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iatroX JournalClinical insight

Mastering UK medical exams (UKMLA, PLAB, MRCP, AKT and Physician Associate National Exam) with iatroX’s adaptive quiz engine

Dr Kola Tytler (MBBS CertHE MBA MSt MRCGP)||4 min read
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The Contemporary UK Examination Landscape

The General Medical Council will require every new doctor graduating in the 2024–25 academic year and beyond to pass the UKMLA, thereby introducing a common threshold of competence across all UK schools 1. International medical graduates currently navigate PLAB, where 70.5 per cent of the 21,058 candidates who sat Part 1 in 2024 were successful 2. Specialty trainees aiming for MRCP Part 1 encountered a first-attempt pass rate of 51.8 per cent in the October 2023 sitting 3. Prospective general practitioners face the AKT; in October 2024 the pass rate stood at 62.5 per cent 4. Meanwhile, physician associates approaching statutory regulation must clear PANE, a two-part assessment that combines a 200-item knowledge test with a fourteen-station objective structured clinical examination; national reporting of pass rates begins in 2025 as part of the expanding register. Such figures underscore a competitive environment in which efficient, targeted preparation is vital.

Why Conventional Question Banks Struggle

Traditional question banks present items in a fixed sequence, causing candidates to waste time revisiting material already mastered. They rarely incorporate evidence-based scheduling of review sessions and often charge substantial fees. The resulting cognitive load can be particularly burdensome for neurodiverse learners, who may benefit from structured, feedback-rich retrieval practice. Studies of computer-adaptive learning suggest potential gains over static delivery, although outcomes depend on implementation and learner context. 5

The Science Behind Adaptive Learning

Item-response theory separates a learner’s latent ability from intrinsic question difficulty, enabling algorithms to estimate competence after every answer and to serve the next item that most efficiently narrows the confidence interval around that estimate. Systematic reviews across higher education suggest that personalised sequencing can improve grades and engagement while fostering a sense of agency 5. Adaptive platforms may therefore provide scalable scaffolding, although their effects depend on implementation and use.

Spaced Repetition And The Forgetting Curve

In 1885 Hermann Ebbinghaus documented the exponential decay of memory; subsequent work has examined how timely reviews alter forgetting. Distributed-practice meta-analyses generally find better retention when study events are spread over time, and studies in procedural domains—from microsurgery to radiology—have reported longer-lasting proficiency after spaced practice 67. Spacing is therefore relevant to clinicians who need durable knowledge rather than short-lived recall.

How The iatroX Quiz Engine Operationalises The Evidence

In a March 2025 LinkedIn post, iatroX founder Kola Tytler announced a free adaptive quiz module designed to reduce knowledge fragmentation for UK clinicians. The accompanying article explains how the engine combines item-response modelling with spaced repetition: stronger domains trigger progressively harder vignettes, while weaker areas resurface at intervals informed by performance. Questions are mapped to the relevant exam curriculum or blueprint, and clinical explanations draw on NICE and CKS guidance, with medicines information from relevant SmPCs on eMC.

Translating Algorithms Into Day-To-Day Revision

Clinicians can use short periods—on commutes, between consultations or during on-call downtime—for brief sets of practice questions. Immediate feedback can link an answer to relevant source material, turning an error into a follow-up learning task. Evening study can then focus on dashboard signals and targeted reading. During the engine’s pilot phase, the mean response time per question was around ten seconds and repeat engagement continued across three weeks; these observations suggest feasibility but do not establish learning effectiveness.

A Forward-Looking Vision Of Examination Preparation

By combining adaptive sequencing and spaced review with a clinical-reference interface, iatroX connects revision with follow-up learning. Mastery still requires deliberate practice, verification and application; the software supports that process rather than making exam success a natural by-product.

Conclusion

Adaptive learning and spaced repetition can support retrieval practice and retention when implemented well. By integrating them into a guideline-linked quiz engine, iatroX makes structured practice more accessible. The intended outcome is more targeted revision, not a guaranteed rise in pass rates or clinical performance.

References

Footnotes

  1. British Medical Association. The UKMLA: change is coming, what you need to know. 2021. ↩

  2. General Medical Council. Recent pass rates for PLAB 1 and PLAB 2. 2024. ↩

  3. MRCP(UK). Part 1 written examination October 2023 performance report. 2024. ↩

  4. Royal College of General Practitioners. Applied Knowledge Test feedback report, October 2024. 2024. ↩

  5. Farrukh H et al. “Personalised adaptive learning in higher education: a scoping review of key characteristics and impact on academic performance and engagement.” Heliyon 2024; 10:e20661. ↩ ↩2

  6. Nguyen J et al. “Implementation of spaced repetition by first-year medical students.” MedEdPublish 2023; 12:81. ↩

  7. Johnson A et al. “A call for spaced repetition in medical education.” Medical Science Educator 2023; 33:711-715. ↩

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