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My experience in PLAB Part 2 OSCE Exam

Author: Satman, Posted on Thursday, December 30 @ 12:43:58 IST by RxPG  

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PLAB Part 2

I appeared in PLAB 2 recently. Thanks to everybody here on RxPG. I studied by my own, and got lot of tips from RxPG PLAB forums (Sajida, Hanna and all thanks) it was really helpful. I did not have any study partner and I realized that its not must to have a study partner for everything, but I did practice my clinical examinations and mannequins with friends i met in coaching centre. My advice is that it’s not at all a difficult exam and the examiners are there to pass us.

Let me tell u about my exam.

I was in the third batch and my exam was to start at 2 O clock. but we were asked to come at 10.45 and then we were quarantined in a room , we were allowed to carry books with us till I think 11.00 and then no books . now sitting in one room all 16 of us. And we had to be there from 11 till 2 pm, that is 3 hours this time was something i can never forget . time was just refusing to pass … looking here and looking there, what to do?? wait , that’s it… then suddenly I saw ..........

a beautiful girl sitting there in black suit, long hair, talking to her self ( oh was she revising some station ) . Just couldn’t help myself, I started staring at her. she never looked at me though . there was no one sitting in the chair next to her. You know what I did . o yes I went and sat next to her. Hmmm was she Indian or Pakistani.?? Ah how does that mater, she was beautiful that’s it. After about 15 minutes it was still 11.15 .I said “hello”. and there was a flicker of movement at the corner of her right eye. Surprised at the unexpected hello . she slowly nodded cosign wavy strands of dyed red hair to fall to her face. “Hello” she finally said pushing up her black rimed glass to have a better look at me. I gave her a sweet smile and said . I am sorry but I was thinking if we could discuss some stations .is it OK with you (.plab 2 style u c ),I added “ its still more then 2 hours for the exam” and smiled. and that was it . the time started running , we discussed/revised all the examinations and then presented mannequins to each other. I was wondering as to ask her where she was all these years, I have been looking for her, and did I know that I am going to meet her in London just 2 hours before my exam , O god You are great , I love You … my This discussion was so very helpful . the last moment revision u c . I would sincerely advise you to discuss some stations just before your exam, it puts you in momentum and you feel confident, not that everyone is as lucky as me to find a beautiful girl for discussion but then you can discuss with any weird looking guy , how does it matter ………………………. and then it was 2 pm . Just found myself standing in front of one station.

1st STATION … it was Eclampsia ( talk to the husband and tell him that his wife suddenly got a fit she is 35 weeks pregnant and she is been taken for caesarean section , fetal heart is normal, mother was recorded as having high BP in this pregnancy . it was good . I went in there was a young guy sitting and I told him all that stuff , TOLD HIM ABOUT ECLAMPSIA , AND ABOUT THE MANAGEMENT PLAN AND PROGNOSIS and he asked if his wife is OK , will his child survive and if he could see her wife right now.
Then the second station.

2nd STATION ….Talk to this mother whose child had a febrile seizure and is now OK. child has mild URTI and thats it. This station was also simple . All usual stuff about febrile seizures I told her about it, management. About PR Diazepam etc. she asked if this is epilepsy.no. and then she asked if she could see her child right now .yes . I also told her all about what she needs to do if this happens again and since child had URTI and I had enough time I also told her about URTI and how to rule out Meningitis and all stuff, what to do in case of fever. She was happy; I did not see towards the examiner, should be happy too …

3rd STATION …. Was BP . gone fine all usaual stuff.I just managed to finish in time? her Diastolic BP was very less. It went down till 40 or even less I guess. What ever it was OK. She was smiling all this while so I was comfortable, even her smile made me remember about the girl I just met outside…

4th STATION … was 20 year old female came after taking 15 tablets of Paracetamol 12 hours back. Now she is repenting taking that, did it because she had a fight with her BF , and it was an impulse rather then planned, anyways we were not to assess risk here .question was to tell her about the plan of management and discuss about future complications and effects of this over dose. DONT COUNCIL HER AND DONT ASSESS RISK SAID THE QUESTION. It went good. I told her about the line of management and future complications that might occur . all what we read in our books . she asked if she can go home now as she is not having any problem . I said NO, u cant go home till the blood results are back, we have to see for some results like INR (blood thickness ) , LFT and all before we can let u go home . tell her about how this can effect the liver n all ….she was happy and did not ask anything else . it was ok she was satisfied, I dont know about the examiner I did not look at him at all, he was Indian and I knew that if I give him smile he might fail me.

5th STATION… Headache. TAKE HISTORY FROM THIS PATIENT WHO IS HAVING SEVERE HEADACHE SINCE MORNING AND TELL THE PATIENT WHAT IT COULD BE. AND LINE OF MANAGEMENT. This was an easy one . Doctor This is the worst headache I ever had . Its in back of my head . Developed suddenly in morning and is killing me . bla bla since it was a station of History taking so I followed the normal pattern of history . ruled out all other causes . Meningitis glaucoma, asked about all migraine, cluster, tension headache.etc etc. Patient asked what is it . I told him about possibility of SAH, that is bleeding between the brain coverings. and we need to do an URGENT CT scan right now. Hearing this his headache got a little relieved . Again he was happy; I again did not look towards the examiner u c.

