PLAB 2 Secrets

Discussion in 'Plab 1 and 2 forum' started by Jeers, May 8, 2005.

  1. Jeers

    Jeers Guest

    Dear Friends,

    I have passed the plab 2 & as a token of thanks to the help I got from the forum I will post the useful tips I learned during the preparation for plab.

    Today I will tell you about some general facts as well as the secrets about history taking.

    The most important thing I felt during the PLAB2 exam was not to loose your cool while facing the exam. Exams naturally makes us tensed.But remember a fail in up to 4 stations will still get you a pass.
    So even if we loose a station you can make it up in the next station.
    But if on the other hand if you think about the bad station you had during the exam, there is high chance of performing badly in all the subsequent stations.

    What is fail?

    To get a D in the stations is a fail.
    But you can still pass the PLAB test with 4 Ds
    An E is called severe fail
    But 1 E is a pass,greater than 1 E is a fail in PLAB 2

    TO fail PLAB 2-

    4D & 1E( ie any thing grater than 4 D)- 5D/ 4D + 1 E

    2E ( one may get E in plab stations only for gross mistakes)

    HISTORY TAKING SECRETS

    In history taking if you examine closely there is a definite pattern of questioning.

    The important things to remember are

    1. First rule out the life threatening causes
    2. Ask important questions about the common differential diagnosis in this country
    3. Go in a pattern

    -GRIPS
    -presenting complaints
    -duration
    -associated complaints
    -important d/d s
    -past history
    -personal history
    -family history
    -medication h/o
    -h/o allergies


    This pattern helps you to remember all the points if at all you missed any.

    Let us take an example
    Case:
    A young lady came to you with headace. Thake h/o & discuss D/d

    So the first thing to do is to think of the
    1. Lifethreatening d/d- Space occupying leasion, Sub arachnoid hemmhorage
    2. Common d/d- migraine, tension headace, glaucoma,

    By ruling out the life threatening causes you are proving to be a safe doctor. which is the vital thing they assess you for.

    You may think it is a big game , but read my experience. I got a lady with menorrhagia-( it was early menopause)the diagnosis was obvious in the first few questions.I was relieved. So when i was thinking what other d/d s to ask as menorrhagia has a long list of d/d s. I just asked her is there any thing you wish to tell me. So she said-Doctor 1 of my friends had cancer, can I have cancer?
    So I got the clue & asked her questions regarding cancer. I noticed my examiner making a tick mark as soon as I asked the questions to rule out CA.

    2. Next comes the common d/d s. It shows that you know the common things in this country. Migraine is quiet common cause of headace than sinusitis.Remember you have only 5 minutes-Priorites questions and ask only the relevant ones.

    In all the symptoms establish the Duration , & severity-
    ask-how long you are having the problem(duration)?
    Do you think this is the worst headace in your lifetime( severity-also gives insight into importaint d/d in this caseie sub arachnoid hemmhorage

    3. Associated symptoms
    In head ace you can ask about associated symptoms like- vomiting( here you ask -do you throw up when youn have headace/ do you have sickness?- it gives insight into migraine
    Also visual symptoms

    4.D/d s-that clinches diagnosis-
    eg: Do you feel like a tight band tied around your head-tension headaces
    Do you have any problem with your vision-glaucoma

    Past History
    Relevant past history is very important to reach a diagnosis

    Here ask ' Did you have similar episodes in the past?'
    Here in head ace if you establish this it points towards migraine which is episodic

    Personal history
    Smoking, Drinking & drugs could be asked here according to relevance
    Bp, DM status could be asked.
    Hera it is relevant to ask about BP in headace as it can pre dispose to SAH -a lifethreatning cause of headace

    Family H/o
    Relevant in stations like Chest pain, breathlessness-asthma, migraine

    Medication h/o
    This is very important in h/o taking stations as most of the people are on some kind of medications.
    Don't ask -'do you take drugs?'- as drugs here means intoxicants
    It is rather good to ask-are you on any medications/tablets
    In this head ace case it is very important to take a medication history as contraceptive pill is a very important cause of head ace in young ladies.
    So you miss it -you miss the important triggering factor.

    Don't forget to ask about allergies
    as it is very common in this country-some may be allergic to ibuprofen or some medication- by asking this you are proving to them that you are not only a safe doctor but also knows about it.

    Alway keep a psychiatric angle in these stations-
    1.stress can ppt headace
    2. Depression can ppt sleeplessness
    3. Anorexia can ppt wt loss



    So going in a pattern will help you to remember most of the things .
    And pattern also carries marks.

    So once more any thing you forget in history taking don't forget these 3 things
    Get the importat d/d s first into your head as soon as you read the station
    1. Rule out life threatening causes first
    2. Then rule out common d/d
    3. Go in a pattern & dont forget to ask about medication & allergies h/o

    4. In the end wind up by asking -'is there any thing you would like to tell me?'- this helps in a great way to cover up any thing you missed
    So to wind up
    Friends
    H/o stations are no fluke. It is a tough station if you don't know what to ask.Always 2-3 stations or more you get in every exams.
    Remember in a history station you can't cook up any thing if you are clueless( unlike the councelling station). Even the most well prepared can get mental blocks in this station as to what to ask.
    So dear friends wish you all the best
    Success is not an overnight phenomenon
    Some make it fast but most make it by hard work.

