When you decide to pursue your medical career overseas, this will usually involve taking exams to prove your clinical skills and knowledge. For IMGs wanting to work in the UK, the exam is called the Professional and Linguistics Assessment Boards or PLAB. I know what you’re thinking, “the what?” Don’t worry, I haven’t made a mistake, this is the exam you need to pass in order to get registered with the GMC and practice medicine in the UK. Any exam is daunting but PLAB doesn’t have to be one of them. I wasn’t the top student in my class but I was able to successfully pass PLAB 1 on my first attempt and trust me, if I can do it then so can you! So what do you need to know before you start on your PLAB journey? NOT EVERYONE HAS TO TAKE PLAB You do not need to take the PLAB exams to gain full GMC registration if you are in one of these situations: You have attained one of the postgraduate qualifications on this list. You have found a job through one of the GMC sponsors on this list. You are joining an MTI scheme. You have enforceable EEA rights. The first 3 are pretty straightforward but the fourth is quite complex. If you have any queries about this it is best to ask the GMC directly and seek advice from an immigration expert. If you do need to take PLAB then keep reading. PLAB IS A CLINICAL EXAM PLAB does not test for everything under the medical sun. You will not encounter questions on rare variations of normal. You will not fail because you forgot that one enzyme that did that one thing you learned in second year of medical school. It is about the application of knowledge to clinical practice. And the clinical scenarios are not random. They will be common or important presentations that an FY2 doctor would be expected to deal with. So what is an FY2 and what do they do? An FY2 doctor is someone who has just finished internship (FY1). They are expected to be able to initiate management of acute conditions, handle common illnesses, not to miss important life-threatening disease. FY2s work in medical wards, surgical wards, A&E, and basic GP clinics. They do not work in complex GP or specialist clinics and therefore specialist knowledge is not necessary. YOU DO NOT NEED TO HAVE COMPLETED INTERNSHIP TO PASS PLAB As mentioned above, PLAB is set at the level of a doctor who has completed internship. However PLAB is required even for those applying for provisional registration ie. for doctors who have not completed internship. If you haven’t completed internship, do not be intimidated to take PLAB. As with any exam, it can be prepared for. We know many doctors who have successfully passed PLAB 1 and 2 without doing an internship, my wife and I included. This leads me on to the next point. PLAB IS NOT THAT DIFFICULT In my humble opinion, PLAB tests for the most fundamental clinical knowledge and skills that you would expect of any safe practising junior doctor. The subject matter consists mostly of must-know topics that are needed in day-to-day practice rather than nice-to-know obscure facts. Unlike the USMLE, it is not used to distinguish the most intelligent from the average. It is not a test of who’s best, just who’s safe. The trickiest part of the exam is making sure you fully understand the question. This requires a good grasp of not just the English language, but British English. And if I’m being completely honest, it’s a very indirect if sometimes convoluted way of speaking! This was something I personally found quite challenging. Going through past questions will help you with this. You’ll also need to be aware of the English layman terms for some symptoms, signs and conditions. For example seizures are referred to as “fits”. YOU NEED TO DEMONSTRATE YOUR ENGLISH ABILITY BEFORE YOU CAN BOOK PLAB On the topic of having a good grasp of English, to book PLAB you need to demonstrate that your English ability is up to the GMC standard. This involves either 1) passing the Academic IELTS or the OET, or 2) proving that your medical degree (aka Primary Medical Qualification or PMQ) was taught solely in English with clinical encounters being 75% in English. Your English evidence is valid for 2 years and needs to be valid when you sit PLAB 1 and on the day you are granted GMC registration. I’ll be posting more information about the English tests soon. YOUR PLAB SCORES MEAN NOTHING I hate to break it to you but scoring highly on PLAB will not gain you any advantage when applying for jobs. As with most UK specialty exams, it is pass or fail: you’re either good enough, or you’re not. That doesn’t mean that you shouldn’t try to do well in it though, obviously the higher you score the more likely you are to pass. Likewise if you fail the exam, it will not matter to future employers. Unlike the USMLE, you will not be asked at interview or in your job application how many times you sat PLAB and your scores between attempts will not be compared. So do not be too hard on yourself if you fail. It is a tricky test and it can take more than one attempt to fully understand and conquer it so chin up, adjust your approach, and try again. PREPARATION CAN TAKE AS LITTLE AS 6 WEEKS FOR EACH EXAM With dedicated and focused preparation, both exams can be passed with 6 weeks revision each. PLAB 1 can be passed in 4 weeks if you push yourself. Links to study guides and study materials are listed in the resources section below. This is generally more true if you have just graduated medical school or just finished internship. That’s because it’s all fresh and you still have a very trainable mindset. If you have been working in one specialty for a number of years it becomes