elapsed marked by a suitable signal (often ringing of a bell). Each time you rotate to the next station you get 1 or 2 minutes to read the brief for the next task before the bell is rung again and you enters the next station to start the next task. Each station will usually last 8 minutes and students are expected to perform at the level of a foundation doctor.

The examination could include any of the clinical material that you have covered in the preceding years. Stations are carefully selected to sample across the range of the curriculum. The CPSA is designed to ensure a fair and reliable assessment of student ability by ensuring each candidate is exposed to a broad range of stations, and with a range of examiners

Tips and tricks – Preparation

Preparing for the CPSA

  • OUR TOP TIP – When organising the CPSA your medical school has to design stations that it can run with ‘healthy’ volunteers. There are likely to be up to ten rotations of the stations running at the same time, and it would be almost impossible to guarentee having multiple patients with aortic stenosis/COPD/insert diagnosis. Therefore, only revise for stations that you think that you could organise! This massively limits the options and the amount of revision/practice you need to do.
  • Many stations will start exactly the same way – introduce yourself, wash you hands, ask permission from the patient to talk to them and ask if they have any pain. Do this for every station. There are no negative marks for offering things that aren’t on the mark sheet.
  • Practice. Lots. Whether on placement, or at home with you family, a good CPSA is all about looking natural and using previous experience/muscle memory. Practice until you are utterly bored.
  • Spend time looking into how you revise best. If you are someone who needs cribs sheets and repetition don’t underestimate the time this takes.
  • Review current CPSA advice – this is a new way the GMC is assessing medical students fitness to practice and more information is sure to be released as the exam gets closer.
  • Buddy up with colleagues who are reliable and you don’t mind looking silly in front of. 
  • Use the experience of examiners in your hospital. Ask them to do practice OSCEs. You may need to ask more than once (don’t give in!)
  • A lot of marks can be obtained from a good opening and closure. Developing a standard ‘patter’ will help you maximise those easy to get marks.
  • Practise, practise, practise. Time keeping is something people often fall down on. 

Examination day

Candidate registration – you’ll need an acceptable form of photo ID needed – this may be your student id card, but you could take your passport or driving licence just in case.

Candidate briefing

  • Candidates are placed  outside their first station 
  • A bell will ring informing you of the start of your reading time
  • Another bell will ring signalling the start of the station
  • Depending on the scenario the examiner may ask you to present your findings or say nothing with the ending of the station being signalled by another bell. 
  • You will then be directed onto each further station until the exam is complete. 


  • Each station will have a description of the scenario and what will be expected.
  • The allocation of marks may be displayed as a pie chart.
  • Read the scenario/pie chart carefully AND answer what it asks, not what you want it to ask.

Tips and tricks – Exam Day

Test Centre

  • Plan how you are getting there, ensure that you have plenty of time and the correct identification.  


  • If you feel lost, stop, you can always ask for or say you want  to look at the station instructions
  • Remember there are no sudden death stations. If one doesn’t go well try to put a line under the sand, easier said than done I know!

Don’t forget

  • Eat and drink
  • Toilet break
  • Suitable clothing (scrubs)

Cite this article as: Iain Beardsell, "Chapter 2 – The MLA Clinical and Professional Skills Assessment," in St.Emlyn's, January 14, 2022,

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