Mastering PLAB 2: Communication Skills Matter
PLAB 2 isn't a memory test of UK clinical guidelines. It is designed to assess whether you can practise safely and effectively as a doctor within the UK healthcare system. That means the way you talk, listen, and interact with patients matters just as much as your medical knowledge.
Many candidates who do not clear PLAB 2 do not lack clinical knowledge - they lose marks because they forget that PLAB 2 is an OSCE that includes communication. Here’s why communication often makes the difference between passing and failing.
1. The exam factors how the patient feels after your consultation
One of the most important aspects of PLAB 2 is how the patient feels at the end of your consultation. The examiners are not just evaluating whether you’ve asked the right questions or ordered the right investigations - they’re assessing whether your patient leaves feeling heard, reassured, and cared for.
Let's look at this clinical scenario for an example, where a 45 year old man presents with chest pain. Candidate A, who is knowledge-heavy, might run through cardiac risk factors in a rigid checklist style before concluding with the appropriate investigations. While technically correct, this approach feels mechanical and impersonal. Candidate B, on the other hand, greets the patient warmly, explores what their main worry is (“Are you concerned this might be a heart attack?”), and then explains the plan step by step in a way that reassures and involves the patient.
Clearly both candidates know the right management, but it’s Candidate B who shows rapport, empathy, and clarity - the qualities examiners are actively looking for in PLAB 2.
2. Breaking bad news is not about science
Imagine you’re faced with a mother whose child’s blood test suggests leukaemia. A knowledge-centered candidate might blurt out, “I’m really sorry, but your child has leukaemia and you’ll be referred to oncology.” The words are medically correct, but the delivery is abrupt and leaves the parent shocked, overwhelmed, and unsupported.
A patient-centred candidate, will approach this differently. They leverage a calm tone and supportive body language. They pause, allowing the mother space to process what’s being said, and gently explain: “I’m so sorry — the results show something very serious. Let me explain what this means and what happens next.” Before moving on, they also check how she is feeling, whether she has support, and only then continue with the clinical details.
In stations like these, the medical facts do matter, but what truly earns marks is the ability to show empathy, use silence wisely, and create a human connection in one of the most difficult conversations a doctor can ever have.
3. Ethical stations require empathy and professionalism
Imagine the scenario where a colleague smells of alcohol during a night shift. A rigid, robotic response such as “The GMC says we must protect patients. I’ll escalate to the consultant” may be technically correct, but it misses the human touch. A more professional response would sound like: “I’m concerned about you - have you had anything to drink today? My priority is patient safety, but I also want to make sure you receive the support you need. I’ll need to involve the consultant.” This approach balances firmness with compassion, showing the examiner that you are not only aware of GMC duties but also capable of handling delicate situations with empathy and integrity.
4. Examinations and procedures begin with consent
Clinical Scenario: You are asked to perform an abdominal exam.
Jumping straight into palpation without explanation loses marks, no matter how perfect your technique. Instead, say:
“Would it be alright if I examine your abdomen today?”
“This shouldn’t be painful, but let me know if it is.”
“We’ll keep you covered, and a chaperone will be present.”
These simple words demonstrate respect, professionalism, and patient safety.
5. Safety netting means giving clear and practical instructions
One of the most overlooked areas by exam candidates is safety netting. It’s not just about ticking a box at the end of the consultation. This is about making sure your patient knows what to do next if things get worse. Imagine a scenario where a patient presents with new-onset asthma. A knowledge-focused candidate might simply say, “Let's start you on a inhaler, and we’ll follow up in two weeks.” That’s medically correct, but it leaves the patient with little understanding of how to manage their condition day-to-day.
A candidate with a patient-centered approach, however, would go a step further: “This inhaler will help when you’re wheezy. If you find yourself needing it more than what is prescribed per day, please contact us so we can review your treatment. If you suddenly become very short of breath or can’t speak in full sentences, call 999 straight away.”
The difference is striking. One prescribes, while the other clinician educates, reassures, and empowers the patient to act safely. In PLAB 2, this practical style of communication is what convinces examiners that you’re not just clinically competent, but also a safe and patient-centred doctor.
Final Thoughts
PLAB 2 is designed to reflect the UK clinical scenarios, where safe patient care relies on communication as much as clinical knowledge. When preparing for this examination, don’t just ask yourself “Do I know the guideline?” Instead, check whether you are:
Listening to the patient’s concerns
Explaining in simple, jargon-free language
Showing empathy where applicable
Giving clear, and practical safety-netting advice
At the end of the day, it isn’t clinical knowledge alone that helps candidates ace PLAB 2. It’s your ability to communicate that knowledge in a way that makes patients feel safe and supported.
