The Professional and Linguistic Assessments Board (PLAB) Part 2 is the next step in your journey to becoming a licensed medical practitioner in the United Kingdom. The exam is costly, and many people have to save for months or take out loans to pay for it. This adds to the pressure candidates feel, along with the Objective Structured Clinical Examination (OSCE) format of the exam.
The OSCE format simply means you will go through a series of stations (16) where you interact with a simulated patient after reading their folder. You are given a total of nine minutes and thirty seconds per station (1.5 minutes to read the task and 8 minutes for the consultation). PLAB 2 is designed to cover everything a doctor appointed to a year 2 Foundation Program (FY2) might see at work. It demands thorough preparation and a calm, adaptable approach when interacting with each station. Each station requires you to interact with live actors acting as patients, and it tests your practical and interpersonal skills.
Many candidates travel from overseas to take the PLAB 2 exam, meaning they will have to spend a lot of money on accommodations, food, and other expenses. With the high stakes and financial investment made, many candidates hope to pass on their first attempt.
Exam Taking Tips
Avoid Memorizing Scripts
While it may be tempting to memorize a script for talking to a patient, it is not advisable, as relying on a script will make you sound robotic and detached. If necessary, you can use scripts as a reference, but they shouldn’t be relied upon, and you must understand that each person you see that day will be unique and may not react as the script dictates. Approach each station naturally and think of it as a real interaction with a patient. You’ve done it before during your training.
Remember to “Be a Doctor”
If you get overwhelmed, try to fall back on your experiences in the hospital or clinic you are coming from. Rely on your clinical instincts and ask yourself how you would handle the scenario in a real-life setting. This approach should keep your focus on providing patient-centered care and help you avoid overthinking.
Stay Calm and Centered
During the exam, it is easy to get distracted by past stations or worry about upcoming ones. Worrying about whether you did a good job or how you could have done better will distract you from the present station you are on. So, it is essential that you stay present and calm when you approach a new station; focus on each station individually and approach it as an isolated case rather than worrying about the whole exam.
Use Rest Stations Wisely
PLAB 2 includes at least two rest stations that allow you to pause and reset between active scenarios. A lot of people spend the time worrying about things they cannot change rather than relaxing and recharging. This, however, is a waste of the rest of the station, as instead of recharging and gathering your strength for the remaining stations, you are spending energy worrying.
Speak Simply and Clearly
Communication is one of the vital areas tested in PLAB Part 2. Avoid using overly complex or unfamiliar language when meeting the patients; you’re being tested on how effectively you convey information, not your vocabulary. Stick to your natural speaking style and avoid attempting to sound “more British” or using colloquialisms that may feel awkward or forced. Also, do not skimp on gathering and giving details to your patients and ensure they understand what they can expect from the proposed treatments (side effects). Do not lie to or withhold information from your patients.
Practice with Peers and Online Communities
Some people prefer to practice alone, but working with others will build your confidence in interactive scenarios. Study groups and online communities can be found on Facebook or Reddit for those who do not have anybody around them taking the exam with them. Platforms like Zoom allow you to conduct role-play sessions with other candidates from around the world.
Understand What is Being Tested
PLAB Part 2 assesses three core competencies:
- Data Gathering: Can you collect relevant and comprehensive patient information in a structured way? “How did this problem start? What remedy did the patient try before coming to see you? What kind of symptoms did she have? Which doctors did she see?” Questions like this are what you need to consider to earn the 4 points this section has.
- Diagnosis and Management Skills: Here, you are tested on whether you can make appropriate treatment decisions and effectively communicate management plans. This section also has four earnable points.
- Interpersonal Skills: You are judged on your ability to demonstrate empathy, show respect for patient autonomy, and how well you can work on a collaborative team, especially when faced with challenging interactions. This section also gives four points.
