PLAB

The Professional Linguistic Assessment Board exam, or PLAB. The plab does not have a linguistic component, for this they use IELTS. IELTS is a pre requisite to plab.

IELTS: 

The IELTS is a test of the candidate’s English skills. It stands for International English Language Testing System. People are required to take this exam to prove they have the minimum acceptable level of proficiency in the English language needed to engage in their academic or work pursuits in the UK, so its not just for doctors. This exam can be taken in many countries, including Pakistan. Currently, it costs around 80 Pounds Sterling and is held twice a month every month throughout the year.

The exam has four sections: Speaking, Listening, Writing and Reading. The result of the test is given as a number on a scale (called band) from 1 to 9. Each band, or scale represents a certain level of competency in English. A score of 1 means that the candidate has only a rudimentary grasp of the language. A score of 9 means the candidate is as proficient as a native English speaker.

Each of the four sections are scored separately on the band of 1 to 9. The individual band scores in the different sections are then added up to give an average. For example, if a candidate gets 8 in Speaking, 8 in Listening, 7 in Writing and 7 in Reading it will give him an overall band score of 7.5.

In order to be eligible to take the PLAB exam, the candidate must have an overall score of at least 7. However, an imposition is made on the individual scores as well. The candidate must have at least 7 in the Speaking section and at least 6 in the other sections. So if a candidate gets 6.5 in speaking, he will not be eligible to take the PLAB exam - even if his overall score is 7 or above.

The IELTS can be taken even while the candidate is still a medical student, although it should be keep in mind that the IELTS result is valid for two years. The candidate must go on to take his PLAB exam within this two year validity period.

THE PLAB EXAMINATION:

The Professional Linguistic Assessment Board exam, or PLAB doesn’t actually have a linguistic component, otherwise the IELTS would not be required. Nevertheless, the ‘misnomer’ remains to describe an exam of a difficulty level between that of final year and post-graduate (i.e., MRC) examinations. It has two parts - PLAB Part 1 & PLAB Part 2.

The PLAB is basically a registration examination that allows you to practice medicine in the UK. In that sense it is similar to the USMLE Steps of the US system. However, there are three important differences between the PLAB and USMLE exams:

• The PLAB exam is considered to be far easier, and less costly than the USMLE exams.  
  
• There are only 2 parts to the PLAB exam, not 3 like in the USMLE Steps (or 4 if you count USMLE Step 3).  
  
• The PLAB is a pass/fail exam. It makes absolutely no difference to your credentials if you pass the PLAB by an extremely wide margin or just manage to get through by a single mark. This is in contrast to the USMLE Step 1 and Step 2 CK exams, in which a candidate’s scores affects the strength of his CV.
  

PLAB Part I
The first part of the PLAB exam, the Part 1 is administered in a number of countries, including Pakistan where it is held three times a year: in March, July, and November. Currently, the exam cost 145 Pounds Sterling.

In order to be eligible to take the exam, the candidate must be a medical graduate (he cannot give it before graduation) from a WHO-recognized medical college and also have the minimum required IELTS score in hand during the time of application.

The exam consists of a 3 hour paper containing 200 questions. The questions are called “Extended Matching Questions” or EMQs - which simply means they are multiple choice questions with a variable number of possible answers to the questions posed of which the best one is selected.  The exam concentrates on the clinical subjects, not on basic sciences. There are also a few questions regarding medical ethics, evidence based medicine, epidemiology, and public health.

PLAB Part II

This part can only be taken in the UK. Recently, the capacity of the PLAB 2 center in London has been expanded enormously, and now the exam will be held several times a month every month, throughout the year. Currently, the exam costs 430 Pounds Sterling.

The Part 2 is a examination of clinical skills - not a paper-based EMQ exam. The system devised for testing the candidate’s clinical skills is called the Objective Structured Clinical Examination, or OSCE.  

When you start the examination, you will go to your first “station” in which you will be given some instructions. It could be taking history from a patient there, performing an clinical examination, or a number of other things. You will have 5 minutes to accomplish your task and 1 minute of pause to think before each station. There are 14 stations in all, with two “rest” stations – so the exam lasts a total of 96 minutes. The primarily skills tested for are:

• History taking and diagnosis based on history alone.
  
• Proficiency at physical examination.
  
• Communication skills with patients.
• Management of emergency cases.
  
  
  These days it is very difficult for people to get a job in UK. Almost impossible. Therefore PLAB is only used to be eligible to get a job in middle east.
  
  
  Note that this is a licensing type exam NOT a postgraduate degree of UK. Those are FRCS FRCP and diploma's are MRCP etc.
  
