General Information about Professional and Linguistic Assessments Board (PLAB)

Introduction 
(please refer to Plab official site for any updates)  


In order to undergo postgraduate medical training in the United Kingdom, a person has to obtain a limited registration with the General Medical Council (GMC) of UK. For obtaining this limited registration one has to pass the Professional and Linguistic Assessments Board (PLAB) Test conducted by GMC. Passing PLAB test allows a person to start the postgraduate training at the level of a Senior House Officer (SHO) in a UK hospital. 

If you are interested in MRCP, MRCS, FRCS, MRCOG, etc, and want to be trained in UK for these exams, than this is the test for you. 

PLAB Test 
The test has two parts: 

-Part 1 is a written paper-pencil exam based on Extended Matching Question (EMQ) system not very different from the MCQ system. There is no scoring system. You may either pass or fail the test. 

-Part 2 is an assessment of clinical skills of an individual called Objective Structured Clinical Examination (OSCE). One can only appear in part 2, when he/she has passed part 1. There is no scoring system. You may either pass or fail the test. 

Eligibility Requirements for PLAB Part 1 
There are two requirements for appearing in part 1: 

-A person must be a medical graduate, in possession of a basic medical degree like MBBS or equivalent. Medical students are not eligible to take PLAB. 
-One must have passed the IELTS test with the required score set by GMC. (See below) 
-Though not a requirement to appear in part 1, a candidate should have at least 12 months of postgraduate clinical experience (like one year of house job) in a teaching hospital in his/her country to work as an SHO in UK. Otherwise the person after passing both parts of PLAB must first obtain this 12 months experience in UK, and finding a house job in UK is indeed very difficult. Therefore you are strongly advised to complete your one-year house job before appearing in part 2. 

Eligibility Requirements for PLAB Part 2 
Passing part 1 is the only requirement for appearing in part 2. One must take part 2 within 2 years of passing part 1, otherwise he/she will have to take part 1 again. 

IELTS 
International English Language Testing System (IELTS) test is a test of English language conducted by the British Council all over the world. You can apply for the test and appear in the test in your local British Council office. The fee for the test is approximately Rs. 31,000/-. The test has 4 parts or bands, listening, reading, writing and speaking. Each band has a maximum score of 9. There is also an overall band score (maximum 9), which is the average of the 4 individual band scores. 
To be eligible to appear in PLAB part 1 one must achieve a minimum overall band score of 7.5 and a minimum of 7 in each. 
For more information on IELTS contact your local British Council or visit www.ielts.org 

Fee for the PLAB 
The fees for part 1 and part 2 is 155 and 465 British pounds respectively. 

Test Centers for PLAB 
Part 1 of PLAB is held in countries outside UK as well. These include Pakistan, India, Bangladesh, Srilanka and Egypt. In Pakistan part 1 is held in Islamabad and Karachi. 
Part 2 can be taken only in UK. 

Test Dates 
Part 1 is held in Pakistan 3 times each year usually in the months of April, July and November. For other countries please refer to official site. 
Part 2 is held more often. 


Format of PLAB Part 1 

PLAB part 1 is a one-day, paper-pencil exam. Correct answers are marked on an answer sheet with a pencil, which is later checked by a computer. Format of the test is called Extended Matching Questions (EMQ). PLAB Part 1 consists of 200 EMQs. Usually 4 EMQs are grouped under a certain topic like for example, the joint pain. Each EMQ describes a certain clinical situation in the form of a short patient history and clinical findings. Than for the group of 4 EMQs there are given upto 20 (A to T) possible answers. Each EMQ has only one correct answer from the list of 20, which you have to mark on the answer sheet. 

Examination Content of PLAB Part 1 
Part 1 of PLAB is a purely clinical exam covering all the major clinical specialties including: 
-Medicine 
-Surgery and Orthopedics 
-Obstetrics and Gynecology 
-Pediatrics 
-Psychiatry 
-Ophthalmology 
-Otolaryngology 
-Accident and Emergency Medicine 

Basic Sciences are not tested in PLAB. 

