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3-medical law & ethics mcat, dat, comlex, oat, nbde, or pcat exam, city and guilds (amspar) certificates in medical terminology and cma (aama) . Bsmsa - british society of medical secretaries and administrators - c&g level 5 amspar certificate in primary care and healthcare management. The amspar primary care and health management diploma at level 5 is designed for practice managers available by distance learning and attendance.