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During the process of registering with the GMC, the step which I feared the most was the PLAB (Professional and Linguistic Assessments Board) 2 exam. As you may be aware, this is an OSCE style exam which consists of 20 stations (two of which are rest stations) in which you have 1 minute 30 seconds to read a task outside the cubicle and then another 8 minutes for your consultation (it’s important to note that the timer begins when you’re outside the cubicle, so every second really does count).
When preparing for the PLAB 2, I had many questions running through my head such as “How will I complete a physical examination or a practical procedure in so little time?”. But now that I’ve successfully passed the exam with good marks I feel able to reassure you that, yes 8 minutes is enough and yes you will be able to interact with the simulator as if it is just another patient. In this blog post, I’m going to share tips that should help you prepare for and pass the PLAB 2. I understand that due to COVID-19 there is a lot of uncertainty. but I am confident that the guidance here will still apply to whatever the future brings for the PLAB 2.
It is not an English test
The PLAB 2 is not an English test. Your English has been tested (either with OET or IELTS) so don’t overcomplicate it by using elaborate vocabulary.
Although this may sound obvious, regular practice is absolutely essential to passing the PLAB 2. Practising with a timer allows you to refine your clinical skills to make sure you’re able to carry out all of the necessary steps of a procedure or examination within 8 minutes. So my advice is, to find a group of fellow doctors who are preparing to take the test and practice your consultation skills with each other.
Don’t be afraid of admitting when you don’t know what’s going on
One of my biggest worries for the PLAB 2 exam was not knowing what to do. What if I couldn’t remember the dosage of the medication? What if I couldn’t diagnose the patient? I had a lot of “what ifs” running through my mind. However, the reality is that the GMC has assessed your medical knowledge on the PLAB 1 exam, so they are not focused on whether you can memorise a specific dosage or medication. Instead, they want to assess how you interact with patients. In real life, we often encounter medical scenarios which we aren’t sure how to deal with, so don’t be afraid to admit when you need help. As long as you have done everything you can, including informing and reassuring the patient, you will be fine.
During the exam we want to show the examiner how much we know, we want them to see that we recognise the disease, possible complications, the treatment and so on, up to a point where it is only us talking. This could be the reason why you fail the station. Always remember that we are dealing with another human being, who may not want to know what antibiotic you will prescribe for their infected wound, but they will want to know when they can go back to work, so make sure you have a two-way conversation, in which you listen to the patient as much as you talk to the patient.
Know where you are
Adapt your consultation accordingly, are you in the A&E? Are you in the medical ward? Or in the GP surgery? The pace of your consultation will ultimately depend on the location of the scenario, so keep this in mind.
Make sure that the patient is comfortable
Before performing any clinical examination or procedure, make sure to check the patient is comfortable and happy for you to proceed.
It’s easy to rush things when under pressure in a timed exam such as the PLAB 2, however, this should be avoided wherever possible. If you rush through an examination or procedure, you’re not going to communicate well with the patient and you may miss out key steps. Try to maintain a steady pace so that you’re able to perform the task within the time limit whilst communicating appropriately with the patient.
As we are already doctors we often assume that those stations in which we have to perform a physical examination will be the easiest, right? We think we know how to do them because we’ve already done them in real life with real patients. Unfortunately, this is not always the case, as the style of clinical examination in the UK can be very different from what we are used to. What did help me enormously was watching on Youtube the physical examinations provided by Geeky Medics as they showed me not only what to do but also how I was expected to communicate with the patient whilst doing so.
When we are practising, we can often create a fake persona for the assessment that doesn’t reflect who we really are. This can sometimes cause us to be perceived as ingenuine, so try your best to be your authentic self. In addition, avoid memorising long pre-rehearsed phrases as they often end up sounding very unnatural.
It is just another day at work.
Finally, my top tip is to try and think of the PLAB 2 as if it is just another day in the clinic. This mindset can help you quickly develop a rapport with patients and communicate more naturally with them.
Try to remind yourself that you are a doctor, you know what you’re doing and you’re going to be fine.