Format of PLAB Part 2 "OSCE" 
Part 2 assess the clinical skills. There are 14 booths or "stations" and in each station you have to perform a particular task. You have to complete each station in 5 minutes. Some stations have patients where you have to take a short history or perform a certain examination according to the instructions. In other stations you might be required to carry out certain procedure like venepuncture, per-rectal examination or others on dummies. 

Examination Content of Part 2 OSCE 
Examination content is the same as for part 1. In addition you have to sharpen your clinical skills of history taking, physical examination and carrying out routine diagnostic and therapeutic procedures. This is yet another reason why part 2 should be taken after house job. 

Recommended Books for PLAB Part 1 

Medicine: Davidson's Principles and Practice of Medicine by Christopher Haslett (Editor), Edwin Chilvers (Editor), Nicholas Boon (Editor), Nicki Colledge (Editor), John Hunter (Editor)  
OR 
Clinical Medicine: A Textbook for Medical Students and Doctors by Parveen Kumar, Michael Clark 

Surgery: Pocket Diagnosis in General Surgery: A Companion to Lecture Notes on General Surgery by Harold Ellis, Christopher J. E. Watson 
Orthopedics: Orthopedics portion of Bailey & Love's Short Practice of Surgery by R. C. G. Russell et al 
Gynaecology: Gynaecology by Ten Teachers by Stuart Campbell , Ash Monga 
Obstetrics: Obstetrics by Ten Teachers by Geoffrey Chamberlain 
Pediatrics: Blueprints in Pediatrics -- by Bradley S., Md. Marino, et al 
Psychiatry, Ophthalmology and Otolaryngology: Oxford Handbook of Clinical Specialties (Oxford Medical Publications) by J.A.B. Collier, et al 
Other Books: 
The complete set of "Underground Clinical Vignettes Set of 8 (Internal Medicine Vol. 1, Internal Medicine Vol. 2, Surgery, Ob/Gyn, Pediatrics, Psychiatry, Neurology, Emergency Medicine" by Vikas Bhushan, et al (small books with approximately 50 clinical cases in each book). 
Oxford Handbook of Clinical Medicine by Murray Longmore, et al (for quick revision just before the test). 
250 Short Cases in Clinical Medicine by Ragavendra R. Baliga 


Recommended Books for PLAB Part 2 
In addition to the books above you should practice more to examining the patients, take their medical histories and perform common diagnostic and therapeutic procedures in your hospital. Also read the following books: 
Hutchinson's Clinical Methods 
You can also get coaching classes for part 2 in UK. Information on these couching classes can be obtained from www.plabmaster.co.uk 

Applying for PLAB Part 1 

For application material and more information contact the following offices: 

General Medical Council 
PLAB Test Section 
178 Great Portland Street 
London W1N 6JE 
United Kingdom 

Phone: 44-207-915-3727 
Fax: 44-207-915-3558 
E-mail: plab@gmc-uk.org 
Website: www.gmc-uk.org 

Shahnaz Farooq 
British Council 
Block 14 
Civic Center 
G-6 
Islamabad 

Phone: 92-51-111-424-424 
Fax: 92-51-27-6683 
E-mail: Shahnaz.Farroq@bc-islamabad.bcouncil.org 

Irum Fawad 
British Council 
20 Bleak House Road 
Near Cant's Station 
PO Box 10410 
Karachi 

Phone: 92-21-56-703-917 
Fax: 92-21-56-836-94 
E-mail: Irum.Fawad@bc-karachi.bcouncil.org

Some medical facts to have in mind:

A temperature of 101 degrees in an adult means you are sick. 104 degrees you are very sick, and need to see someone.

Symptoms are common, and many diseases have the same symptoms. But if you have symptoms and SIGNS, then see your doctor if they persist. For example, mild chest pain can be many things, and might be just indigestion. But if associated with pain down your left arm, it is usually more serious. Abdominal pain might be gas, but if you have a temperature of 101 also, then you need to see a doctor. Swelling of your leg is common, but if associated with the SIGN of redness and pain, it might be thrombophlebitis. Cloudy urine might be normal (e.g. vaginal discharge might cause this) but if there is associated burning, you have an infection.

Aspirin is good for fever, as is Ibuprofen. Tylenol is good for fever, and also for pain. Aspirin and Ibuprofen are good for inflammation, Tylenol more for pain. You can take Aspirin for mild pain, and if it does not work in 30 minutes or so, you can add Tylenol. But don't take Aspirin and Ibuprofen together. Aspirin and Ibuprofen can upset the stomach and cause indigestion.

