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How I passed my PLAB 2 Exam with focused preparation – Dr Mitashi Singh

If you are a doctor preparing for your GMC PLAB 2 exam then this blog is a must to help you pass. We are lucky to have Dr Mitashi Singh – an IMG (International Medical Graduate) doctor who recently passed her PLAB 2 exam – share her own experience of how she prepared and passed first time…

– Register for our next Free PLAB 2 Webinar here
– Join the Arora PLAB 2 Telegram teaching group here.
– Join Arora PLAB 2 Academy+ programme here.

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How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

Introduction

For most IMG (International Medical Graduate) doctors the PLAB 2 exam is the final challenge on the lengthy pilgrimage to GMC registration. First of all, congratulations on getting this far. Well done!

This exam is different from anything you have taken so far. While it can be (and often is!) a terrifying prospect, it is also a great taster of the life of a junior doctor in the NHS. The exam is broad-based. You will encounter a variety of scenarios: seeing out-patients in general practice, sorting out ward-based issues, teaching a (keen) medical student, the (often dreaded) emergency SimMan patient and even a couple of telephone or video consultations. 

The assessors do not participate in the scenarios – they sit in to observe candidates going about this ‘pretend’ work day. Each case is evaluated in three equally weighted domains – ‘data gathering, technical and assessment skills’, ‘clinical management skills’ and ‘interpersonal skills’. Your job is to give them a glimpse of the doctor you are within the 8 minutes allotted to each scenario. 

I was especially worried because it had been a while since I had managed certain kinds of scenarios. I was easing back into clinical practice at the time I sat this exam and was quite terrified of making mistakes. It was a huge relief to pass, and the good scores in some of my stations were a huge confidence boost! I will walk you through my prep, the exam experience itself, and finally leave you with a few pointers!

To read more about the PLAB 2 exam itself, click here 

How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

My PLAB 2 preparation

I had about ten weeks of prep time in all – four before the academy and about six after.

The most crucial element was time management. I needed to learn how to allocate the 8 minutes allowed per scenario and use them effectively. Enter, Team Arora! I was really lucky in my choice of academy. Since I was in batch001 (shout out to the rest of the gang!), I wasn’t sure what to expect. The course definitely helped each one of us nail this aspect of our preparation. 

The next key part of preparation was moving from managing a condition to managing the situation that you are presented with. This actually applies to every single case that you encounter, not just the angry patient or underperforming colleague scenarios. Depending on the context and type of your clinical experience so far you may struggle with this initially. Again, Arora academy drummed this way of practice into us – as a default built-in feature of their approach but also by iterating it for all the (100 some?) cases we role-play practiced during the course.

The final bit was the clinical content for each of the cases – understanding differentials and the clinical management for each presentation. Although I had a strong clinical foundation before taking PLAB 2, most of my previous exam prep was oriented towards MCQs. The challenge now was to consolidate this information. For example, instead of being able to pick out one alarming feature in a child running a temperature from a list of four options, you now need to be able to recall all the red flags so that you can rule them out efficiently in less than a minute during your PLAB 2 case. Luckily all key clinical guidelines were covered in the Arora videos and flashcards. Like most IMGs I also needed to spend some time on understanding the NHS referral system and what level of care an FY2 doctor is expected to provide.

The IPS domain can be challenging if English is not your usual language for interacting with patients. Cultural factors that shape the doctor-patient relationship also come into play into whether or not you need to work in this area. I think individual feedback is necessary here so that you can build on your strengths and tweak anything in your consultation style that would not translate well into NHS practice. I was mostly okay in this domain other than a tendency to waffle around difficult diagnoses and dire outcomes. I also had to unlearn a tendency to ‘protect’ patients from uncertainty. Having good mentors at the academy you pick goes a long way in cementing this bit. As you keep practicing your own style will get solidified, and hopefully, IPS will cease to be a source of stress during your preparation. For our IPS teaching playlist, click here.

Conventional wisdom around PLAB 2 is that it is all about practice, practice and more practice. I think it is about just the right amount of practice, and most importantly the right kind of practice. I started practicing a week before joining the academy but what helped me most was practice during and after the academy. Your course mates are an invaluable resource! During the course, we naturally gravitated towards people who had similar (or complementary) learning/consultation styles and we helped each other out in the lead up to our individual exams. The Mock exams (as part of the Academy+ package) were a key element of practice too for me. 

How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

My PLAB 2 Exam Day

My mantra for exam day was to “Be sensible. Be kind. And help the patient.”  I went into the exam in good spirits, but all-in-all it was a bit of a roller-coaster. I was thrown off by my second case. I spent the better part of two minutes looking for gloves to wear before demonstrating a procedure to a medical student. In retrospect, it was perhaps a good way to get rid of some of the nerves – flustered, and with my hands visibly shaking I started joking a bit about what not to do. All three – the role player, assessor and I were sort of biting back smiles at this point, and I was able to shakily get back on track. I had another dip – in an area that traditionally I always go blank in – but I managed to get back on track using principles learned at the Academy. An emergency management station also did not go well – again something I was always worried about. But thanks to all the practice, I just disconnected from each scenario and moved to the next – back to my mantra. 

I had mixed feelings at the end of the exam. All of the adrenaline needed washing out. I felt like I had messed up a few stations – and wasn’t sure that I had done as well as I could have.

How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

Result Day

I had been fairly successful in blocking out the exam for most of the long wait for the result. But during the week that the result was expected, I was definitely a basket of nerves. Ironically, I didn’t realise that the result had been declared until much later when I started getting concerned text messages from my academy mates!