6th STATION . This was again very simple.History taking for PALPITATION .AND HERE IT SAID DISCUSS DD WITH EXAMINER. so I ruled out all Heart causes, Thyroid, anxiety panic attacks.pheochromo. etc etc . This was again fine . Here I am not sure but patient said no to everything and was giving history suggestive of. Angina. Forget it. It what was important was to tell the examiner that you had asked about all DDs. it was over.

7th STATION. This was Child CPR in hospital setting . Went fine . When I called for Crash team that was when examiner said WHAT will u do now and I told look for signs of life again for 10 sec, and then again start 5:1. that was it he said its OK doctor . Have a seat now . then he asked me how I am feeling. A little nervous?? he said good luck . dont worry exam is an easy one . and bla bla . Then
8th STATION. ah this was a rest station . for a moment while sitting there I just remembered that beautiful smile , those eyes . ahhh it was soo refreshing . had a glass of water . And then to the next station.

9th STATION . Examine legs of this patient who has come for routine Diabetic check up.known Diabetic since last 15 years. There was an elderly male lying on the bed with legs exposed . I started with that brief intro GRIP. and then took his permission to examine/touch . It was normal . U ll practice this enough before your exam. common station . all went fine . just in case . in this station NEVER FORGET TO CHECK FOR SENSATIONS. VIBRATIONS SENSE , POSITION SENSE , DORSALIS AND POST TIB , AND ANKLE JERK. rest is all formality. Patient smiled I smiled and here I was confident, looked towards the examiner . a small gap. and then he smiled too. I was like ahhh its OK . Next station

10th STATION. SPINE EXAMINATION . had low back pain . This was again the usual station and everything went fine except the palpation part .when I was palpating his back, the examiner stood up and came very close to see what exactly I was doing and I stopped , looked at him , and he said . continue continue . I was like what the hell. Why dont u sit down and let me examine him (actually i was not sure as to how exactly do we look for tenderness there. oops I dont know rest was fine. did all the tests SLR and for femoral nerve. shud be OK I thought .

11th STATION. female with pain lower abdomen . history and DD TO EXAMINER . This went good . she gave positive history of greenish discharge through her front passage and previous history of PID . LMP was 2 weeks back . but I still kept a possibility of Ectopic in mind. it was ok . Common station I guess.

12th STATION. AHHHH THIS WAS BAD real BAD . Must be a Pilot station. Question was …Attend to the Concerns of this 40 year old lady who had GOT Right mastectomy done 2 days back for CA Breast . I went in with confidence and came out without it , lost all in side that room . She was shouting at me all the while . asked me what are the side effects of chemo and radiotherapy . I just started with hairloss. and there she was Shouting again . SHE SAID. You have cut my breast and now you want to take my hair away . WHAT THE HELL . she fell short of hitting me . I looked towards the examiner for help but he too was least bothered . and I was just waiting for this 5 minutes to pass . she asked about her daughters getting breast CA . I started explaining that there is slight increase in risk but .and again she just did not let me speak . shouting again. and all this 5 minutes what I remember is that I was saying . I can understand your concerns . I can understand your concerns . but she was least bothered about my concerns. ahhh I was out in 5 minutes.

13th STATION. CVS EXAMINATION WITH FOCUS ON HEART FAILURE .. This went fine . Patient was lying straight . and I asked the examiner that I wud like to examine the patient at 45 degree reclining position . examiner helped me to lift his bed up . then I did all fine JVP , CVS . Abdomen for liver . pedal edema. etc etc . and when i came out I jusr remembered that I forgot to auscultate the lung bases . ufff how badly I wanted to get back into that room and tell the examiner that I ll auscultate the lung bases as well . but I just remembered that I am suppose to forget about the station once out . there is another task ahead . And there I went.
14TH STATION. SUTURING . I struggled hard to open the needle through the pack , it was different and there was nothing like pull here . I tried for about 5 seconds and then told the examiner That I am unable to open this. he said very casually . its nothing doctor just tear it .its a paper . And I tried again and did it this time . rest all was fine. but I could complete only One stitch and 30 seconds were remaining . examiner stopped me and said leave the second one , U dont have time . what wil u do with this needle now .I said I ll throw it in Sharps Bin . he said then do it . and I did it . O i did it.

15th STATION. KNEE PAIN HISTORY and DD to examiner ,. This patient had right knee swelling and pain ( all assumed, actor) . I asked all DDs and guess what he did not say yes to anything . I had in my mind septic arthritis, as it was only one joint and with swelling. also ruled out any bleeding disorder , trauma etc . but no positive history for anything . I told examiner about my DDs and . later on some one told me that he gave history of urethral discharge as well. I missed it . Anyways, u dont miss that…may be something like Reiter’s syndrome (arthritis, redness of the eyes, and urethritis ,……. not sure, check it )

16th STATION . FOLEYS CATHETERIZATION.. there was an assistant to assist you . I did all fine but knowing that this was my last station I was very casual, and guess what? Time was over when the catheter was still about 1/3rd outside . I told the examiner that I ll inflate the balloon after putting the catheter full inside .and he said . ok go Doctor

Ah I was out . exams over and I started looking for her .where is she . I caught her.How was the exam? I asked. She smiled and said “kind of OKAI”. O gosh. her smile, her eyes ( only if looks could kill, I was dead) and I told her that my exam was also OK types , as if she asked me :) .. then I asked her .R u going to Eastham. She said “No, my Boyfriend is waiting outside.”

Satman passed his plab part 2 in his first attempt and is now searching for three things: Attachment, Job and a girl without a boyfriend.

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