A sprain will go away; a fracture will continue to cause pain. If you have an injury that persists, see your doctor. This can be said for just about any injury or disease - if it doesn't go away, have it evaluated.

Infections should not be treated by steroids. For instance, if you have a skin infection, don't put a steroid cream on it. It will make it worse. Steroids can be used for inflammation, but not if a wound is infected.

Vaginal odors usually mean infection, and should be evaluated.

A cold or cough with green or yellow sputum should be evaluated and probably treated with an antibiotic.

Menstrual pain usually can be alleviated with oral contraceptives. After 3 months on OC's if the pain is still there, it should be evaluated.

If you are not sure if a condition is an emergency, err on the side of safety and seek medical advice. And always use common sense.

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Antibiotics are useless for viral infections. Don't ask for antibiotics--but if you have an infection, and your doctor prescribes antibiotics, TAKE THEM AS DIRECTED.

Don't suddenly discontinue a prescribed medicine without discussing the decision with your doctor.

Scalp wounds, even minor ones, bleed copiously. Yes, stop the bleeding, and seek medical attention if necessary, but don't panic.

Most doctors are not money-grubbing fiends after all your cash. 

And yes Homeopathy is useless.

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In case of injury apply ice to control the bleeding as well as the resulting tissue swelling. Fresh injuries should never be given Heat therapy.
After a burn pour cold water on the area to cool it and control further damage to tissues.
If you hit your finger nail while hammering a nail then immerse it into ice to control pain and bleeding before you see a doctor.
Do not try to control pus by simply having antibiotics. Pus anywhere has to be incised and drained and not just suppressed with antibiotics. If you try to suppress it with antibiotics only then it results in a condition called Antibioma which is difficult to treat and becomes a chronic indurated mass which might at times suppurate. 
Sore throat is best treated with Warm Saline Gargles.
If you break a bone immediately try to immobilze the limb on a wooden splint in order to prevent any abnormal movement of the broken limb and avoid further bleeding, injury to surrounding tissues by bone splinters and to relieve pain. Then you should move the patient to doctor. Avoid any tight constricting bandages which might obstruct the blood flow to the distal limb.
Nails of the toes have to be cut straight and not rounded off at the corners to avoid developing Ingrowing Toe Nail.
In high grade fever or Sunstroke apply cold sponges on the body to reduce the temperature before proper medical help arrives. Even a cold water bath can be given to prevent very high body temperature and its complications.
If you suffer from Diarrhoea - keep drinking large amounts of water mixed with some sugar and salt and a dash of lemon till IV fluids are started.

Images of the week

World Photography Organisation has revealed some of the incredible submissions for the 2015 competition
Collection of photos is spectacular, with amazing photos of wildlife and some of world's greatest landscapes!!!

My first operation theatre day

Operation theatre is an extremely important component of a surgeons life. The anticipation of witnessing live operations was running high. Like every new thing, it also possesed its phobia, thus   it would be wrong to say I was not worried at all.  Yes, it did make me worry.
Operation theatre, as I saw works upon three sets of  people.  The doctors including anaesthetics,nursing staff and the patient. All of these three are dependent upon each other.  Patient doesn't count much but even then what will anyone do if patient isnt there.
My observation at first

People in the operating room wear a protective cap covering their hair
masks over their lower face, covering their mouths and noses
long gowns, with the bottom of the gown no closer than six inches to the ground.  As ny duty was in a operation theatre 2 that was dealing with cholelithiasis through procedure called laproscopic Cholecystectomy (gallbladder removal)
The surgeon may also wear special glasses that help him/her to see more clearly. The circulating nurse and anesthesiologist will not wear a gown in the OR because they are not a part of the sterile team. In our setup where there is definite shortage of staff and equipment, one doctor has to do atleast 4 operations on his/her OT day. That doesn't give time to doctor to take longer time. 50 mins to 90 mins average on one laproscopic Cholecystectomy operation.  Thats how it goes in government sector in Pakistan.

Quote of the Day

If you don't know where you're going, any road will take you there.