It was a pass!!

Also, I had failed two stations – one that I thought I had done badly on, and one that I thought I had done okay on. I passed the teaching station with a solid 10, and the emergency station had been cancelled entirely for our test day. Most exciting were two stations that I scored perfect 12s on (I don’t think it is possible for some of us IMGs to totally accept the pass-fail nature of these exams, and not look at the scores.)

How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

My Key Pointers

1. Take responsibility for your clinical knowledge – this will help you not just on the exam but through the rest of your career. Guess what, through you, it will also help all your patients!

2. There is no -one size fits all-advice – for prep. I think it is important to build confidence through the duration of your preparation. Whatever it is that is worrying you about your exam – focus on that.

3. For approach – the Arora method worked well for the entire gamut of scenarios that I was presented with. Importantly, it also worked when I was faced with a completely unfamiliar patient presentation.

4. For consolidating clinical info – I found it helpful to work backwards from symptoms to differentials and then to outcomes and managements. Also, I focused on life threatening and time sensitive diagnoses because I wouldn’t want to mess these up in real life. Unsurprisingly, getting this sort of thing wrong would be the reason you could fail a station in the exam.

5. Beware of the prescription station. This one also requires practice – a conclusion I have arrived at after failing mine due to running short on time.

6. For practice – practice with people who build you up while also pushing you to do better. I found all my practice people at the Arora Academy, and honestly an equal share of credit for my Pass on the exam goes to them. Take a break from practice if you find that you are becoming mechanical and just reciting things from memory.

7. Mocks – don’t time them too close to the exam. If you find the idea of 16 stations back-to-back daunting or exhausting it might be worth it to squeeze in at least one full-length mock. At Arora Academy there are two mocks built in to the package – to take at a time that suits your exam date.

8. For each scenario – practice being present, and in the moment. Listen to what the patient/actor is saying to you. Remember my mantra: Be sensible, Be kind, and help the patient.

9. Between scenarios – practice some sort of delete and refresh technique. I would picture myself in my happy place (a forest if you must!), and then see myself walking into a room with the next patient’s name on a prominent placard (I used to struggle a bit with remembering the names of the patients).

10. Living arrangements – For most IMGs the PLAB 2 experience also comes with the added stress of figuring out a new living set-up. During my prep-time I was lucky to live with friends who came to be my home-away-from-home. Find an environment that works for you. If you find that you are not feeling settled, do seek alternatives.

11. The value of a pre-PLAB attachment – I was given this advice early on, and managed to get a short attachment before my exam but after completing my course at the academy. I found this extremely helpful. I was able to see some of the principles I had learned in the Academy being implemented in practice – and this was the best way to cement them into my working style for good.

12. The day before the exam – eat well, get in a few back-to-back role-play cases with a safe practice partner. Think about just showing up to work the next day with the objective of helping each patient that you encounter. Might be worth scouting the exam centre beforehand: I took ten minutes on the day of the exam walking around the block trying to find the entrance to the building. Get your outfit sorted. Get your papers sorted.

13. On the day of an exam – Remind yourself that it is just a regular day at work. You are a doctor who has cleared part 1 and you already have all the information to be able to succeed in this exam. You just have to show up, be present and help each of the patients you encounter. Remember to disconnect between scenarios, before walking into the next station. My exam was in the first half of the day. For me it was important to eat a good breakfast, because I did not want low blood sugar to cause issues. Having said that, there were cookies (and water) available at the rest stations. Remember your rest stations could appear anywhere in the exam… It might be worthwhile to figure out a way to centre yourself again during your rest station.

14. After the exam – Congratulations on getting it done! Your bit is truly over for now and you deserve some time off! I think almost everyone feels overwhelmed. It is normal to not be able to gauge how you have done on the exam. I chose to walk back to the hotel because I was feeling super-wired when I walked out of the exam centre.
Post exam blues are also a thing. It took me longer than I expected to recover from all the build-up and the stress. It helped to get some time to just vegetate and also to have an attachment waiting for after the exam. I think it is common to feel home-sick also at this point – you are in no man’s land until the result is out and this is prime territory for all the existential angst that you may have been harbouring to reveal itself.

15. Result day – Just waiting for the result is nerve wracking. Have your support people at hand. And your celebration plans in place – irrespective of the result – celebrate being done with one iteration of the PLAB 2 journey.  Also, remember, your performance on this exam in no way reflects your capacity as a doctor. Neither does it predict the course of your future career. You know, like they (only sometimes) say back home, it is just an exam!

How I passed my PLAB 2 Exam with 10 weeks preparation – Dr Mitashi Singh

How Arora can help you Pass PLAB 2

For our most comprehensive ‘all-you-need’ PLAB 2 Academy+ Package click here

For all other Arora PLAB 2 resources (Gold Package, Mocks, Online course, etc) click here

To register for our next free PLAB 2 webinar click here: Next Free Webinar

To join our Free PLAB 2 Telegram teaching group click here

For Dr Aman’s PLAB 2 YouTube videos click here

Author Bio — Dr Aman Arora

Hello and welcome to Arora Medical Education! I am a Portfolio GP with a 24/7/365 passion for helping you fly through your medical exams and maximise your career. You can find out more about me here.

I’ve been fortunate to teach over 50,000 doctors globally through a combination of face-to-face, online, audio and social teaching, helping them pass exams such as MRCGP AKT and SCAMSRA and PLAB. You can find out more about my previous roles and qualifications here.

Feel free to contact me with any thoughts, questions or ideas to help you reach your potential. I look forward to meeting you soon!

aman

Author Bio — 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.

aman

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