    So Prepare ,practice & practice ....
    God will never deny you anything if you have put the effort
    I will post COUNCELLING SECRETS next week

    Bye for now
    Jeers
  2. Guest

    Guest Guest

    Thanks
    May Allah bless u
  3. Shipra

    Shipra Guest

    That was very helpful....thanks a lot Jeers.
  4. satya

    satya Guest

    that was very good . thanks
  5. Jeers

    Jeers Guest

    CRACKING OPEN PSYCATRIC CASES

    Dear Friends,
    Thanks for the encouraging replys.
    I am happy to know that at least some of you are benifiting from it.

    Today I will discuss a tough h/o taking topic

    CRACKING OPEN PSYCATRIC STATIONS-the nightmare at history street


    If you ask me which is the worst h/o station you can get , I have only one answer-psychiatry stations

    There are 2 importaint resons for this:

    1. Some don't even thing that they have got a psychiatric station
    2. It is very tough to get them to talk


    It may sound strange-but this is true

    Listen to few true stories that happened to few of my friends

    Story NO:1

    This was the H/o scenario

    An old lady was having sleeplessness. She was getting up very early & was tired all day.
    When asked she told that she was taking some medications for RH:arthritis-she poured out a long list of tablets she is taking.
    OK-arthritis. The candidate immediately got the diagnosis.He lashed out-Dear your tablets might be causing the sleeplessness.(he thought some of the tablets she mentioned...some of the names he was hearing for the first time...was the source of her sleepless night). He continued-dear I will get the tablets checked by the senior & change the tablets for you(brilliant!!!!! he has asked for senior's help-not only is is smart now he has proved that he is safe).The lady kept on asking -Is it the tablets that is causing it doctor?????? He answered ...yews...yes...& yes. The 5 minute bell rung & he walked out of the station with an air of achievement.

    But unfortunately he failed....

    Why?? Didn't he get the diagnosis????

    Well it was a psychiatric station-with the lady with Depression

    The reason was that her husband died few months back.

    Let us see what all clues he missed
    1. Any person with a c/c disease c/o sleeplessness suspect depression
    2. He ignored all her clues & stubbornly stuck to his diagnosis
    3. If he used his common sense(which leaves through the back door of GMC building as soon as we enter the building for plab) to ask what do you think is the reson for your sleeplessness. she would have told about her husband's death

    [b]Story no:2[/b]

    A young girl brought by her mother with weight loss.Take history

    The canadidate Mr.X read the station...bingo !!!!! anorexia nervosa
    He thought ...cool!!!!! It is going to be a walk over.
    He entered the station and started firing a volly of questions.
    How long have you had wt loss? How much wt in what time....

    He couldn't complete the question the girl barked at him....

    What do you mean doctor.....!!!!!
    I have not lost any wt....

    Boom.!!!!! Mr X was shocked . He never expected such a hostile approach from the patient. His confidence was shattered & he started to sweat.O my God!!!! what now to ask.
    He tried to be nice but that anorexia girl refused to open her mouth after that as if she her batteries were down after the initial fire.
    Ding dong. The bell goes & the candidate leaves the station with able to ask the great SCOFF(hope you guys know the classical Qs for Anorexia)
    questions he had mugged up with great effort!!!!!

    What went wrong here???

    1. He couldn't ask the right question to make her talk.But he never forgot to ask the wrong questions that will mess up the whole thing.Let us rewind & see...

    Mr.X entered the the cubicle.
    Saw a young girl sitting in front without looking up at him.
    What he should have done.-was to Greet & introduce & then
    ask.
    - Miss.Y Your mother seem to be very worried about your wt loss. Is it OK if I ask you few questions about it.
    OR
    You seem to be very worried about something , can you please tell me what exactly you are worried about?
    British people like others to reflect their thoughts when you talk to them.
    If he is happy ask ' You look very happy, yould you mind sharing it with me'

    If you ask the first question Miss.Y will tell you you that her mother is worried about her wt loss......
    And bingo! she will continue to talk to you

    3. Another important thing is to show empathy to the patient
    ie you should not shoot questions at then but listen & say -' I can understand that you are worried , do you mind if I ask you few more questions.
    4. One should always go into a psychiatric station expecting surprises. Patient may shout at you OR he may just refuse to talk. Both are very embarassing. The GMC is not playing dirty trics at you. This is the way psychiatric cases behave in real life. An anorexia girl is mostly an angry young girl who denys that she has lost weight

    To most of us such a hostile approach from the patient is too much & we panic.
    The moment we panic is the moment we loose the station.
    So anticipat such situations in respective scenarios & don't get carried away by the patient's reaction.

    Why I went in so much detail was that
    Many Titanics have sunk striking the
    icebergs of Psychiatric H/O stations

    I hope at least some of you out there will agree with me on this.

    So good luck friends
    Wish you all the best.
    May God give you all, the chance to enjoy the fruits of your hardwork powered by your dreams

    with regards

    Jeers
  6. Kanchan2005

    Kanchan2005 Guest

    Hey Jeers ! Keep up your good work...its really helping us a lot...we extend all our good wishes and prayers to you. Wish u every success in life. :)
  7. tanious

    tanious Guest

    thank you very much jeers

    your message is very helpful and transparent....i wish you the best .... and no wonder you have passed....

    i am very afraid of the plab 2 exam as i don't have any practical experience here in my country and i'm wondering if i have a chance in passing the OSCE.

    and what is the course that you found the best....and how much time one must spend preparing for the plab 2.

    i thank you again for your sincere message and i hope you the best
  8. Guest

    Guest Guest

    Hi Jeers

    Hello Jeers...
    Well..i should congratulate you for the way you have put the principles to approach a patient and enter the cubicle...u have a lovely way of narration.
    Ur messages have really been useful in view of approaching a patient...
    Thanks a lot for the advices..keep up the good work.
    Any other advices and suggestions are welcome.
    Regards.
  9. Jeers

    Jeers Guest

    COMMUNICATION SECRETS

    Dear Friends,

    COUNSELLING SECRETS

    Today we will discuss about Counselling Stations.

