What is covered in this blog:
– What is PLAB 2?
– How is it marked?
– How to prepare effectively?
– My experience with the PLAB 2 exam
– How can we help you prepare?
– On a final positive note
What is it?
PLAB 2 is the second and final part of the PLAB (Professional and Linguistics Assessment Board) assessment run by the General Medical Council (GMC), UK – taken after successful completion of the PLAB 1 exam. PLAB needs to be cleared to enable a doctor to work in the UK.
PLAB 2 is an OSCE based exam, usually taken at the GMC building in Manchester. It can be taken at various times throughout the year.
– 18 stations in total.
– Each station lasts 8 minutes.
– 90 second break between each station.
– 2 rest stations included.
– Total 3 hours, 10 minutes exam time.
As with the PLAB 1 exam it tests your ability to deal with some of the issues seen by a UK trained doctor who is about to start their Foundation Year 2 program.
It is not based on fact, recital and memorisation – it assumes you have certain levels of knowledge having cleared PLAB 1.
It assesses how can you apply that knowledge in various situations that you might see as a doctor in the UK, whether that be a mock consultation or a ward based situation.
It is important to remember that PLAB 2 assesses you against UK current best practice so bear that in mind when you’re preparing or when you are practicing role plays and situation scenarios.
How is it marked?
PLAB 2 marking has changed recently and I’ve examined both the old system and the new system. Currently each case is marked in three areas:
1) Data gathering, technical and assessment skills.
2) Clinical management skills.
3) Interpersonal skills.
Each case is scored out of 12 marks – 4 marks each for the 3 domains. The maximum that you can score for PLAB 2 is 216 marks. The pass mark varies for each day – to pass PLAB 2 you must achieve the pass mark for that day as well as pass at least 11 stations.
Domain 1: Data gathering, technical and assessment skills
This area assesses areas such as history taking, examination skills, your practical procedures and any investigations that you might think about – in essence how you gather data in order to try and work out what a potential diagnosis might be, or which issues arise in a certain situation.
History taking can include core medical requirements – for example drug history, past medical history and red flags, as well as other areas that link with a presentation such as psychosocial history and ICE (ideas, concerns and expectations).
Examination may be tested on real-life actors, using anatomical models or as part of an electronic simulated mannequin. Areas tested include common everyday examinations (for example cardiovascular, respiratory, abdomen, various joints) and model examinations (such as breast examination, eye examination, rectal examination).
Practical procedures that may be tested are things that you might come across in a typical ward in the UK – measuring blood pressure, taking blood, urinary catheterisation, inserting cannulas, suturing, calculating common drug doses etc.
The PLAB blueprint has a more complete list of examinations and procedures which is worth reading through.
Domain 2: Clinical management
This area assesses how you manage the situation, both clinically and non clinically. For example if you’ve come up with the correct diagnosis, how do you now explain that to the patient? How do you involve the patient in a correct, safe, appropriate management plan?
Are you using UK current best practice when handling the situation? In essence, now that you’ve gathered the data in the first half, how are you now managing it, and is it appropriate for working as a UK junior doctor?
This area assesses your ability to effectively tie together data gathering and clinical management in a patient-centered way.
For example, are you involving the patient regularly? What is the rapport like between you and the patient? Are you effectively using open and closed questions?
Are you thinking about ethics? It may include your ability to handle challenging situations such as breaking bad news, capacity and consent.
It can assess how you manage that situation from a patient’s point of view or perhaps a relative’s point of view, and if you handle the situation in a professional manner or not.
Our PLAB 2 Communication Skills 1-day Course and Audiobook Course both teach these areas in detail.
How to prepare for PLAB 2?
PLAB 2 preparation is very different to PLAB 1 preparation. With PLAB 1 you can prepare on your own – you can look through questions, you can simply learn the material. PLAB 2 is about regular practice and there are a few different ways that doctors can prepare.
1) Form a study group
Find people that are doing the exam and practice various scenarios by looking at the PLAB 2 blueprint and using practice material.
2) Join an Academy
By far the most common approach. There are several academies available, both in the UK and internationally – each with their own pros and cons. We don’t run our own (simply as I do not have space in the calender for this) but we do run our intense 1-day Communication Skills Course.
Academies are all about getting you through common scenario-types, making sure you understand the principles behind certain situations and learning how you can adapt to perform to the best on the day. It’s not the only way to pass PLAB 2 but it’s one of the best ways of getting some practice under your belt.
3) Mock exams
Useful if you want to feel the ‘pressure’ of the exam before the exam date. These can help to feel what its like to go through 3 hours of intense roleplay consultation practice – not something you may have done too often in the past. They are also useful to figure out what you need to focus on in the last few weeks.
4) Online and Audio training
Useful to get started and to prepare when on your own. There are numerous online and digital earning tools for PLAB 2 – we have our own audio and video courses but of course others also exist. Useful to understand key concepts and listen or watch examples, these can help supplement practice with colleagues, allowing you to learn at your own pace.
I am an ex-GMC PLAB 2 examiner (examining between 2016 and 2017).
Whilst examining I saw many recurring themes where I thought I could help with preparation – whether that be through communication skills and general confidence in approaching a challenging situation.
Since I stopped examining I have helped hundreds of doctors prepare for PLAB 2 – through face-to-face courses, webinars and audio course training.
I particularly focus on enhancing interpersonal skills – an area that many doctors struggle with.
I aim to simplify the process, focusing on efficiency of your 8 minutes, and encouraging the flexibility to adapt to situations that you are perhaps not expecting.
I do not apply a ‘script based’ style of teaching as I believe that this leads to a very doctor-centered approach and given that I am an ex-GMC PLAB examiner I am conscious of probity issues whilst teaching.
How can we help your preparation?
I am passionate about guiding you through the PLAB process in the method that suits you best. We provide a number of methods to help you prepare for your exam.
An intense 1-day course focused on maximising your interpersonal skills for PLAB 2. This is an area that many struggle with and the whole day is focused on intensive role-play and direct feedback. I cover a range of scenario types such as patient emotion, counselling, ethics, and patient-centred care. Click here for details.
25 Common PLAB 2 communication and consultation scenario type challenges. I break these down through audio and teach through a variety of tips and suggestions for how to deal with these. It is designed to listen to again and again and in a variety of situations e.g. travelling, at the gym etc. Click here for details.
220+ medical conditions, diagnoses, tests and investigations explained in simple terms. Improve the quality of your scenarios by breaking down explanations into patient-friendly language. Also designed to listen to again and again and in a variety of situations e.g. travelling, at the gym etc. Click here for details.
2 or 3 hours of individualised teaching for one person. Either face-to-face in our office in Birmingham or online via Skype. We focus on role-play practice and detailed communication and consultation skills training. Click here for details.
On a final positive note
Finally to end on a positive note, most doctors can and do pass PLAB 2. Just like any exam or assessment it takes good planning, constructive preparation and a positive mindset – things that can significantly help boost confidence before you enter that exam centre!