GMC | How do I prepare for part 2?

4/2/18, 3)07 PM

How do I prepare for part 2?

Find out how to prepare for the part 2 of the PLAB test including:
the format of the test
what the exam covers, including the domains you'll be marked against
resources to help you

The format of the test

Part 2 is an objective structured clinical examination, or ‘OSCE’.

The exam comprises 18 scenarios, each lasting eight minutes. You’ll be tested in settings such as a mock
consultation or an acute ward.
Candidates will be given one and a half minutes between scenarios to read the instructions and patient
information. The whole exam will take around three hours and 10 minutes. There will be a minimum of two
rest stations, allowing candidates a nine and a half minutes break each time.

What the PLAB part 2 exam covers

The PLAB test covers everything a UK trained doctor might expect to see on the first day of Foundation Year
Two (F2).

It tests your ability to apply knowledge to the care of patients rather than how well you can remember and
recite facts.

All the questions relate to current best practice, and you should answer them in relation to published
evidence and not according to your local arrangements.

Names of drugs referred to in the exam are those contained in the most recent edition of the British National
Formulary (BNF).

The PLAB blueprint sets out the scope and content of the test in terms of the topics, skills and procedures
that a doctor who passes the test would need to know and be able to do, and the professional qualities
expected of a doctor working in the UK.

For each scenario in the test, you will be marked against three areas or ‘Domains’:

Domain 1 - Data gathering, technical and assessment skills

Covers history taking, physical examination, practical procedures, investigations leading to a diagnosis.

Domain 2 - Clinical management skills

Covers formulating a diagnosis, explaining something to the patient, formulating a management plan.

Domain 3 - Interpersonal skills

Covers how the candidate approaches the station: whether they establish a rapport with the patient, how
they use open and closed questioning, involving the patient in the management and demonstrate their
professionalism and understanding of ethical principles.

When marking against the Domains the examiner will assess your competency across a number of skill
areas.

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Below is some further guidance on how your skills will be tested in the part 2 exam.

Clinical examination
The examiner will assess you on your ability to conduct a physical examination of a simulated patient. This
will be an actor who is trained to display signs when required.

Where a station includes uncomfortable or intimate examinations, we will use an anatomical model. In these
stations:
Do not speak to the model – you will not gain any marks for doing so
Tell the examiner what you are doing and why only if the instructions tell you to
Do not perform any actions on an anatomical model that would be unsafe or painful to a real person.
We expect you to be able to carry out any basic physical examination, such as examination of the abdomen,
breast, chest, hand, heart, and joints. You must be able to perform a rectal or bimanual vaginal examination.
You must also be able to use the appropriate equipment in carrying out an examination of the ear, eye or
nervous system.

You may be required to perform an examination or other procedure on a high-fidelity simulator which can be
programmed to show normal and abnormal clinical signs. A role player may speak from outside the room
using a microphone connected to the simulator. You can find more information and a video on the
manufacturer’s website.

Examination of someone's mental state is a form of clinical examination for the purpose of the Part 2 exam.

Practical skills
The examiner will assess you on your ability to perform common practical procedures. Again, we may ask
you to deal with a simulated patient or an anatomical model.

Do not speak to the model – you will not gain any marks for doing so.
Tell the examiner what you are doing and why if the instructions tell you to.
Do not perform any actions on an anatomical model that would be unsafe or painful to a real person.
The practical skills may include:

Checking blood pressure

Performing venepuncture
Inserting a cannula into a peripheral vein
Calculating drug dosage
Giving intravenous injections
Mixing and injecting drugs into an intravenous bag
Giving intramuscular and subcutaneous injections
Basic cardio-pulmonary resuscitation (adult and child)
Suturing
Interpreting an electrocardiogram (ECG), X-rays or results of other investigations
Interpreting basic respiratory function tests
Performing urinary catheterisation
Taking a cervical smear
Safe disposal of sharps.

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Interpersonal skills
We test these skills by observing the interaction between the candidate and another person, usually a
simulated patient or occasionally the examiner. The examiner will assess your approach to the patient all
through the examination. This may include:
Explaining diagnosis, investigation and treatment
Involving the patient in the decision-making
Communicating with relatives
Communicating with health care professionals
Breaking bad news
Seeking informed consent/clarification for an invasive procedure or obtaining consent for a post-
mortem
Dealing with anxious patients or relatives
Giving instructions on discharge from hospital
Giving advice on lifestyle, health promotion or risk factors.

Resources to help you

You can find a range of resources to help you prepare which include Good medical practice (our core advice
to doctors) and the PLAB blueprint.

You can find a sample station on our specimen questions page.

Read our examiners' top tips on how to avoid common errors in the Part 2 exam (pdf).
Adjustments can be made for candidates with a disability or particular requirement. Find out more about
reasonable adjustments to the PLAB test.

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