    Well before starting listen to this story.

    One day Mr.A & Mr.Z were waiting at the train station, Mr.Z looked very worried. Mr.A was bored &badly wanted to talk to someone. So to break the ice Mr.A asked 'Mate you looked worried, What is it?'
    Mr.Z replied 'Well , I am troubled about my dog'. So I will talk to him about dogs & strike a conversation , thought Mr.A
    ' Ok, Dog is man's best friend....... dogs are very loyal.... bla....bla.......
    ...dogs are even more affectionate than wife & kids.... bla.....blaaaa !!!'

    " Stop it!!!! will you " barked Mr.Z , he got up angrily & left.
    Mr.A was shocked. What a rude man , Mr.A thought. I tried to comfort him & he turn my back at me!!!!!!

    What happened here? Why did Mr.Z leave the place in anger. If you want to know that you have to know why he was worried. Mr.Z had a dog which bit his wife & kids & at the train station he was buried in thoughts how to get rid of his dog. This was when he met Mr.A who was giving a lecture about 'dogs-the best creatures on earth'-the very things he didn't want to hear at that moment!!!!!! So do you expect Mr.Z to thank Mr.A & kiss him good bye for such nice words!!!!!!??????

    Well friends, you may wonder what is this story to do with PLAB2. Neither there are dog stories in PLAB2 nor there are dog bites( beware , some human bites can prove very fatal!!!!!)

    I just cooked up this story to expose exactly what happens in COMMUNICATION STATIONS in PLAB2.

    Let us see an example....

    STATION 1:
    A man is getting discharged from ward after a heart attack ,Talk to him & address his concerns

    What usually happens here is that standing outside the cubicle we get screwed up about not knowing what to talk but thinking how to talk about sooooooooo..... many things. Isn't it true
    What all we have to talk.
    Diet change,,Exercise, BP monitoring... Bld sugar... Driving... Sex....Medications... the list is never ending. Is this GMC mad?? How on earth are we going to talk about all this in 5 minutes???? This is always an unanswered question!!!!!

    So what most of us do is that is to enter into the station & say A-Z about all this -or rather how much we can squeeze in in 5 minutes. We get out of station happy that we said so much or worried thinking whether we missed out anything.

    The good thing about Communication Stations is that most don't fail it compared to examination stations & history stations. But beware, if you are unlucky to get D in communication station , Ds may add up for doom.....As we all know there will be 3-4 communication stations in every PLAB2 exam & they are fairly simple if you know how to tackle it.

    Here the most important thing we miss is to 'address their concerns'
    That is why exactly why we have communication stations.
    in simple terms it is to ask them about the concerns & talk to them only about what they want to know rather than pouring out what all you know about the topic!

    Keep in mind in certain communication stations if we fail to address the concerns of the patient the examiner may fail to address our concerns in the mark sheet!!!!

    Let me relate my experience.
    I got a communication station where I had to talk to a young mother having a kid with epilepsy. It was written specifically talk to her & address her concerns.
    Well we all know so much about epilepsy that we can talk for hours about it. See what all we can talk
    what is epilepsy?
    Your child can have recurrence
    So take medication
    School
    Holiday trips...
    Discos...
    Drinking..
    Carbmez....sun creams...
    If she has am attack what to do.
    ... bathing.......

    Well the list is never ending.

    So I entered the station & after introducing myself & said. So Mrs.W , you are happy that your daughter is getting d/d today, I have come in to talk to you about her. Is there any thing in perticular you want me to talk about.
    She said, ok doctor I want to know about her schooling... discos...whether she can swim , cycle.Thank God, I was relieved. I just talked about only what she wanted to know & got well enough time. When the bell rang the patient was happy & I was even more happy.Said bye bye & left.
    Just imagine if I started from what was epilepsy... I might not have got enough time to talk about cycling & swimming about which she wants to know( or rather points which carries marks)


    Station 2

    There are other types of communication station where you have to demonstrate how to use some devices
    Well my friend got a spacer device.
    Here we have to explain to him how to use the spacer for his kid.
    Here we have to clearly show him how to fit in both the conical halves , which opening goes into the mouth & which one for inhaler.
    It is extremely important to demonstrate to him once completely.
    My friend was very keen on talking him about the inhaler. The patient stopped him in between & said that he knows about inhaler & wants to know only about spacer.At last you have to ask him to do it for you once ,to check if he understood what you said. Checking to see if he understood what you said also carries marks. He demonstrated to my friend very nicely how to do it at the end when he asked the patient to do it for him( well he did it better than my friend ... what a nice trained actor he is !!!!!!) My friend was happy, then the patient asked him 'Doctor , did I get it right?' Well we have to acknowledge the patient for his newly learned skill. 'well , you did a fantastic job, dear!!!!'my friend replied.
    My friend asked him if he had any thing else he wanted to know.
    He wanted to know how to clean it & when to give it?
    So it is always important to involve the patient in the conversation which will help you to know what he wants to know.

