Where to start? In the United Kingdom (UK) you must be registered with the General Medical Council (GMC) before being allowed to practice medicine. It is a GMC regulation that foreign doctors should undertake the Professional and Linguistic Assessment Board (PLAB) before commencing any NHS jobs or practising as a doctor in the United Kingdom. The PLAB consists of two parts: o PLAB part 1 is a theory exam where they will assess your clinical knowledge (200 EMQ or SBA questions- 3 hours from all the systems and subjects). Usually the pass mark fluctuates from 125-130. o PLAB part 2 is a clinical skills exam only conducted in Manchester and can only be sat after passing PLAB 1. Here they judge you on your communication skills and also whether you are a safe doctor to practise. So all the foreign doctors need to take the PLAB, however, before that you need to have either a passing International English Language Testing System (IELTS) band or an exemption. It is sensible to check with GMC or their website whether you fall under the exemption of giving IELTS. If your degree teaching and communication with patient is in English, with written evidence from the college principal or dean, it is likely that they can give you an exemption, provided you haven’t spent no more than one year after your graduation. What is next? Once you achieved 7 in all bands in IELTS according to new rules (please check www.gmc.org, website regularly for any change in the IELTS score) then you are required to book exam dates with the GMC. You need to set up an account with GMC through their website. They require all your primary medical qualifications (PMQs) and IELTS details. You need to make sure that you are very clear about the dates of MBBS and internship completion. Mismatch dates only delay your registration once you pass your PLAB. You can use this account for booking your exam dates, viewing results and apply for the registration after wards. There are many centres to prepare for both PLAB parts 1 and 2 in the UK. Theory part i.e. part 1 can also be self prepared, if you can get hand of good notes from your colleagues or seniors who have already cleared the tests. There are doctors who have passed PLAB 1 without going to the centres. But for PLAB2, it is recommended that you go to some of the centres and practise. The main trick to pass these exams is solving as frequently and many questions as possible. It is recommended that you also start looking for a clinical attachment placement whilst preparing for PLAB 2. If you are fortunate enough, get the experience before part 2. What is clinical attachment? A clinical attachment is a non-pain attachment to allow exposure to the NHS. It can last for four to six weeks depending upon the hospital you apply and the consultant you are under (some consultant are happy to extend your attachment or give posts in other departments, it is better speak to them after completion). It is very rare you can get an NHS jobs without prior NHS exposure and a clinical attachment can fill this gap. How can you apply for the clinical attachment? The best way of doing this is to consult your senior who is already working, to know which places are providing it. You can also look into different websites of different hospitals. Hospitals normally have a Human resource department (HR) who help arrange attachments thus should be contacted. There are a few hospitals and universities who are ready to provide you one. In some instances, there is a fee contribution for this. Usually it takes 3-4 weeks to get a response from them. Before commencing clinical attachment you need to go through a Criminal Record Bureau (CRB) check and occupational health screening. The health screening is usually done via an appointment with the hospitals’ occupational health department and usually consists of screening for communicable diseases like TB, Hep B,C, HIV, MMR and vaccination status. They also check your two references. All these pre-employment checks normally take 2- 6 weeks. The other way of applying for this is to write to the consultant straightway, as many as you can get hold of and particularly the hospital nearby you. You can get lists of the consultant and their addresses working in your area in their hospital websites or just googling them. It is advisable to make a good plan ahead i.e. to apply for it when you are doing PLAB so that you do not have to wait longer after PLAB 2. Normally people spend 2-3 months just to get a placement for the attachment. This can be avoided if you are actively looking for it well ahead. Please bear in mind it is strictly not required to have a GMC registration for doing clinical attachment, however each trusts varies. Health Exchange Nepal (HexN) is a charity organisation promoting exchange of medical knowledge and is happy to provide clinical attachment and support under the HexN PLAB programmes for PLAB candidates. However it is limited to four candidates a year. Please see the website (www.hexn.org) for further details. What to expect in the clinical attachment? Although this is not a training post, it provides valuable experience for foreign doctors, helping them, to understand how NHS works. You need to be proactive during your attachment period as your senior or consultant has no obligation to teach or guide you. If you are not, then you will not get full advantage of it. Request your consultant to be one of your referees as almost all the consultant would be happy to do that. As you may all agree at some point that this might be very helpful given that referees from back home respond poorly due to their own various reasons. It is advisable to have at least three referees on your hand before applying for any NHS jobs, preferably all from the UK. History taking, developing communication skills, performing basic clinical procedures (under observation), clerking patients are the main areas you can explore yourselves and build up some confidence within whilst at