PLAB
part 2 is the clinical examination where your communication skill,
safety towards the patients care, Clinical Knowledge, Clinical
skill, your personality and behaviour are all tested.
Few tips for success:
Dress up well, Boys may have a clean shave and if possible wear
suite, Girls can wear suite or any formal dress.
Though you are given only 5 minutes and you feel short of time,
never rush, don't have fixed aim of completing the task I believe
that completing the task is not the criteria to pass or fail .It
is how you perform is important, do the clinical skill slowly
and methodically never rush (CPR may be an exception) It applies
to taking history as well. If you are unable to complete the task
thank the patient and tell the examiner what you would like to
do if given extra time. Always stop at 4.5 minutes ring, whatever
stage you are at. In the remaining 0.5 minutes thank the patient
and summarize the findings to the examiner.
Every time, when you practice in your house, please introduce
yourself and take a verbal consent (even for taking history) never
forgets to introduce and take consent. Sometimes examiner will
introduce you to the patient even then it is better to introduce
yourself again to the patient.
After introduction ask a rapport-building question. How are you,
how many children's do you have (for females), where do you work
(for males) how is the pain etc
If you are asked to do an orthopaedic examination it is safe and
better to ask the patient where is the pain, will it hurt if I
touch.
Always ensure privacy
Talk clearly and audible.
Don't hesitate to ask again if you did not understand the statement.
Always allow the patient to talk; many times they will take you
towards diagnosis.
Never cut their sentence or neglect their queries
Be generous with the usage of please and thank you
Never land up in argument with the patient, if she is not agreeing
to your advice you can tell that I will ask the help of an expert,
for example: while advising on life style to a post M.I patient
or a newly diagnosed cirrhosis, patient may be reluctant to agree
to your advice to cut down the alcohol consumption. The best way
of dealing then is to tell the patient " I am not expert
on advising on this I will ask a dietician to come and talk with
you, is that okay "
Be positive, empathetic and humble.
While examining be, as gentle as possible, ask the patient to
inform if you hurt during examination.
After entering the station (Examination or clinical skill station)
look at the tray, it will give you an immediate idea, what to
be done for example: looking at the gloves will remind you to
wear them, looking at the tray which has knee hammer, in a case
of thyroid examination will remind you to test for jerks.
Be thorough with the CPR, Examination of an unconscious patient,
Primary and Secondary survey. 2-3 out of these 4 is sure to appear
in any test.
Questions for primary survey, Secondary survey, Examination of
unconscious patient and CPR are often confusing. One way to understand
the question may be in this way
CPR- Question or scenario indicates of the sudden onset for example,
A patient collapsed, Suddenly fell down from the bed and not responding.
And question will also indicate that something has happened in
front of you or near you.
Unconscious patient- Usually it will be stated that here is an
unconscious patient. (Look for the word)
Primary survey- most confusing, in many tests they have asked
to do primary survey on a patient who is conscious and talking.
So don't panic to see a healthy patient, primary survey question
tells that you have to do an initial survey, or you are the first
doctor examining the patient. (Ambulance staff may have put a
cervical collar) So you have to start from ABC and in circulation
check for all blood loss and fractures and then do D and E.
Secondary survey- Always they mention that ABC is being done do
a complete examination of the patient.
Never take these lightly - BP measuring, I.V Canulation, and Suturing
Not to forget -
-To through sharps in to sharps bin
-To thank the patient at the end
-To make the patient go back to his original position, ask him
to sit down if you have made him stand
After the test you may feel that you have made many mistakes,
don't get disheartened wait for the result. I am sure you would
have passed.