    So in short the golden rules are

    1. Never forget to address the patient's concerns- ask then what they want to know specifically rather than giving a long lecture. Because only the points what they want to know carries marks
    2. Involve them in the conversation- they will give you hints as to what they want to know. Make them talk rather than you do all the talking.
    3. Ask in between-'Are you with me/ do you understand' It shows the examiner that you are really interested in patient's understanding rather than displaying your knowledge.
    4. For God's sake avoid medical jargons. 'A growth in your large bowel is better than carcinoma colon'. One of my friend talked about 'First line management'- the patient asked him 'What is that doctor?'
    Using medical jargon's isn't seen as a display of your knowledge but is seen as your inability to communicate effectively to the patient'

    Communication stations are relatively easy but form a major bulk of plab2 exam. Here your skill in conveying ideas effectively is tested.



    Dear friends
    I wish to sell out some of the PLAB2 materials which came handy for my preparation. They are

    1. London PLAB Handbook
    2.Past Test-PLAB2 made easy
    3.A-Z of PLAB-part2
    4. Communication skills -2 audio casettes
    5. Otoscopy & opthalmoscopy slides -1 CD

    AIPPG STAFF: post for sale ads in Marketplace forum only

    So keep in mind in communications stations

    Talk about what they want to hear
    Rather than what you wany to say


    Next week I will discuss about a tough communication station that can get you into trouble.
    Well you gussed it right-BREAKING BAD NEWS

    So we will discuss "BREAKING BAD NEWS WITHOUT BREAKING YOUR BACK" next week

    Thought for the day:

    [i]Don't be bothered about the boy next door who made it
    But let's be on the right track in the right direction
    [/i]


    Bye for now

    Jeers
  10. AKIN

    AKIN Guest

    I believe God sent you to this forum.I am anxiously waiting for your next post.I wish you the v. best of luck as you look for jobs.
  11. Guest

    Guest Guest

    i mailed u but got back my mail
    i am intrested in
    Communication skills -2 audio casettes
    how much do they cost
  12. Guest

    Guest Guest

    Jeers... you have an excellent way of presentation...you have got the knack of it I should say. Lots of good wishes for you... :)
  13. Jeers

    Jeers Guest

    Breaking bad news without breaking your back

    Dear Friends,
    Thankyou once again for your encouraging replys.
    It is wonderful to know that this information is helpful.

    Today we will discuss the toughest communication station-breaking bad news

    BREAKING BAD NEWS WITHOUT BREAKING YOUR BACKS

    Well, one day a gardner decided to go for a long trip. But he couldn't find some to water his exotic potted plants. 'If it is not watered it will dry up when I come back'., he thought. 'so I have to find some solution to keep my plants from drying.So he decided to pour a bucket of water into each flowerpot so that they will have enough water for a week. So when he came back after the trip, he found his plants rotten in a pool of water. 'O,! God, It was better to leave to dry up , now I am responsible for the disaster. So to pour a weeks water at the base of the potted plant will not serve the cause instead of watering it daily. The quantity of water we give is the same. But the way we give it does really matter.

    Now friends, this is the cardinal principle behind breaking bad news. Any lay man can go & tell the relatives that the patient is dead/ having cancer.But he will have no control of the way patient takes it & he will be totally responsible for the aftereffects.

    Breaking bad news is an art -a skill which is as priced in this country like any other medical skill we acquire. Now do you understand why we are send results as not ' YOU FAILED' but as ' SORRY TO LET YOU KNOW THAT YOU ARE UNSUCCESSFUL THIS TIME'. Both conveys the same message- but it is in the way it is said that makes all the difference.

    Well there are only 2 common scenarios you can get in PLAB test on this
    1. Patient died in ward-taly to relatives
    2. Patient has cancer(ANY)- talk to patient or relatives

    Breaking bad news is a big issue in this country.
    Even Consultants take it in a really serious way in this country.
    Even the seating is arranged before breaking bad news.

    Story 1- How not to break bad news

    A man was admitted to the ward with fever. He died today morning in the wards out of some sudden cause. Break bad news to his wife.

    The canidate walked into the cubicle . Saw a lady sitting in the cubicle. He sat down-his chair was quiet far away from the patient. 'Why can't they put the chair a bit more closer, now I have to shout & tell her ', well I will manage , after all it is 5 minutes business', he thought. Well Mrs. x, I want to talk about...your husband.... ' he couldn't complete it, the lady anxiously asked-'what happened to my husband , doctor.... she started to chant the same statement as if a tape recorder was on. 'Well, Mrs.X. , he broke in ' I am sorry it is not good news , your husband passed away' What doctor, 'again he went to the loo with out calling me for help' 'No , Mrs.X, I am sorry to tell you that your husband is no more...'

    Booo...Boooo.. the lady burst into tears. The canidate got up set at this oscar winning prefomance. He searched his mind as to what to ask next. Well , Mrs.X don't worry, he died a peaceful death..... we would like to do a postmortem.....' Who cares, the lady is busy crying-she didn't bother to listen to him any more. Well she found happiness in crying till the bell rang. The poor canadite was even more upset & left the station after a failed attempt to stop the lady cry.' How many questions I have memorised to ask her, Only if that b**** stopped crying can I ask any thing more.!!!!! Well this did reflect on his perfomance in the coming stations

    Well needless to say he failed!!!

    Let us see where all he went wront.

