The 2026 MLA content map: what changed and how to use it

27 October 2026

In short: The GMC published an updated MLA content map in October 2025. It applies to UK medical students sitting MLA assessments in 2026-27 and to PLAB candidates from September 2026. The appendix linking presentations to specialties is gone, the conditions list is longer and openly non-exhaustive, and the capabilities are spelled out in more detail.

Key points

The new map applies to MLA assessments in academic year 2026-27 and to PLAB from September 2026. The old map still covers 2025-26 and PLAB up to and including August 2026.
The appendix that mapped presentations and conditions to areas of clinical practice has been removed.
The conditions list has grown by 118 and is described as not exhaustive.
Domain 3 now spells out escalation, prescribing, communication and safeguarding in more detail.
Domain 4, practical skills and procedures, is unchanged.

Who the new map applies to

The GMC says MLA assessment providers must align with the updated map for:

students at UK medical schools sitting MLA assessments in the final or penultimate year of their degree in academic year 2026-27 and beyond
candidates sitting PLAB from September 2026.

If you sit before those points, the previous map still applies. Check which version your exam date falls under before you build a revision plan around it.

The six domains

The map is still organised into six domains:

Areas of clinical practice
Areas of professional knowledge
Clinical and professional capabilities
Practical skills and procedures
Patient presentations
Conditions

The GMC describes them as interconnected rather than standalone. Its own example is acute coronary syndromes: candidates are expected to understand the coronary anatomy, interpret signs and symptoms in the context of the patient's presentation, and form a prioritised differential that guides management. That is one condition touching several domains at once.

The biggest change: the appendix is gone

The old map had an appendix linking each presentation and condition to one or more areas of clinical practice. The GMC removed it after feedback that it narrowed assessment and learning. Its example: sepsis wasn't mapped to child health or primary care, so it wasn't assessed in those settings, even though that knowledge matters for patient safety.

For revision, this means you can't treat a condition as belonging to one specialty. Ask how it would present in a child, in an older adult, in general practice and in the emergency department.

What changed in each domain

Domain 1, areas of clinical practice. No new areas were added. Clinical haematology now covers blood and blood product transfusion. "Diabetes" is named in endocrine and metabolic, and gastrointestinal now includes hepatology and hepatobiliary and pancreatic surgery.

Domain 2, professional knowledge. Clinical imaging is a new area. Medical ethics and law has a new descriptor that refers to Good medical practice. Social and population health now includes health inequalities and the social determinants of health.

Domain 3, capabilities. The descriptors are more specific about:

knowing when to ask for help in uncertain situations
when and how to escalate patient safety concerns
prescribing, including stopping medication, polypharmacy, fluids and blood products
communication: finding out what matters to the patient, and sharing options that include taking no action
safeguarding vulnerable people.

It also asks you to evaluate information critically, including details from digital tools that use artificial intelligence.

Domain 4, practical skills and procedures. No changes.

Domain 5, patient presentations. The list has been streamlined, with acute and chronic versions combined (for example, "skin rash (acute and chronic)"). Broad presentations such as "abnormal vaginal bleeding" replace narrower sub-types, so you are expected to work out the possibilities through history and reasoning. The domain also reminds you that patients may have no symptoms, may have several problems at once, and may describe symptoms in their own words.

Domain 6, conditions. 118 conditions were added, including giant cell arteritis, cardiomyopathy, Huntington disease, myalgic encephalomyelitis, torsades de pointes, hyperemesis gravidarum and polycystic ovary syndrome. Some were folded into broader terms: myocardial infarction and unstable angina now sit under acute coronary syndrome, and iritis under uveitis. A new appendix groups conditions by body system.

How to use the map in revision

Use Domain 5 as your station list. Each presentation is a station you could be given. Practise taking a history for it without knowing the diagnosis in advance.
Use Domain 6 as a checklist, not a boundary. The GMC says the list is not exhaustive and assessments may include conditions beyond it.
Read Domain 3 as a marking guide for behaviour. Escalation, shared decisions, safeguarding and communication are named capabilities, so practise saying them out loud.
Skim the new conditions. The GMC expects most of them to be in UK curricula already. Its advice to UK students is unchanged: your degree course is the best preparation for the MLA.

How MedExamHelper fits

Every MedExamHelper station opens with a prebrief that shows the setting, the patient, the complaint, your task and the broad marking domains. It doesn't show the diagnosis, so you practise working from the presentation as Domain 5 describes.

Common questions

When does the new MLA content map apply? To UK medical students sitting MLA assessments in academic year 2026-27 and beyond, and to PLAB candidates from September 2026.

Does the new map apply to PLAB? Yes. PLAB candidates sitting from September 2026 are assessed against the updated map.

Has Domain 4 changed? No. The GMC made no changes to practical skills and procedures in this update.

Do I need to learn all 118 new conditions? The GMC says most of them are already covered in UK medical school curricula. Check the A–Z list against your notes and fill the gaps rather than starting again.

Is the conditions list everything that can come up? No. The GMC describes it as not exhaustive, so assessments may include conditions that aren't listed.