a bit more challenging but it is still doable. ATTENDING AN ACADEMY IN PERSON IS NOT ESSENTIAL FOR PLAB 1 Everyone has their own learning style; attending a course in person may be ideal for some but not for all. Thankfully, because PLAB 1 is a written exam, it is possible to adequately prepare at home. You can do this through self study with free or paid resources, or – if you really thrive with formal instruction – you can attend an online course instead of an in-person one. This will help save you lots of money because you will not have to come to the UK. Personally, I did not attend a PLAB 1 course but my wife did. It worked out well for both of us and we passed on our first PLAB 1 attempt. DO NOT UNDERESTIMATE THE VALUE OF PAST PLAB 1 QUESTIONS Your preparation for any exam, including PLAB 1, should not consist solely of reading text. You need to apply this knowledge to correctly answer exam questions so it’s vital that going through past questions is part of your preparation. This will also help you familiarise yourself with the style of questions and the commonly tested topics. There are many freely available study materials online which I used to prepare for PLAB 1 and I’ll provide a link to these in the further resources section below. Bear in mind that with free materials there is often no explanation for the answers. Make sure to cross-check answers with reference materials. Paid study materials often do have explanations but I’d still recommended that you check the answers. In terms of notes, beware that some academies intentionally put mistakes in their notes which they only correct if you attend the course or pay for a subscription so be wary of using copyright notes that you obtained illegally! ATTENDING AN ACADEMY IN PERSON IS YOUR BEST CHANCE OF PASSING PLAB 2 THE FIRST TIME I can’t say that it is the only way of passing as I have met a doctor who passed PLAB 2 without attending a course, but I can say that it markedly increases your chances! PLAB 2 is a practical exam so it is not a test of knowledge as much as it is a test of bedside manner. Your ability to communicate clearly and compassionately to patients while taking an effective history or performing a physical examination is being scrutinised here. Practical skills are also tested such as cannulation and phlebotomy. This is why attending an academy where you can receive individual feedback from teachers who are familiar with the exam and the marking scheme is highly valuable. TIME MANAGEMENT IS AN IMPORTANT SKILL In PLAB 1 you have 3 hours to answer 180 multiple choice questions. In PLAB 2 there are 8 stations, each station lasts 8 minutes. When you’re under the pressure of taking an exam these times can fly by and you can be left wondering what just happened?! It’s important to ensure you simulate the real exam during your preparation so that you are familiar with how it will be on the day. This can include taking paid mock exams, a definite must for PLAB 2. PLAB WILL BE REPLACED BY THE UKMLA IN 2022 At present, PLAB is solely for IMGs. UK medical graduates do not need to take a national licensing examination but that is set to change in 2022. The UK Medical Licensing Assessment will be introduced for UK and international graduates alike. EU graduates however are currently exempted from any UK licensing exams. Somehow, due to EU law, the GMC cannot make EU graduates take the future UKMLA but this may change with Brexit. We don’t know much about the UKMLA at this time but it is likely to be similar to PLAB. If you plan to move to the UK I would suggest doing it sooner rather than later while all the resources are directly relevant to PLAB and the academies are still familiar with it. SUMMARY Not everyone has to take PLAB. Check whether you can apply through a different route. PLAB is a clinical exam. It does not directly test basic sciences but rather the application to clinical scenarios so direct your preparation efforts accordingly. You do not need to have completed internship to pass PLAB. But you still need to take it even if you are applying for provisional registration. PLAB is not that difficult. It tests for the must-know topics that are needed in day-to-day practice rather than nice-to-know obscure facts. You need to demonstrate your English ability BEFORE you can book PLAB. This can done through IELTS, OET or your PMQ. Your PLAB scores mean nothing to future employers. No need to put your score on your CV or specialty application. Preparation can take as little as 4 weeks for PLAB 1 and 6 week for PLAB 2. Structure your preparation well and you can pass both exams in less than 6 months. Attending an academy in person is not essential for PLAB 1. This depends on your learning style. Consider self-study or online classes if travelling to the UK for a course is out of your budget. Do not underestimate the value of past PLAB 1 questions. This will help you familiarise yourself with the style of questions and the commonly tested topics. Be sure to check answers against reference materials. Attending an academy in person is your best chance of passing PLAB 2 the first time.PLAB 2 is a practical exam so it is not a test of knowledge as much as it is a test of bedside manner. Academies will give you valuable feedback to increase your chances of passing on your first attempt. Time management is an important skill. Ensure you simulate the real exam during your preparation so that you are familiar with how it will be on the day. PLAB will be replaced by the UKMLA in 2022. There is no definite information about the UKMLA yet but we know that it’s coming! Source