    1. He didn't do the initial prepration.- We don't barge in & speak out a bad news. You have to say that you will take the patient to a silent room. Give your bleep to your mate & tell him where you are.

    2. GMC is not careless to leave the chairs wide apart. You can't sit at another corner of the room kilometres away & break a bad news. You have to bring the chair closer to the patient 's seat & assume a suitable body posture & break bad news. The GMC was trying to see the canidate's knowledge about the situation by putting the chair far apart.

    3. You have to ask the patient if she wishes to have some one with her at that moment. This shows your concern for the patient.

    4. Don't use beautiful metaphors like 'passed away' ' his soul attained unification with the Almighty' ' he attained moksha.....!!!!!' JUST SAY
    'HE DIED'.

    5. Now she will weep . So now STOP... STOP...STOP.... for God's sake( if you want to pass this station)
    Say' Are you allright,
    Would you like to have some tissues
    Would you like to have a glass of water.'
    All these shows that you are empathising with the patient.
    Now ask' Is it OK if I continue, or do you want me to come back later?'
    This shows your understanding of the situation. So in almost all cases she will ask you to continue. If you fail to handle this situation she will prefer to see you again after 6 months!!!!
    Now she is ok & she will continue to talk to you.
    If you have handled it effectively till this , you have passed the station, as rest is not relevant.
    If you continue to fire questions at her when she is still weeping nothing will happen.

    In cancer case few more points are to be noted.

    1. Always remember to talk about what you can do for her to make rest of the life better like analgesia ( pain is an important issue in cancer which you have to address)...Mc Millian nurses....Hospice...Support groups...Societies...leaflets.

    2. If she ask 'when will he die Doctor ?' NEVER COMMIT A TIME- even if it is written outside the station that he will live for only 6 months.
    just say ' I am Sorry, Mrs.G -I cannot answer this question, Let us take things as it comes.'

    So the gist of it is
    GIVE TIME SO THAT THE BAD NEWS WILL SINK IN SLOWLY-NEVER RUSH
    SHOW EMPATHY & UNDERSTANDING

    This is the safest way to shake off this question.
    That is it , I hope others can relate their experience

    Thought for the Day
    Well it is again a story...

    Two friends Tim & Tom set out in search for the treasure into a huge cave. .Soon they lost their way in the cave & now tired & desperate,they now started the search to find the way out of the cave. Both knew that a map was hidden somewere in the cave which showed how to get to the secret tunnel that led them out of the cave. Every day both went out from the main cave through the many tunnels to find a way out. When they were back at night Tom asked 'Tim, any luck?'
    'No, not at all, 'Tim replied. One day Tom accidently came accross a torn half of the map,' Ereka, if I got hold of the other half I am out of this mess' That night Tim asked' Tom, any luck?' No was the reply, as Tom didn't to share the hard earned secret with his friend. Well the search continued for years.... It is fabled that after many years 2 sketetons were recovered from the cave. One was that of Tom who was clasping a torn half of the map. Later the other half of the map was recovered from the torn clothes of the other skeleton lying next to him - well you gussed it right !!! it was Tim's little secret.

    Well friends - Hope you get the message.....!!!!!

    Phir Milange...

    With Kind Regards

    Jeers Bib





    [/i][/b]
  14. thanku

    All ur tips and suggestions are extremely useful. I suggest u to publish a book for PLAB 2.Anyway GOD bless u.[/b]
  15. mo

    mo Guest

    thanks for everybody very useful information.
  16. Jeers Bib

    Jeers Bib Guest

    Manikin Secrets

    Hello Dear Friends,

    MANIKIN SECRETS


    Today we will discuss the important things you need to know in manikin stations.

    Three manikin stations are for sure.
    1.BP
    2.CPR
    3.Sharps station -Venapuncture/Canulation/Suturing/Arterial Blood gas

    Well to be frank- manikin stations are the easiest to pass as well as to fail.
    Because every aspect of this stations depend on practice rather than knowledge.

    Let us see a real scenario

    Story 1
    Mr.M was a smart overseas doctor. He did enroll for a plab course but never though it to be amusing to practice few manikins which he thought were too easy for him. After who wants to go back and learn the alphebets once he has learned the language!!!! Fortunately(for GMC) / unfortunately(for him) he got a IV canula station. He walked into the station with delight as it was a cool walk over. For he knew it just like tying his shoelace. Afterall back home he was famous to get venous access for patients in whom others failed even to dig out a proper vein.
    So Mr. M entered the station, He gave a long lecture of what he was going to do to the invisible patient in the cubicle. He took out the canula & tried for a vein.
    But in the first go he didn't get the vein!!! O ! My god!!!! It was the end of the world for him. Such a misery for me, that too in the PLAB exam!!!!! He panicked. Ok he tried the second time & pushed in the canula. Woo!!!!! I got it at last, He thought. He was relieved & Thanked the patient & left. After all who can challenge me in my greatest skill??? a silly plastic hand from UK, Hooo!!!!!
    He reflected.

