PLAB 2 – 10 Top Tips To Ensure Success

Hello PLAB candidates!

As part of today’s PLAB focus, we will be sharing some top tips on flying through your PLAB 2 examination. Let’s go! Here are our 10 Top Tips to ensure your success:

Tip 1: Introductions matter
If you are interacting with a simulated patient during the PLAB 2, you will be required to behave just as you would with a real patient in an NHS setting. Any time you meet somebody new, what do you begin with? A greeting and introduction.

A good introduction is like the following:

‘Hello, my name is Rahul and I’m one of the doctors. I would like to have a chat with you about your health, is that okay?’

or

‘Hello, my name is John and I’m one of the doctors. I would like to take a sample of blood from you today, is that alright?’

In the above introduction, you told the patient your name and role, why you are there and obtained consent to speak to them or carry out a procedure. The next step consists of confirming you have the correct patient:

‘Can I confirm your name and date of birth please’

You are now in a great position to begin your interaction or procedure with the patient in the PLAB 2.

Tip 2: Empathy, empathy, and empathy!
As a rule of thumb, you should always display empathy throughout your consultation. Always come across as considerate and concerned during the PLAB 2 station, no matter what the nature of the station is. This is particularly important when breaking bad news or dealing with an upset patient, you must be able to respond appropriately with empathy. This means to be able to acknowledge and address how the patient feels while still keeping the interview moving forward. We often find that candidates become uncomfortable in such situations and ignore a clear cue for empathy!

As a rule of thumb, you should always display empathy throughout your consultation. Always come across as considerate and concerned during the PLAB 2 station, no matter what the nature of the station is. This is particularly important when breaking bad news or dealing with an upset patient, you must be able to respond appropriately with empathy. This means to be able to acknowledge and address how the patient feels while still keeping the interview moving forward. We often find that candidates become uncomfortable in such situations and ignore a clear cue for empathy!

For example, the patient may say:

‘I’ve been very worried lately. I think my condition may be due to cancer and I’m scared of dying’

In the PLAB 2, an excellent response would be:

‘I can only imagine what you are going through. Your symptoms could be caused by a wide number of causes, one of which may be cancer. However, it’s too early to jump to this conclusion. How about we have a chat about your health and work towards getting to the bottom of this?’

Empathy is a core area we focus on practicing during our PLAB 2 courses.

Tip 3: Culturally appropriate
The PLAB 2 assesses whether you are able to communicate with your average patient in the UK in an appropriate manner. Therefore, using culturally appropriate language, greetings, and salutations are important.

The general vibe of the consultation should be relaxed, friendly, and professional.

  • Greet them using a friendly ‘hello’.
  • Ask the patient how they would like you to address them: ‘Do you prefer John or Mr. Smith?’
  • It is acceptable to call patients by their first name if they wish you to.

Tip 4: Body Language
It is said that the majority of our communication as human beings is non-verbal and we could not agree more! It’s all too easy to forget about body language in the heat of the PLAB 2.

Try to maintain neutral, upright, and professional body language throughout the examination (open body language). Avoid crossing your arms and legs, covering your face, or mumbling (closed body language).

‘Open’ body language facilitates an exchange of information between all parties involved. It makes it likely that the patient will perceive you as a friendly and confident professional. Closed body language, on the other hand, will put you across as cold, unengaged, and uninterested.

Tip 5: Clarify understanding 
If you are being examined on a station that involves speaking to a simulated patient, it is vital that the simulated patient follows what you are saying. As doctors, we are familiar with medical concepts, however, most patients are not. When we give them lots of information at once, it can be difficult to process everything.

In the PLAB 2, you must clarify that the patient understands everything so far. You can do this in a number of ways, however, the easiest way to do it is to simply ask the following question:

‘I can imagine this is a lot of information to take in at once, is everything clear so far?’

A simple sentence like the above can boost your worth in the examiners’ eyes immensely. We recommend you write the above sentence down and practice saying it as part of any patient interaction.

