Since news broke in 2015 over the UK’s plans to introduce a new medical licencing exam, there’s been some confusion. Not to be mixed up with the US’s exam of a similar name, understanding the difference between the UKMLA vs USMLE, and working out which is easiest, is important. This article aims to help you do that.
- The UKMLA and the USMLE are medical licencing exams for separate countries; UK and the US respectively
- Both will work on a pass/fail basis in the future
- The formats of UKMLA vs USMLE differ in various ways
- No clear advice can made on recommending which is the easiest; due to the UKMLA’s delayed introduction in 2024
What is the UKMLA?
The UKMLA is the GMC’s working name for an assessment exam set to replace the UK’s existing Professional and Linguistics Assessments Board test (PLAB). One obvious difference between the UKMLA vs USMLE is in the acronym. The former stands for United Kingdom Medical Licensing Assessment. The latter stands for the United States Medical Licensing Exam.
Currently International Medical Graduates (IMGs) from outside the European Economic Area (EEA) wishing to register as doctors in the UK have to pass the PLAB. The UKMLA will differ however because it will extend to all nationals. Including British graduates and EEA citizens also.
Reasons for the UKMLA’s projected 2024 implementation are best highlighted from comments of those involved in formulating the exam themselves. Mark Porter, chairman of the British Medical Association (BMA), stresses the following points as reasons for the exam’s introduction.
“It is important that patients have confidence in the training of those who are treating them, no matter where they have trained.”“GMC proposes single test for all doctors wishing to work in UK”, BMJ, 2015
To find out more about how the UKMLA differs from the existing PLAB – as well how they might compare, see our article “Will the UKMLA Be Harder Than PLAB“. There we also go into some detail predicting what the upcoming UKMLA might be like for students who may find themselves in the position of having to take it in the future.
What is the USMLE?
Thanks to the USMLE’s long history we know much more about it than the UKMLA. Set up by the Federation of State Medical Boards (FSMB), it actually dates back to the US Constitutions’ Tenth Amendment. Put in place to protect US citizens from impaired physicians or possible medical incompetence.
In terms of comparing the UKMLA vs USMLE, the American exam shares a key similarity. It’s also an exam designed to licence doctors seeking to practice within a country.
Where it differs, is it’s format. The USMLE is incorporated into US medical school curricula so that students pass Step 1 of the exam before the beginning of the third year of study.
The UKMLA, given the limited information we know, could also work this way. Streamlined into UK medical school curricula, the exam might be planned to coincide with the end of a four, five or six year program of study.
There is also the possibility for IMGs to do all parts of the USMLE independently of US medical schools, but the cost of doing so is potentially high.
It’s 2020 prices (as per the USMLE website) are the following:
- $645 for Step 1
- $645 for Step 2
- $1300 from Step 2 CS
Still, there are many case reports from IMGs who score well on the USMLE and go on to practice in the US. Despite it’s perception as being a “difficult pathway”.
Another key difference you’ll see comparing UKMLA vs USMLE is that the latter comprises three exams. The UKMLA, as far as we know, only exists of two exams (the AKT and the CPSA). Meaning the overall cost of passing the UKMLA, in comparison to the USMLE, could potentially be less when it finally comes into existence.
UKMLA vs USMLE: What’s Easier?
Obviously we don’t know much about the difficulty of the UKMLA at this point. Everything we do know is just a best guess.
The USMLE, on the other hand, has lots of data and anecdotal reports available that can attest to its difficulty.
“Speaking from personal experience, USMLE Step 1 was one of the hardest things I had to do.”https://medschoolinsiders.com/medical-student/wish-i-knew-before-usmle-step-1/
Scored on a percentile system (although this will change to pass/fail in the coming years), the passing grade for Step I of the USMLE is 194 – scored on a range of 1 to 300. Interestingly, this score has increased during the years, rising to this mark from 192 in 2017 . Despite it’s reputation as a “tough exam” however, US and Canadian candidates secured a 94% pass rate in 2018 .
Generally a good score on the USMLE is considered to be in the 230 range, with a standard deviation of 19 . Based on my own personal experiences discussing percentile scores with IMGs having taken the USMLE though, few score near this range. This could suggest why the PLAB, to many IMGs at least, might be considered the “easier” exam.
Another key thing to bear in mind when discussing the difficulty of the UKMLA vs USMLE (we are using our investigations into PLAB to make assumptions here), is that the latter gives a greater number of potential answers to multiple choice-style questions. What this could mean for the discussion? The idea that USMLE questions could have a greater margin for error. Compared to PLAB Part I questions, which have only five potential correct answers, this is just an assumption however.
The UKMLA vs USMLE are two very different exams but have their similarities. Both grant access to medical licencing in two of the most competitive countries in the world to become a doctor. One provides a gateway into a social health system (UK), the other into the private health sector (US).
What’s attractive about both these routes to an IMG is the potential earning capacities for a doctor working in either system over the long-term.
The US, on average, has higher salaries for physicians. But the UK, as it stands, could generally considered to be an easier place to get training. Stay tuned on exact amounts in an article here in the future.
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