    But sadly when the results came the plastic hand ditched him!!! AND HE FAILED!!!!
    Let us see what all mistakes he made.
    1. He explained procedure to the manikin which is not needed. You are mainly expected to talk about the essentials only in brief to the examiner & not to manikin. In this station mainly the skills are tested & not your communication Skills. THe main thing you have to do in this station is to warn the patient that a sharp scratch is comming up.Most of the examiners will say that 'Ok doctor, please proceed(as time is wasted by talking-the time which should be utilised for thr procedure)

    2. He panicked when he didn't get venous access initially.& he reused the same canula. This is a fatal mistake. Not to get vein in the first attempt is not a crime!!! But if such a thing happens, what we are expected to do is to a) Discard the canula into sharps bin b) take a new one c)apologise to patient & try again ( not to keep on banging with the same needle)

    3. When he panicked , he forgot to discard the needle into the sharps bin.
    REMEMBER IF YOU FAIL TO FEED THE SMALL YELLOW BIN IN THE CUBICLE IN ANY OF THE SHARPS PROCEDURE YOU WILL FAIL. THIS IS THE MOST IMPORTANT THING EXPECTED FROM YOU IN THIS STATION
    4. Many forget to take off the torniquet which is seen tied to the hand even when the canidate leaves the station. This is considered as bad practice.

    5. Excert for U.catheritisation you get plenty of time to do the procedure- so you don't have to rush through & make mistakes.

    6. To do procedures under aseptic precaution is important in U.catheritisatn & suturing. Some find pleasure in scratching their head after they wear the gloves-which will end up in a bad way.

    7. In venapuncture, you need to label the blood bottles in plab. One of my friends pretended to label it with an imaginary pen-So the examiner asked him are you going to label the bottle / not Doctor? They expect you to label bottles before them. It is common as we want to assume that as well because we assume so many other things for PLAB.

    8. Manikin stations is practice & practice only.It doesn't matter how many times you have done it overseas , if you don't learn to do it in the way it is practiced in this country , you may find it difficult to pass.

    THOUGHT FOR THE DAY
    Hights by which great men have reached & kept were not attained by a sudden flight,
    But they when their companions slept, were toiling upward at night.


    So friends
    Wish you all the best

    Phir Milenga

    Jeers Bib
  17. plab2nirvana

    plab2nirvana Guest

    hey JEERS

    i ahve failed in plab 2 i took in May and unfortunately i still dont know how to pass.... i had taken the plab swamy course..... and wont say they didnt teach well but maybe coz there aint any individual attention i couldnt find my weaknesses .. though its understood i must be not up to the mark at many places thats why i havent made it in my first attempt...
    can yu suggest any particular way i should take now..... i m from a decent college from india... among the top 5 ... and i scored respectable marks in my plab 1
  18. Guest

    Guest Guest

    thanx mate................ur skills are really admirable,esp your style which glues one and all and very compulsive to read it up but Surely puts the message across...
    Thanks mate for all the help.
  19. sunita

    sunita Guest

    thank you

    to be funny in serious situation is an art and you have got it your reveiws have kickstarted my preparations of plab2 thanx :p
  20. ..

    Hi .. thank you for your efforts ..and congrats for passing the exam .. Let me tell you that I'm one of those who r very familiar with all of this ..actually I was teaching them to my classmates in one of the courses..and everyone was saying... u r definetly going to pass .. u r going to make a hell of a doctor ...etc.. except that I'm already a doctor.. I always knew my abilities in communicating with patients...and people in general .. i'm this kind of person who listens more than he speaks.. and I've helped getting many of may patients off the edge ..although I'm not a psychiatrist...but at the end..I'm their doctor..

    anyway .. after the above intorduction .. I have to say that I've failed the exam ... the severe failure was not in an examination station...or a history taking.. or breaking a bad news..or even in a maniken... I even managed to get a depressed psychiatric actor to talk and calm down ( I got a B in this one ).. but i failed in a simple GOUTY patinet counselling .. dunno what I missed .. I let him talk for what seems like hours.. i answered whatever he asked me.. I offered pamphlets and websites ..if I could choose one station out of 14 that I definetly sure of passing ..it would be this one.. But, instead , I didn't get a B , or a C , or a D , I've got an E , a severe failure !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    Dunno what to do about it ..I'm planning to set the exam again .. but I've lost every confidence in the fair grading of my performance in the exam ... I thought of complaining to the GMC ..but then i thought.. no one is going to give a damn about u.. so let's face it .. I lost the firts chance.. and I hope that I'm not going to lose the second one..inshalah..

    Thanks again bro...all the best
  21. DR_ AN

    DR_ AN Guest

    v informative!!!!!!!

    plzz contiue sending us ur posts
    they r extremely helpfull !
  22. DR-AN

    DR-AN Guest

    london handbook of plab part 2

    i do need that book .. how can i get it ??
  23. Guest

    Guest Guest

    Hi Jeers

    Hi Jeers

    I would like to get some information from u,and that is, would u let me know what books to read for the part II Plab.(Do we need to read the OHCM and OHCS books again in detail) At Present i am reading london Part II Plab book.Iwould be interested in purchasing the material from u(especially the audio cassettes). if u could let me know the price of them and if u could give me ur email address or phone number.On the other hand, if u have already sold them would it be possible for u to let me know from where we I get the same materials.

    In anticipation of a very quick reply.

    Thankyou.
  24. Jeers

    Jeers Guest

    EXAMINATION SECRETS

    Hello Dear Friends,

    It is a long time since I had posted replys. I was in a web free world for quiet a long.
    Any way I am happy to see a wide range of responses.

