What is the National Clinical Assessment and how to prepare? UKFPO FY1
If you are an international medical graduate (IMG) applying directly to the UK Foundation Programme (UKFP), you may be required to sit the National Clinical Assessment (NCA).
The NCA is a high stakes clinical exam, and for many applicants it is unfamiliar and poorly explained. Understanding what the assessment involves and how it is structured is essential for effective preparation.
This blog explains what the National Clinical Assessment is, who needs to sit it, and how to prepare in a focused, practical way, so you can approach the exam with clarity and confidence.
– Get UKFPO Updates and Teaching Emails here
– Register for next Free UKFPO Webinar here
– Pass with NCA+ Package here
What is the Clinical Assessment?
The National Clinical Assessment (NCA), sometimes referred to as the Clinical Assessment (CA), is designed to assess whether a doctor is clinically ready to start the UK Foundation Programme (FY1).
It is required for doctors who qualified from medical school more than two years before the start date of the programme and are applying directly to the UK Foundation Programme.
The assessment consists of 12 stations, known as Clinical Competence Assessments (CCAs). Each station is designed to test your ability to manage common clinical situations expected of a new Foundation Year 1 doctor in the NHS.
Each CCA runs as follows:
– 1 minute to read and prepare for the scenario
– 9 minutes to complete the task
All stations are timed and structured to assess safe, clear and practical clinical decision making.
The total duration of the exam is approximately 4 hours, including briefing and transitions between stations.
Preparation needs to reflect both the format and the level expected. At Arora Medical Education, we prepare candidates for all NCA case types through our Live NCA+ Course, with a strong focus on structure, communication and exam technique.
Where does the Clinical Assessment take place?
The National Clinical Assessment (NCA) is held in Manchester, at sites within Manchester University NHS Foundation Trust.
Assessments usually take place at:
– Wythenshawe Hospital, or
– Oxford Road Campus
Candidates will receive their exact venue details directly from the organisers ahead of their exam date.
How much does the Clinical Assessment cost?
If you are required to sit the National Clinical Assessment (NCA), you must pay a fee of £850 (GBP). This fee is non-refundable and must be paid directly to Manchester University NHS Foundation Trust, which administers the assessment on behalf of the UK Foundation Programme Office.
Details about how and when to make this payment are sent to eligible applicants by email once you have completed the UKFP eligibility process.
When does the Clinical Assessment take place?
For the UK Foundation Programme, the National Clinical Assessment (NCA) usually takes place in early November.
All eligible applicants are expected to receive an email by early September with instructions on how to complete payment for the assessment.
Your specific exam date and time within the assessment window will be confirmed closer to the exam. Candidates should ensure they are available for the full assessment period, as dates cannot usually be changed once allocated.
Results
All applicants who sit the National Clinical Assessment (NCA) will receive their results by end of November.
Results are issued directly to candidates, and successful completion is required to progress with entry into the UK Foundation Programme.
How Should You Prepare for the National Clinical Assessment?
Preparation for the National Clinical Assessment (NCA) should be structured around the UK Foundation Programme curriculum and the level expected of a new Foundation Year 1 doctor.
The assessment focuses on safe clinical practice, clear communication, structured data gathering and appropriate management of common scenarios you are likely to encounter when starting work in the NHS. Preparation therefore needs to go beyond reading and focus on applying knowledge in timed clinical situations.
Our Live NCA+ Course is specifically designed around these requirements. It covers the full range of NCA case types and aligns closely with the foundation programme curriculum.
The course can be attended:
– In person, or
– Via live stream, for those unable to travel
In addition to live teaching, the package includes:
– On-demand video teaching
– Flashcards focused on common scenarios and key principles
– NCA Case bank for role-play practice
All components are tailored specifically for doctors preparing for the NCA, with an emphasis on structure, clarity and exam technique rather than memorisation.
Further details about the course, including format and content, can be found on the UKFPO Clinical Assessment course page.
Key Dates
– Eligibility applications open in Oriel: Early July 2026
– Results of eligibility application release: Mid August 2026
– Application for NCA Exam: September-October 2026
– Arora UKFPO NCA Course: October 2026 (click here)
– National Clinical Assessment (Manchester): Early November 2026
– Clinical Assessment Results: End November 2026
– Start of Foundation Programme: August 2027
FAQs
Can I choose the date of my Clinical Assessment?
No. If you are required to sit the National Clinical Assessment, your date and time are allocated to you. Candidates are expected to be available for the full assessment window.
I have passed PLAB. Do I still need to take the Clinical Assessment?
Yes, if you are deemed eligible for the Clinical Assessment.
There are no alternatives or substitutions for the National Clinical Assessment. PLAB is used to assess eligibility for GMC registration, whereas the Clinical Assessment determines whether you are ready to start the UK Foundation Programme.
They assess different things and one does not replace the other.
Will I receive feedback on the day of the assessment?
No. You will not receive feedback on the day of the assessment.
Results are released later by email. Detailed feedback, where provided, is issued after results are confirmed, in line with UKFPO processes.
Can I appeal my Clinical Assessment result?
You can appeal the process, but not the academic judgement or result itself.
Details of the appeals process are published on the UK Foundation Programme Office (UKFPO) website and should be reviewed carefully if you are considering an appeal.
I have failed PLAB but passed the Clinical Assessment. Can I still start Foundation training?
No. Without GMC registration, you cannot start a UK Foundation Programme post. If you fail PLAB and do not obtain GMC registration, your Foundation application cannot proceed.
I failed the Clinical Assessment. What happens to my application?
If you fail the National Clinical Assessment, your application for that recruitment year will be withdrawn.
You would need to reapply in a future year, subject to eligibility criteria at that time.
How long is the Clinical Assessment result valid for?
A successful National Clinical Assessment result is valid for two years.
How Arora Medical Education Can Support You
Clear Teaching Built for Busy Doctors.
If you want a guided path, our NCA resources help you build confidence at each step. Everything is created by senior UK NHS clinicians and previous GMC examiners with experience in the exam and in teaching.
You can choose:
– NCA+ Package – a full NCA preparation system with live teaching course, case banks, videos, audios and flashcards.
– Individual resources such as NCA mocks.
Each option follows a clear plan that helps you stay organised and focused. Explore these more here.
Also:
– Get NCA and UKFPO Updates and Teaching Emails here.
– Register for next Free UKFPO Webinar here.
NCA Course Director - Dr Aman Arora
Hi! I’m Dr. Aman Arora, a Portfolio GP with over a decade of clinical and teaching experience, dedicated to helping doctors achieve their goals with confidence. Having had the privilege of supporting more than 50,000 doctors worldwide across exams such as MRCGP AKT, SCA, MSRA, PLAB 2 and PLAB 1, I understand the challenges you face and the strategies needed to overcome them. Through personalised face-to-face sessions, engaging online courses, mocks, audio and a vibrant social media community, we’re here to guide you every step of the way.
Whether you’re looking to pass crucial exams or take the next big step in your medical career, we’re here to help you succeed. Feel free to get in touch with any thoughts, questions, or ideas — I look forward to working with you and being part of your journey.
Senior NCA Tutor - Dr Pooja Arora
Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).
You can find out more about Pooja’s previous roles and qualifications here.
