Author: shreerav, Posted on Monday, July 12 @ 02:43:09 IST by RxPG  

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After sharing my experience with PLAB 1, I thought I would write about PLAB 2, although many of the facts may be repetitions of the extremely well written previous posts of similar kind. I took the exams on Mar 11th .

I would like to also add that this is primarily for such of those women who are likely to have gross restrictions on their time and freedom due to child care responsibilities.

Pre exams- I attended the 2 weekend courses. I could afford no more time away from home.I found it useful in the following ways-
1. You get quickly oriented to the dynamics of the PLAB 2 exam.
2. You understand how exactly you need to prepare for the exam with the limited time you have.
3. You have access to manikins
4. You make good friends who will help you fill in the blanks left behind by the incompleteness of the course you have attended.

Once back from the course, I divided my time between manikin stations, history stations, examination and counseling.One advantage of PLAB 2 for women with kids is that you don’t have to sit in a room with your books like for PLAB 1. (Although that luxury would be quite welcome!)

Once you spend some time learning the manikin stations, history and counseling stations, you can constantly practice these things while at work. I would practice the manikin stations while cooking, cleaning and the sort – because all you need to do is keep thinking and talking to yourself although you are physically doing something else.

In addition to practicing the routine manikins I would also practice some variations of the stations like what I would do if something went wrong.

Say for example, if you don’t manage to obtain blood in the IV cann station, the vital thing is to gracefully and professionally execute a salvage procedure. I found it extremely useful to practice this beforehand so that if it does happen, you wouldn’t as much as bat an eyelid. Just stop and say to the examiner, “I am extremely sorry, I haven’t been able to obtain blood. Would you like me to repeat the procedure?”

You must plan precisely what you would do if he said “yes please”, because it is at this point in time that we are very likely to break the rules of the aseptic technique considering the enormous stress we are under.

Similarly plan what you would do if you are unable to shoot off the ABG needle, and the like.
I would spend about 2 hrs every day rattling off the manikins, as it puts you in the autopilot mode in the exams.

History taking- It is very important to learn the DDs for the vital stations – so I would work on them every day for about an hour.

You can follow which ever technique you like for history taking. I followed the system of asking about the presenting symptom in detail followed by a head to toe review-

Head- neurological symptoms
Forehead- fever
Eyes- blurred vision, discharge
Nose- discharge, URI
Ear- discharge
Mouth- ulcers,
I would ask about appetite, loss of weight and lumps or bumps.
Neck- Swellings
Chest- heart and lung symptoms, breast lumps in females
Abdomen- all symptoms
Bowel, bladder, external genitalia

Menstrual history in females
Legs- Swellings
Skin
Joints, back

This would be followed by past, family, social travel and all that.

Personally I found this a comprehensive technique for pre anaesthetic check also. Its easy to remember what to ask next.

Counselling stations- I used patient . co . uk quite liberally to quickly read up and note down vital points.

Constant practice is so very important and I would do that almost every waking minute of the day. It’s easy; you could be feeding your baby but simultaneously be counseling for epilepsy/ something.

Examination- This might sound strange, but I did most of the examinations on myself, because I figured I was better than a pillow. I did not have a study partner as there was no one taking exams nearby, and also, with kids its difficult to coordinate study with anyone else. Only stations like joints, I would practice on my husband, or kids when they were in the mood for it.

CPR- Although it may seem superfluous, I practiced this twice a day. There are various theories as to what happens when a mistake is committed in CPR, so I did not want to take a chance. After all it hardly takes a few mins.

I had made a list of “cannot afford to forget ” and “must ask” questions for each station- and I would revise these regularly. For eg travel history in a patient with fever, etc.

On the day of the exam-

To be well rested is really important- your mind needs to be sharp.
Dress- Formals, do take time with your appearance.
Ensure you don’t get hypoglycemic for the next couple of hours.

The new GMC building is quite a daunting one, and as I was entering the huge revolving doors, I had half a mind to revolve right out and run away, but remember, staying calm is half the battle won!

Everyone is really kind and polite. They do a verification of your ID and documents, and give you a card with your photograph on it to wear around your neck.

Try hard to stay calm, as I was pretty unnerved by all that formality.

When the exam begins,
1. Read the question carefully.
2. Try to recall the “cannot forget”/ “must be done” points for that station.
3. Don’t worry too much about the name of the patient. I was so paranoid I would forget the name. The examiners were introducing all patients to us- This is Mrs. Brown, you can talk to her.
4. The task was kept quite accessibly on the coffee table in the station.


All of us candidates come out of the exams and say “the examiner in the intussception station was nice” or the hemicolectomy examiner was grumpy or whatever.

What do we mean by nice? He was pleasant; maybe smiley, looked kind and sympathetic, and probably seemed helpful.

We manage to gather this info from what, the 4 words the examiner spoke to us? It is primarily from his non verbal communication. Imagine how much more they must be judging us in that same time!

You must come across precisely the same way to the examiner and simulator.

I entered with a bright, confidant smile for the examiner, and an equally bright one for the simulator ( unless it’s a bad news station)
The importance of being courteous and polite simply cannot be overemphasized. Listen to the simulator carefully. Choose your words well. Intermittently ensure the simulators understanding of your advice.

Towards the end ensure the simulator says “ I have understood everything you have said doctor and I have no further questions”. You may then rest your case, or if you have time, you could add a few more points.

In the history stations, even if you feel you have taken a brilliant history, its always good to ask the simulator if there is anything he would like to tell you, before you talk to the examiner. (just to be sure) You ll never know, you may hear something important that you’d forgotten to ask.

In the examination stations, if a simulator is in pain, its good to ask-

1. If he has taken any painkiller in the past few hours
2. If he is allergic to any painkillers
before you prescribe any. Don’t forget to offer painkillers first though.

Please practice giving crisp, clear, brief instructions to the simulator. If you don’t, the simulator will not do what you have asked.

Sometimes strange things happen, like we had a renal colic station on Mar 11 th and after giving all the renal, ureteric colic etc DDs I said, “ in a young woman of child bearing age, ectopic pregnancy has to be kept in mind”. I don’t know why, but the examiner burst into loud laughter for several seconds! I was quite shocked and worried wondering what I did wrong. I still wonder why?

When dochina entered the CVS station, she had barely come in , when the examiner unceremoniously put the steth in her hand. Why he did that, we don’t know! She of course, was unperturbed and calmly placed the steth on the patients bed and continued as she had planned.

There may be fire drills in the midst of the exams. Don’t panic!!

Remember, be polite and calm. Have faith in yourself. Attend as many days of the course of your choice as possible. Try to get a study partner. If you cant, make the best of what you have.

I must also say, my performance was not flawless. I myself could think of things I could have done much better. But I passed. Even if you forget one thing, or something goes wrong, don’t panic please. Complete the station as gracefully as you can.

I think I have covered all that I wanted to say. As Dr.Salil said, I’m no expert either, but just want to share my experience.

Congratulations to all colleagues who have passed. Good luck to all of you waiting for your results and exams.