Assessing Medical Student Perceptions of a United Kingdom Medical Licensing Examination (UKMLA) Aligned Applied Knowledge Test (AKT) -Focused Teaching Programme: A Longitudinal Study

Background The United Kingdom Medical Licensing Assessment (UKMLA), introduced in 2024, establishes a national standard for medical graduate competence and is compulsory for registration with the General Medical Council. Evidence from similar licensing examinations supports near-peer teaching as an effective preparatory approach. This study assesses a longitudinal, near-peer, UKMLA-aligned teaching programme delivered by OSCEazy, evaluating its perceived impact on student knowledge, confidence, preparedness, motivation, and anxiety. The findings inform scalable strategies to enhance UKMLA readiness. Methods A longitudinal 23-session, near-peer, UKMLA-aligned teaching programme was delivered online by medical students from September 2024 to January 2025. Sessions focused on AKT preparation and were mapped to the UKMLA content framework. Pre- and post-intervention questionnaires assessed perceived knowledge, confidence, preparedness, motivation, and anxiety. Quantitative data were analysed using descriptive statistics and Wilcoxon signed-rank tests, with thematic analysis applied to free-text responses. Results A total of 496 responses were analysed (224 pre- and 272 post-intervention), with no baseline differences. Post-intervention, students demonstrated significant improvements in UKMLA understanding, confidence, preparedness, knowledge, and motivation (all p≤0.01), along with reduced exam-related anxiety (p<0.0001). Thematic analysis revealed a shift from overall uncertainty to speciality-specific learning needs, with more students reporting no knowledge gaps. Responses regarding feelings about sitting the exam reflected decreased anxiety and uncertainty, increased confidence and positivity, and the elimination of strongly negative emotions, with reassurance emerging after the session. Conclusion A long-term near-peer teaching approach enhanced UKMLA knowledge, confidence, and readiness while decreasing anxiety. Incorporating such methods into undergraduate curricula could provide a scalable strategy for licensing exam preparation, meriting further assessment as the UKMLA progresses.