  
  A Brief detail o MRCP:
  
  
  The membership exams of the Royal Colleges have multiple parts that are given over a space of a few years. Every Royal College responsible for its specialty publishes a Regulation and Information Manual every year that contains details on the different parts of the Membership exam, their formats, the centers where they can be taken, application forms, fees, rules of exemption from different parts of the exam - and a lot more.
  Currently the first part of the MRCP(UK) exam can only be given when 18 months have elapsed from the date of graduation. This prerequisite may or may not change. As we shall see, the NHS is overseeing extensive reforms in the SHO grade and it is quite possible that the membership exam details may be affected by these reforms. One must use only the most current Exam manual from the relevant Royal College to keep abreast of the changing situation.
  The MRCP(UK) Part 1 exam consists of two papers in an MCQ format containing 100 questions each. The composition of the different subjects tested in this exam is as follows; the number refers to the number of questions in both papers that will come from that subject.
• Cardiology 15
  
• Clinical hematology and oncology 15
  
• Clinical pharmacology, therapeutics and toxicology 20
  
• Clinical Sciences 25
  
• Dermatology 8
  
• Endocrinology 15
  
• Gastroenterology 15
  
• Infectious diseases and tropical medicine and sexually transmitted diseases 15
  
• Nephrology 15
  
• Neurology 15
  
• Ophthalmology 4
  
• Psychiatry 8
  
• Respiratory medicine 15
  
• Rheumatology 15
  

Clinical sciences comprise:

• Cell, molecular and membrane biology 2
  
• Clinical anatomy 3
  
• Clinical biochemistry and metabolism 4
  
• Clinical physiology 4
  
• Genetics 3
  
• Immunology 4
  
• Statistics, epidemiology and evidence-based medicine 5
  

After passing the Part I exam (the result is mailed 4 weeks after the exam). The candidate is eligible to sit for the MRCP(UK) Part 2 exam. The Part 2 exam can be given 6 months after the Part I exam if the candidate feels he is ready.

The MRCP(UK) Part 2 exam also consists of 2 MCQ papers of 100 questions each. The composition of the exam is as follows:

• Cardiology 20
  
• Dermatology 8
  
• Endocrinology and metabolic medicine 20
  
• Gastroenterology 20
  
• Hematology/ Immunology 10
  
• Infectious diseases and GUM 18
  
• Neurology/ Ophthalmology/ Psychiatry 22
  
• Oncology and palliative medicine 10
  
• Renal medicine 20
  
• Respiratory medicine 20
  
• Rheumatology 12
  
• Therapeutics and toxicology 20
  

If the candidate fails the Part 2 exam, he is free to try again. The only restriction to the number of attempts he can make is that he must pass this exam within 7 years of passing the Part I exam.

The pass result of the Part 2 exam is valid for only two and a half years. The candidate must sit for the 3rd and last part of the membership exam before these two and a half years expire. He is eligible to sit for the third part of the exam 6 months after passing his Part 2. Therefore, the window of time available to him to pass the third part of the exam is 2 years. This 2 year period is called the Period of Eligibility and begins 6 months after the part 2  is passed. To illustrate: if a candidate passed his Part 2 in April 2005, then his period of eligibility for the third part will start from October 2005 and last till October 2007. If he has not taken the last part within the Period of Eligibility, he will be compelled to retake the Part 2 exam.

The last part of the membership exam is called PACES, the Practical Assessment of Clinical Examination Skills. To quote from the 2004 Regulations and Information to Candidates Manual:

“The MRCP(UK) Part 2 Clinical Examination (PACES) is composed of five stations (three ‘clinical’ and two ‘talking’), each assessed by two independent examiners. Candidates will start at any one of the five stations and then move round the carousel of stations at 20-minute intervals until the cycle has been completed. The stations are:

Station 1

• Respiratory System Examination (10 minutes)
  
• Abdominal System Examination(10 minutes)
  

Station 2

• History Taking Skills (20 minutes)
  

Station 3

• Cardiovascular System Examination (10 minutes)
  
• Central Nervous System Examination (10 minutes)
  

Station 4

• Communication Skills and Ethics (20 minutes)
  

Station 5

• Skin / Locomotor / Endocrine / Eye Examination (20 minutes)
  

The MRCP(UK) Part 2 Clinical Examination (PACES) lasts a total of 120 minutes (including four 5-minute breaks between stations).”

If the candidate passes, he will be awarded the MRCP(UK) diploma.

It should be mentioned here that the MRC diploma, particularly the MRCP(UK) diploma has become internationalized. Training in the UK is not an essential prerequisite to taking any of the 3 parts of the exam. There are MRC exam centers established in 14 countries around the world (Saudi Arabia, Oman, Singapore, Kuwait, and Sri Lanka, to name a few). Pakistan has no such centers, and if Pakistani doctors are training and studying for the MRCP in Pakistan, they must travel to the UK to give them (they cannot go to a non-UK center – those centers are established only for those doctors training there).

There are thousands of MRCs across the world who only go to the UK to take the exam and after passing, return to work in their home countries or seek jobs elsewhere. Obtaining the MRCP(UK) demonstrates a competitive level of competence and can help to further the careers of overseas doctors in their own home countries as well as creating opportunities for them to find jobs in other countries. Many MRCP(UK) doctors, for example, use this qualification to seek jobs in the Gulf states, where this degree is highly valued.