Key Strategies During the Exam
Listen and Give Space to the Patient
It is important to let the patient speak without them feeling rushed or interrupted. The GMC values active listening and strong communication skills, so it is essential that you validate your patients’ concerns and, despite your concerns about time, avoid interrupting them. Rushing will come across as you being impatient, so give your patients time to explain their symptoms or worries.
Adapt to the Setting of Each Station
Understand the context of each station and adjust your behavior accordingly. For instance, in an Accident & Emergency (A&E) scenario, you may need to demonstrate a sense of urgency, while a General Practice (GP) setting might require a more systematic approach. Knowing the context will help you manage your time better and adopt an appropriate mindset.
Respect Patient Comfort and Consent
Before you perform any action on your patient, always check that the patient is comfortable with what you propose and obtain verbal consent before you begin any examination or procedure. This shows respect for patient autonomy, which is a central value of the UK healthcare system. Be mindful of cultural sensitivities that may pop up and ensure patients feel respected and reassured.
Recognise Cultural Sensitivity
With the diversity of the UK population, it is crucial that you understand cultural factors that can influence your patient. An older Indian woman will likely have different sensibilities from a middle-aged Caucasian man. A culturally sensitive approach will help you build trust and communicate effectively, especially when discussing personal topics or asking for consent for physical examinations.
Focus on Professionalism in Ethical Situations
PLAB Part 2 will likely include scenarios aimed at testing your ethical judgment. Be prepared to handle these cases with professionalism and respect for patient autonomy and confidentiality. Ethical dilemmas require you to prioritize patient welfare above all else, so demonstrate a compassionate, fair approach.
Adapt to Uncertainty and Limitations
You’re not expected to know everything. Part of PLAB Part 2 is recognizing when you’re out of your depth and showing humility by seeking guidance. Admitting gaps in knowledge, when necessary, demonstrates your professionalism and commitment to patient safety (Non-Maleficence). Remember to reassure patients when you are unsure and let them know you’ll seek additional support as needed.
Pass Mark and Scoring
The passing mark for PLAB Part 2 is determined by the overall performance of candidates on each exam day rather than a fixed score. The GMC assigns the pass or fail grade based on the average performance of the day’s candidates.
Practical Preparation
Get Familiar with the Venue
If possible, visit the exam center beforehand to familiarize yourself with the location and all the peculiarities that you will encounter on your journey there. Familiarising yourself with the surroundings will allow you to arrive at the exam location on time.
Embrace a Realistic Practice Schedule
One of the first things you need to do while planning for your exam is to create a study schedule that is well-detailed and planned. The schedule should be personalized to you and made to suit your idiosyncrasies. Dedicate regular time to practicing a variety of cases with different scenarios. Real-time practice in eight-minute intervals prepares you for the pacing and pressures of the actual exam.
Don’t Forget Self-Care
Preparing for the PLAB Part 2 exam can be exhausting, so it is necessary that you do your best to maintain a balanced routine. Ensure you sleep well, eat healthy meals, and take regular breaks while practicing, as it will help improve memory retention and concentration and reduce overall stress.
Use High-Quality Resources
Resources like the GMC Good Medical Practice and CanadaQBank will come in handy during your preparation. Reviewing the GMC Good Medical Practice guidelines helps you understand the ethical and professional standards expected in UK practice. Online resources like CanadaQBank provide scenario-based practice that closely mirrors PLAB Part 2. The QBank will teach you the time-tested approaches to the cases that have been tried by thousands of candidates in the past who successfully passed the PLAB 2. Luckily, the QBank contains 384 classic simulated cases inspired by the recent PLAB 2 exams. You also get possible questions and answers that the examiners and patients could ask during each clinical scenario. What makes it even better is that this is updated very frequently.
Consider a PLAB 2 Prep Course
If possible, join a structured PLAB 2 course to gain firsthand experience with mock stations and simulated patient interactions. Courses like this are led by experienced instructors who offer personalized feedback and targeted practice, making it a valuable investment, especially for candidates unfamiliar with OSCE-style exams.
