The PLAB test is changing: your queries answered

Richard Hankins, the General Medical Council’s (GMC) Head of Registration, Enquiries and Testing, answers some of the most common questions we’ve been asked by candidates and doctors wanting to take the Professional and Linguistic Assessments Board (PLAB) test.

The NHS has long relied on the skills and knowledge of doctors who have qualified from outside of the UK but the GMC needs to make sure everybody working in the UK meets our standards. We have made some changes to the way we test doctors from outside the European Economic Area (EEA) known as International Medical Graduates (IMGs). Most of the changes will be introduced this coming September following an independent review [PDF], commissioned by the GMC.

We have made some changes to the way we test doctors from outside the European Economic Area (EEA). Most of the changes will be introduced this coming September.

We have been asked lots of questions since the changes were announced and hope this blog will be helpful to those considering taking PLAB and those who are already in the process.

We created a short video, which explains some of the changes. A detailed blueprint (a guide to what the test covers) and some example test questions [PDF] are also available on the GMC’s website to help candidates feel more confident about the process.

Why are you making these changes?

It’s our job, along with employers, to make sure doctors trained outside the UK have the level of knowledge, practical skills and professionalism we expect here. The PLAB test is the main route for IMGs who want to work in the UK, so ensuring the test continues to be robust and reliable is essential.
How will PLAB differ to the testing already in place?

A number of changes will be introduced including:

A revised practical assessment, which will involve an additional four scenarios (up from 14 to 18) for PLAB part 2 (the practical assessment). The scenarios will be more reflective of a patient consultation or other routine interaction rather than just asking a doctor to demonstrate a procedure.
New questions and practical scenarios that will have a stronger focus on the professional values and behaviours expected of doctors working in the UK, as detailed in Good medical practice.
We will change the way the pass mark in PLAB 2 is set to help boost the accuracy of the test. We will be using a method known as ‘borderline regression’, a widely-used and recognised way of setting the pass mark for practical exams like PLAB.
All candidates will be given more feedback on their performance in each section of the test. This will help them to address any knowledge or skills gaps prior to re-taking the test or starting work.

What about doctors who passed the PLAB test in the past, under the old style test? Will their skills and knowledge be at the right level? Are you going to check on this?

Doctors who have passed the current PLAB test, which will be replaced in September, will have demonstrated they are at the competency we expect to see in a doctor entering their second year of their Foundation Training Programme. This is the required standard and the new pass mark will continue to be at this level.

Once licensed, all doctors must take part in revalidation. Through this process, licensed doctors demonstrate, on a regular basis, that they are up to date, fit to practise and able to give a good level of care.
Why is PLAB changing when the GMC has expressed intentions to introduce a medical licensing assessment (MLA) for all doctors in the future?

Plans for the MLA are in the early stages of development. In the meantime it’s important the PLAB test is rigorous and up to date. The MLA would create a consistent standard of entry on to the UK medical register. You can read more about the MLA here.
Do all of the changes apply to candidates who have already taken PLAB part 1?

Yes, the changes will apply to all candidates who have not passed either parts 1 and 2 before September 2016.

However, a new limit on the number of times candidates can take the written or practical part of the assessment, and the two-year time limit for doctors to have their application for registration approved with a licence to practise in the UK after passing the PLAB test, will not take effect until September 2017. From then, candidates must then pass the written and practical parts of the test within a maximum of four attempts each.