doing attachment. Some trusts clearly mention to you not to get involved in clinical treatment decision part and please make sure you abide by their rules. You can write in your CV or on your experience section in NHS portfolio about your attachment experiences/appointments. There is an important place for clinical audit when it comes to get shortlisted for the job. You can mention about your interest in getting involved in clinical audit or request to your senior in the ward or your consultant about this. If you manage to get one, it strengthens your portfolio. Applying for NHS jobs? To look for NHS jobs it has own jobsites where you can create an account and add your all details. It is really important that you get training posts. These means getting into foundation programmes run by different deaneries. Foundation year 1 ( FY1 or F1) is equivalent to internship back home and this is followed by Foundation year 2 (FY2 or F2). This could be rotator y too in different faculties. Most deaneries have a single annual intake in August, however the applications for this usually start around September or October the previous year. See www.foundationprogramme.nhs.uk for further details. You need to plan ahead whilst you are doing Foundation programmes such as deciding in which field you are going to pursue after F2. You will then apply for a speciality job which lasts 2 years (labelled ST1/ST2, CT1/CT2 etc) or more years depending on the speciality. Some people try and pick specific foundation tracks in order to have more exposure in the speciality they wish to enter into. All specialities have a royal college (such as the Royal College of Physicians) and some require you to complete membership exams (e.g. MRCP) before progressing as a specialist in your 3rd year (ST3 i.e. specialist training 3rd year). Thus, it is desirable to complete part of your membership (e.g. Part 1) in your foundation years allowing you to take the remaining parts in ST1 and ST2 as these years can be difficult in terms of time management. You can apply for trust jobs, trust locum or service jobs. But in order to help you in future career and prospects, taking training posts give you more advantage than other posts. Many hospital or deaneries shortlist candidates on the basis of their CV or form application or NHS portfolio. It cannot be stressed enough that you should work hard on your CV and/or application form as this can mean the difference between getting shortlisted or rejected. Facing an interview? Once shortlisted, carry all the relevant certificates with you. Please expect some clinical emergencies case scenarios thrown at you in the interview related to the posts you are applying for. It is also good idea to have enough knowledge about clinical audit and its principle and methodology. Please make a habit of reading some international journal or some RCT or meta-analysis presentations from various websites as some of the consultants are fond of asking in this area. Please visit following for this http://www.tripdatabase.com/ http://www.ncbi.nlm.nih.gov/pubmed/ http://sumsearch.org/ Please do not get surprised by some of the questions related to Good Medical Practice outlined by GMC and it is sent out to you in a booklet after you registered with them. It is also available from the website. Others frequently asked question is about your previous experiences and qualification and what are you good at and weak at etc. It is important to be honest and tell them clearly that you don’t know if you do not know the answer. They like people who can admit their weaknesses rather than people who can give a false impression. What else you can do in order to enhance your portfolio to get into NHS? It is getting more difficult to get into NHS these days as the posts are drying up sooner. This is partly due to producing enough doctors within the country and surplus of foreign doctors in the UK. You need to out-stand the crowd or be able to show them that you are pro-active. First of all, a well- written CV or portfolio is really important. This means you reflect about your experiences as an attaché in the ward all the time in your CV or portfolio wherever possible. Please make sure you have written documents or Certificates of your experiences wherever possible. There are many things you can do after passing PLAB and getting GMC registration number besides clinical attachment, such as appearing for membership examination into your subject of interests is one of them. Some of the membership examinations do not require any prior experience in the UK, such as the MRCP UK (please visit www.mrcp.org for further details). Continuous Medical Education (CME) or Continuous Professional Development (CPD) is another way you can work to get stand out from the rest of the competitors. This can be found in many websites for free on various interesting topics. You can do as many as modules you like. You can visit :- http://www.cme-cpd.eu , http://learning.bmj.com for CME- CPD and registered with them to do their free CME modules. They provide certificates on completion on each module and you can add these into your training section of your NHS portfolio and take it with you during your interviews. The credit can also be transferable later when you have e-portfolio setup when you are doing Foundation programmes. So we wish you luck for your career as a doctor in United Kingdom. Although this is a general idea from many experiences from previous doctors in the UK, it might not work in some cases. Please feel free to give us some feedback if you find this section helpful at all. Best of Luck This article is written by Dr Suresh K Pun and published at Hexn.org If you are still hesitating, click here to compare between USMLE vs PLAB vs MCCEE vs AMC If you need more information about PLAB, Check our free PLAB Forum
The website is www.gmc-uk.org , not gmc.org. If you'd like to check the rules and any changes in them. Thank you for the helpful article.