    Well I feel sorry for the person who send in a message in desperation. Well I can understand the emotional turmoil you are going through. Well dear friend, Just remember one thing...
    We are not Gods to be perfect. We do make mistakes ,learn valuable lessons from it so that we won't repeat it. That is why we tred on the earth as human beings .So give space for yourselves to make mistakes & learn from it. You may say it is easy for any one to give philosophical messages.
    Dear friend, I have seen people who had only tastes of success, they passed all exams in the first go, were lucky to get jobs in no time, move around bragging about their success & luck, trying to put down all others who were less fortunate than them. I know a guy who fitted to this catagory, but now he is packing his bags to go home as GMC has decided to cancel his registration as he found pleasure in perfoming an intimate physical examination on a female patient without a chaperon. I feel sorry for him as he was among the lucky guy who got every thing you can dream of in no time.It is better to make mistakes in exam & learn a valuable lesson than make mistakes in life that may seal ones fate.
    So don't think that failure in an exam is the end of your life .Sit down ,Reflect & find out where you went wrong.Identify your weak areas & work on it so that you will never ever make those mistakes again.
    Every one whom you may look upto as successful has gone through many failures in life. The only difference is that he never let failures weigh him down, but turned every stumbling blocks into stepping stones .

    So dear Friend , Cheer up, this is not the end of the world. One day you should look back on your failure as a incident that made you stronger rather than as a disaster that caused you to crumble. YOu will succeed , just make sure you won't give up before the success reaches you

    By the way about the books for PLAB, I don't think Handbooks are
    essential for PLAB2, If you have time to go through it ,well & good.It will be useful if you read the VIVA topics from it.
    Regarding the Books for PLAB2, different people find different materials useful. I choose not to promote any material through this site. But if you are keen to know what i found useful.Mail me at
    jeers2005@yahoo.com

    For the person who showed interest in the material I used in my preparation, please mail me at jeers2005@yahoo.com or leave your mail & I will contact you.

    Today we will discuss few
    EXAMINATION SECRETS

    Examination in PLAB is wierd. You may see 2 testicles sitting on the desk and smiling at you when you enter the cubicle to a sulking man wearing a breast prosthesis waiting for you to have a feel of his plastic boobs.!!!!

    Examination is among the few stations where practice with a partner turns out to be very useful.
    The core of good examination is
    1. Systematic approach towards examination-Step by step approach towards examination carries points. They don't expect you to do the palpation & then describe the inspection finding. Even if you forget a inspection finding & it strikes you at the time of palpation leave it. You can summarise it at the end.
    2. In most of the examination stations- you may find it hard to finish it in 5 min.Not finishing it doesn't mean that you will fail that station.
    Practice will help you a long way with this. If you find it difficult to finish at the 4.5 min bell-don't worry.
    When you hear the 4.5 bell stop your examination & summarise what all you wanted to do in a systematic manner. To rush to complete examination at 4.5 bell will mess up everything.
    3. Explain properly what you are going to do-to the patient briefly at each step. What I meant was that in a live patient it is bad to treat him like a log of wood & rush through the examinations.It is taken very badly if you cause pain to the patient.
    Try to be as gentle to the patient as possible .So when you do abdominal examination( esp-Mc-burny/Murphy's) look at the patient's face rather than admire the beauty of his tummy.
    If he grimmaces in pain,apologise to him for causing pain & proceed.
    4. Certain positions of examinations are cardinal-Eg.1.Thyroid should be palpated only from the back2.Mention that Testis will be palpated in the standing position
    6. Always remember to examine the associated systems- In breast -never forget to palpate the lymphnodes. as well as the other breast.

    7. [u]Orthopaedic Examination[/u]
    It is lengthy & so go in a systematic manner of-look,feel,move +special tests
    The 2 thing you should never forget in a joint examination are1. Distal neurovascular status-ie distal pulse & sensation 2. Special Tests
    So in short- These examination stations are the ones where practice alone will give you the edge.

    So remember finishing the examination is not the agenda,
    But how much systematically & gently you can proceed with the examination in 5 minutes is what they are looking for.


    So wish you all , all the best

    Phir Milange

    Jeers Bib
    jeers2005@yahoo.com
  25. Guest

    Guest Guest

    jeers i tried sending u email but its retrned twice saying address has fatal errors:-(((..pls email me mrcppart1@yahoo.com
  26. Cheers Jeers

    Cheers Jeers,

    that was amazing... but the best of all is...'he never let failures weigh him down'.... in ref to a succesful person. this is cool man.

    rocking dude.

    Im here in this country for 9 months, trying hard to get a job, luckily at the moment doing locums... but this is my fav linee.

    Goin thru ur msgs for the first time over the last 10 mins..thinking abt appluding u for the great work...but couldn't as I am again another lazy bugger :wink: .

    This line somehow struck me hard n made it inevitable...

    Coming to the fren who haven't made it thru exam... bhai ..there's a song in my lang 'parigedadam parigedadam gelichevaraku parigedadam'... it means we'lll just keep runnin till we succeed. Aisa hi hai London/UK. Jeethna hai tho Baghnaa hai. Sorry, daudnaa hai. We shall never giv up brooooo. Take care n gud luk wid ur exam.
  27. Guest

    Guest Guest

    good job

    good job, thanks for so much help.
  28. Ugwuoke A,O

    Ugwuoke A,O Guest

    Re: Breaking bad news without breaking your back

    I just arrived London for the plab part 2 test. Going through you guys writings has turned a nightmare into reality for me. I even think reading your write up alone is enough for the exam. Please keep it up. :lol:

    Ugwuoke A,O
  29. Guest

    Guest Guest

    Thnx for the helpful hints.keep up the good work
  30. relax

    dear friends,
    i just got my results three days ago and was very happy to find out that i had passed in my first attempt.also i did not attend any coaching centers only read london plab handbook part 2, that was more than enough.

