Medical Licensing Assessment (MLA) List of Presentations

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Introduction

All medical students in the UK will need to pass the Medical Licensing Assessment (MLA) before being able to join the medical register and work as a doctor. The MLA will consist of two parts:

Applied knowledge test (AKT): a 200-question online multiple choice exam using single best answer (SBA) questions
Clinical and professional skills assessment (CPSA): a practical examination (e.g. OSCE) run by medical schools

The medical licensing assessment content map sets out the content which could be tested as part of the MLA, either as part of the AKT or CPSA.

As part of the content map, there is a list of patient presentations which could be tested in the MLA. These medical conditions could be tested in a single best answer (SBA) question in the applied knowledge test or as part of an OSCE station in the clinical and professional skills assessment.

Presentations vs conditions

In the MLA, presentations are defined as “signs, symptoms, investigation results and other relevant patient-related issues”, whereas conditions are defined as “pathophysiological diseases or clinical diagnoses”.

A presentation could be associated with multiple conditions. For example, breathlessness is a very broad patient presentation with multiple possible causative conditions (e.g. pulmonary embolism, cardiac failure, lower respiratory tract infection, anaemia).

Being familiar with these patient presentations is important before taking the medical licensing assessment. We’ve included an alphabetical list of the patient presentations below, with relevant links to Geeky Medics articles. We’ve also included a breakdown of patient presentations listed by areas of clinical practice. This list is based on the General Medical Council’s MLA content map.

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List of MLA presentations

A

Abdominal distension
Abdominal mass
Abnormal cervical smear result
Abnormal development/ developmental delay
Abnormal eating or exercising behaviour
Abnormal involuntary movements
Abnormal urinalysis
Acute abdominal pain
Acute and chronic pain management
Acute change in or loss of vision
Acute joint pain/swelling
Acute kidney injury
Acute rash
Addiction
Allergies
Altered sensation, numbness and tingling
Amenorrhoea
Anaphylaxis
Anosmia
Anxiety, phobias, OCD
Ascites
Auditory hallucinations

B

Back pain
Behaviour/personality change
Behavioural difficulties in childhood
Bites and stings
Blackouts and faints
Bleeding antepartum
Bleeding from lower GI tract
Bleeding from upper GI tract
Bleeding postpartum
Bone pain
Breast lump
Breast tenderness/pain
Breathlessness
Bruising
Burns

C

Cardiorespiratory arrest
Change in bowel habit
Change in stool colour
Chest pain
Child abuse
Chronic abdominal pain
Chronic joint pain/stiffness
Chronic kidney disease
Chronic rash
Cold, painful, pale, pulseless leg/foot
Complications of labour
Confusion
Congenital abnormalities
Constipation
Contraception request/advice
Cough
Crying baby
Cyanosis

D

Death and dying
Decreased appetite
Decreased/loss of consciousness
Dehydration
Deteriorating patient
Diarrhoea
Difficulty with breast feeding
Diplopia
Dizziness
Driving advice
Dysmorphic child

E

Ear and nasal discharge
Elation/elated mood
Elder abuse
Electrolyte abnormalities
End of life care/ symptoms of terminal illness
Epistaxis
Erectile dysfunction
Eye pain/discomfort
Eye trauma

F

Facial pain
Facial weakness
Facial/periorbital swelling
Faecal incontinence
Falls
Family history of possible genetic disorder
Fasciculation
Fatigue
Fever
Fit notes
Fits/seizures
Fixed abnormal beliefs
Flashes and floaters in visual fields
Food intolerance
Foreign body in eye
Frailty

G

Gradual change in or loss of vision
Gynaecomastia

H

Haematuria
Haemoptysis
Head injury
Headache
Hearing loss
Heart murmurs
Hoarseness and voice change
Hyperemesis
Hypertension

I

Immobility
Incidental findings
Infant feeding problems
Intrauterine death

J

Jaundice

L

Labour
Lacerations
Learning disability
Limb claudication
Limb weakness
Limp
Loin pain
Loss of libido
Loss of red reflex
Low blood pressure
Low mood/affective problems
Lump in groin
Lymphadenopathy

M

Massive haemorrhage
Melaena
Memory loss
Menopausal problems
Menstrual problems
Mental capacity concerns
Mental health problems in pregnancy or post partum
Misplaced nasogastric tube
Muscle pain/myalgia
Musculoskeletal deformities

N

Nail abnormalities
Nasal obstruction
Nausea
Neck lump
Neck pain/stiffness
Neonatal death or cot death
Neuromuscular weakness
Night sweats
Nipple discharge
Normal pregnancy and antenatal care

O

Oliguria
Organomegaly
Overdose

P

Pain on inspiration
Painful ear
Painful sexual intercourse
Painful swollen leg
Pallor
Palpitations
Pelvic mass
Pelvic pain
Perianal symptoms
Peripheral oedema and ankle swelling
Petechial rash
Pleural effusion
Poisoning
Polydipsia (thirst)
Post-surgical care and complications
Pregnancy risk assessment
Prematurity
Pressure of speech
Pruritus
Ptosis
Pubertal development
Purpura

R

Rectal prolapse
Red eye
Reduced/change in fetal movements

S

Scarring
Scrotal/testicular pain and/or lump/swelling
Self-harm
Shock
Skin lesion
Skin or subcutaneous lump
Skin ulcers
Sleep problems
Small for gestational age/ large for gestational age
Snoring
Soft tissue injury
Somatisation/medically unexplained physical symptoms
Sore throat
Speech and language problems
Squint
Stridor
Struggling to cope at home
Subfertility
Substance misuse
Suicidal thoughts
Swallowing problems

T

The sick child
Threats to harm others
Tinnitus
Trauma
Travel health advice
Tremor

U

Unsteadiness
Unwanted pregnancy and termination
Urethral discharge and genital ulcers/warts
Urinary incontinence
Urinary symptoms
Vaccination

V

Vaginal discharge
Vaginal prolapse
Vertigo
Visual hallucinations
Vomiting
Vulval itching/lesion
Vulval/vaginal lump

W

Weight gain
Weight loss
Wellbeing checks
Wheeze

Presentations by MLA area of clinical practice

There are 24 areas of clinical practice as part of the UK medical licensing assessment content map. Patient presentations can be mapped to multiple areas of clinical practice.

For example, breathlessness is mapped to nine areas of clinical practice: acute and emergency, cancer, cardiovascular, child health, general practice and primary healthcare, neurosciences, obstetrics and gynaecology, perioperative medicine, and respiratory.

When we look closer at the MLA content map, we can see some patient presentations frequently appearing across multiple areas of clinical practice (Figure 1). The top three patient presentations in the MLA content map are breathlessness, trauma and urinary symptoms.