Tip 6: ICE 
ICE stands for ideas, concerns, and expectations. This is a framework that involves exploring what the patient thinks is causing their symptoms, their worries, and what they want from the consultation. This is a high-yield concept and loved by PLAB examiners. You can implement ICE in your patient interaction by using the following lines:

  • Ideas: ‘Have you had any thoughts about what may be causing this?’ 
  • Concerns: ‘Is there anything, in particular, that is worrying you about this?’ 
  • Expectations: ‘Is there anything you specifically wanted me to do for you today?’ 

You may think that this is trivial. However, in the PLAB 2 setting, if you ask these questions you are well on your way to smashing the station.

Tip 7: Prepare your lines for common scenarios
While reading this article, you may have gathered that you can be confronted by a wide range of scenarios in the PLAB 2. These scenarios range from breaking a diagnosis of cancer to a patient, counselling a woman on contraception, calming an angry patient to asking sensitive questions about sexual history.

Simply trying to face these stations as they come is not a good strategy. In fact, you should prepare some sentences and phrases in response to common scenarios in the PLAB 2 such as the following:

  • Angry patient: ‘I can see that this is really upsetting you. I’m here to help’.
  • Sensitive questions: ‘I need to ask you some more questions, some of which are sensitive, am I okay to go ahead?’
  • Breaking bad news: ‘I’m afraid I don’t have good news today’

Taking your time to prepare for such common scenarios will decrease the amount of stress you experience in these situations during the PLAB 2. As part of our PLAB 2 courses, we have prepared an extensive list of scenarios and phrases you can easily use to wow your examiner.

Tip 8: Close properly
Abruptly ending interaction with a patient is never a good idea. In your PLAB 2, try to end your consultation with a short summary of the consultation repeated back to the patient. It may go something like this:

‘Just to make sure I got all the correct information, you’ve had some diarrhoea and vomited twice since a friends barbeque yesterday. You haven’t noticed any blood in either of them and you are otherwise fit and well. Is that all correct?’

This short summary is useful for you, as it coalesces all the main points you gathered during your consultation and summarises your findings appropriately for the examiner.

‘Thank you for your time, if you have no further questions that is the end of our consultation.’

Tip 9: Present systemically 
The examiner will often ask you to present your findings to them. It is crucial that you do this in a concise and systematic manner. For example, if you were presenting a history, you would start with the presenting complaint, move to the history of presenting complaint and then onwards such as the following:

‘I spoke to Mr John Smith, a 65-year-old gentleman who has presented with a 2-hour history of left-sided chest pain. The pain started while he was watching television at home and was unaffected by his usual GTN spray. He also vomited once and has felt nauseous since. He has a past medical history of hypertension, has no allergies and currently takes ramipril once daily. He has been smoking 10 cigarettes per day for the past 30 years. His history is otherwise unremarkable’. 

The above rules apply to anything you do; always have a system and work through things in order. This will help you convey information to your examiner in a way that is easy to understand.

We often talk about communicating with patients, however, we forget that communicating with other healthcare professionals is also assessed in the PLAB 2. The above is a good example of this. In our PLAB 2 courses, we teach you about the SBAR format of communicating with colleagues and many other techniques.

Tip 10: Practice
Practice really does make you perfect for the PLAB 2. This is a hands-on practical examination and often requires you to go into ‘auto-pilot. Make yourself familiar with saying phrases like the above, develop a flow to taking a history, have a system to counselling a patient on any condition and practice breaking bad news.

It is very helpful to have a study buddy during this time and both of you can test each other through roleplay.

A great free resource you can consult to get you used to speaking like a doctor in the NHS is the Geeky Medics series of videos on practical procedures. They have an excellent way of speaking to patients throughout their videos and you would do well to learn from them.

By | 2021-01-15T12:06:43+00:00 July 22nd, 2018|PLAB 2|Comments Off on PLAB 2 – 10 Top Tips To Ensure Success

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Mary Rose
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