    the first thing that i can tell u about the exam is that u have to relax, u have done five yrs of medical training do not forget that. there is no way they can test ur medical knowledge in five min but they can test whether u are a safe doctor or not. as long as u try and make sure that you do not miss something of urgent or utmost importance, you will breeze through it.

    everyone that i know who went in a happy and relaxed mood passed, have confidence in yourself and faith in God. that is all you need!!!

    all the best you guys,
  31. Guest

    Guest Guest

    Thank u for your helping mentality
  32. guest 18

    guest 18 Guest

    Seriously guys,
    Check the job conditons here in UK. Only then think of spending you time/money/efforts/ on PLAB.
    Dont jump into it just because it is there.
    Please think before you leap.
    A sincere request to all from a Post-plabber without a job for>1 year.
  33. Guest

    Guest Guest

    please reply soon...

    thanks for all the info which u have cum forward to share with all of us abt plab 2...twas really very useful for all beginners like me.. can u please tell me when exactly after plab2 do u actually get to study the speciality which u choose??
  34. Concerned

    Concerned Guest

    PLAB SECRETS:

    DONT DO IT!.

    Thats the secret which NO-ONE tells you. The other bit is about....the degrading conditions you will live in whilst looking for the job thats never going to come, the debts you will incur, GMC laughing all the way to the bank with your money,.... did I mention the humiliation when you retrn with empty pockey and a deflated ego whilst your sensible friends have got PG seats!.

    Oh you dont like to hear these things, do you?

    You think I am being selfish.

    You think I dont want you to have a share of the brtitish pound pie.

    You think your Nirvana lies in the UK.

    Well think again.

    If you care about all things that matter to you the most, then listen.

    FOR THE LOVE OF GOD STOP TAKING PLAB.

    DONT GO TO UK.

    IT WILL RUIN YOU.

    Ofcourse you could come and see for yourself if you'd like. Better still why not give it six months. It all kicks off this August. You may meet your seniors in UK back in INDIA in a hurry looking for PG seats.

    STOP WRITING PLAB.

    If by this post one of you has a change of heart then it was worth the effort.
  35. Guest

    Guest Guest

    hai

    :lol: :lol: dear jeer u r way of presentaion is v.good and seems to be very helpful for plab 2.thanks for sparing ur precious time these helpful guidelines.. indeed good enough..keep it up..best wishes for u...
  36. Guest

    Guest Guest

    hi..advise seeker

    hi i want to give plab1 ,can u give me any sagestion how i can easilly pass in one attemp.any secrete,any books should i go through,any emq/sba books
    plzzzz
    i like ur advise on plab2 passing
    plz give me advise on plab 1
    thanxxx
    my email add is ...smarty_nida@yahoo.com
  37. Guest

    Guest Guest

    Thanks Jeers Bib

    I just want to thank Jeers Bib for his very insightful and well presented plab 2 secrets.
    Your comments are very helpful and i encourage others who have passed to help others as well.
    In your case i must say you have a gift for teaching/writing and if you publish 'A short guide to passing plab 2 'it will be well worth it.
    Stay blessed and all the luck in the world to you.
    TESS7
  38. aziz7

    aziz7 Guest

    thanks

    thank u jeers for such a wonderful work... please continue to guide us
  39. Guest

    Guest Guest

    hi

    i am going to take plab2 in feb 14
    feeling scared
  40. Guest

    Guest Guest

    SCARED OF WHAT?
  41. Guest

    Guest Guest

    hi

    what r the books to be read for plab 2 other than the one of the cource
    :?:
  42. valli

    valli Guest

    hi

    i live in welwyn garden city
    need a study partner on line
    taking exam on 14th feb
  43. dune

    dune Guest

    hi valli

    i am also taking the exam 14th.want to be your discussion partner.i wish us the best
  44. valli

    valli Guest

    hi

    thats an exellent idea
    i have started my preparation through the forums
  45. valli

    valli Guest

    HI DUNE

    how is ur preparation
    how can i contact u

    all the best friend
  46. dune

    dune Guest

    hello valli

    sorry dnt get to see ur reply earlier. i registered wit fast track medics in london so i ll join them for the course which starts on the 12th till 17th jan.do u reside in london or outside london?i am trying to read some things b4 the course starts so i can get my bearing and go along.are u male or female. i am a female.suggest how we can get in contact.how are u getting along wit preparation too?
  47. dune

    dune Guest

  48. mugdha1

    mugdha1 Guest

    hi dune

    i have mailed u
  49. JEERS

    THANKS A STACK JEERS! YOU'RE A REAL SAINT CONVEYING YOUR KNOWLEDGE THE WAY YOU'VE DONE. I REALLY FEEL LIKE THESE LITTLE POINTERS WILL BE REMEMBERED IN THOSE TIMES OF SHEER PANIC. I'VE NEVER SAT THE PLAB2 BUT WILL DO SO TOMORROW FOR THE FIRST TIME. VERY NERVOUS! SO THANKS FOR THE ENCOURAGING WORDS. LOOK FORWARD TO THE NEXT ONE!
  50. rafi

    rafi Guest

    HI JEERS
    i have seen u have been really helpful..can u guide me what books shall i follow apart from the course?and what is the best method to practice as i live far away from the course location,and is impossible for me to practice on the manikins once i have attended the course?plzzzzz reply to me

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