www.7plus7.com

Preparing for the PLAB Test from BMJ Careers 16 November 2002
Wai-Ching Leung gives some advice on how to prepare for both parts.

Before applying for the PLAB test
Make sure you really want to work in the United Kingdom
Check with the General Medical Council that your primary medical qualification is acceptable for limited registration and that it does not qualify you automatically for full registration
Make sure you have got the required score in the International English Language Testing System assessment (IELTS) examination
Plan when and where you are going to take the test. Part 1 is held six times a year and can be taken both in the United Kingdom and overseas (currently Bulgaria, Egypt, India, Nigeria, Pakistan and Sri Lanka). Apply early to make sure you will get a place
Read the documents “PLAB part 1 and 2-advice to candidates2 (available for download at www.gmc-uk.org)

Most overseas doctors from outside the European Union are required to sit the Professional and Linguistic Assessment Board (PLAB) test before they can practice medicine in Britain. The PLAB test is specifically designed to assess doctor’s ability to work safely as a senior house officer (SHO) in a British hospital.

Part 1

Part 1 is a three hour written paper consisting of 200 extended matching questions. The emphasis is on clinical management and the ability to apply knowledge to the care of patients. It includes; diagnosis; investigations; management; the context of clinical practice.

In the first three areas, you are usually given important information about a patient and asked t select the most likely diagnosis, or the most appropriate investigation or management from a list of options. The last area includes ethics and law, evidence based medicine, epidemiology, and health promotion.

Tips on Preparation

Draw up a revision plan
Revise from concise textbooks or handbooks published in the United Kingdom, such as the popular Oxford series. Use large textbooks only to look up specific points
Revise thoroughly:
Characteristic symptoms, signs and investigations of emergency conditions, as well as for common conditions such as acute chest pain
Don’t spend too much time on the rarer conditions that might appear only in postgraduate examinations
Carefully study Good Medical Practice (www.gmc-uk.org/standards/default.htm
Get an up to date copy of the British National Formulary. Note any differences in the names of drugs from those that you are used to in your country
Read reviews of management of common conditions in journals such as the BMJ, and Postgraduate Medicine
Familiarise yourself with the format of extended matching questions. It is essential to get as much practice as possible in answering them. Many self assessment books consist of questions either the PLAB or medical final examinations (available from internet bookshops and the BMJ bookshop)
Familiarise yourself with the format and the instructions on the marksheet used in the PLAB test. You will find a specimen copy in “PLAB part 1-advice to candidates.”

Part 2

Part 2 can be taken only in the United Kingdom. Exam sessions are run 10 times a year. You must pass Part 2 within two years of passing your part 1, and you are allowed a maximum of four attempts. Otherwise you have to sit Part 1 and IELTS again. Although the official closing date is just over two weeks before each test, the sessions are often overbooked so it is wise to apply early.

Part 2 consists of an objective structured clinical examination (OSCE) with 14 stations and tests of your clinical and communication skills. You are examined for five minutes at each station. There are two rest stations, and the whole examination takes 96 minutes. You are assessed on your clinical management of conditions seen across a range of medical and surgical areas commonly seen by junior doctors. The five main skills tested are:
Taking a history and reaching a diagnosis
Carrying out a physical examination and recording your findings
Communication
Performing practical skills
Managing emergency stations

At each station, you will be demonstrating these skills on manikins, models or standardised patients (actors, who give a history or display symptoms according to a predetermined script).

At each station, you are assessed on a number of objectives in the five skill areas. But you are not told of the objectives you are assessed against at each station.

You will be given a grade from A to E for each objective. Each of the objectives may carry different weights, and an overall grade is calculated. To pass the test, you must obtain an overall grade of C or above at 10 or more of the 14 stations, and must not have a grade E at more than one station.

Tips on preparation

Arrange a short clinical attachment in the United Kingdom before your test to help familiarise you with: how doctors interact with patients in Britain; the legal and ethical advice in Duties of a Doctor registered with the General Medical Council (www.gmc-uk.org/standards/default.htm) and Good Medical Practice put into practice; the colloquial terms commonly used by patients; and the equipment routinely available
If possible, enrol on a PLAB part 2 course with practice OSCE
Alternatively, ask your senior colleagues to give you five-minute mock station tests
Get access to a clinical skills laboratory and practice the practical skills listed on page 32 of “PLAB part2-advice to candidates”
Drill yourself thoroughly on the management of common emergency conditions such as basic adult and paediatric cardiopulmonary resuscitation

Tips on taking the test

Before each station, you have one minute to read the instructions, which tell you what you need to do. Read them carefully and mentally plan your approach. Aim to complete the task within 5 minutes. Note whether you should address the standardised patient or the examiner.

Carry out the tasks efficiently. But don’t rush, and pay attention to the communication aspects. Spend the first 300 seconds establishing rapport.

You will hear a warning bell 30 seconds before your allotted time at each station. Make good use of the remaining time to mention any other key points or perform key tasks.

When you move to the next station, concentrate on the tasks ahead and forget what happened in previous stations.