Hello team! Today we are joined by one of our tutors at Docty, Dr John Smith!
John is a GP based in Harrogate and has been teaching and examining the PLAB for many years. We will hand it over to him as he explains the importance of using clinical guidelines during your preparation for both the PLAB 1 and PLAB 2!
Hi there! I’m John. Today I’ll be showing you why using clinical guidelines can give you an edge during your PLAB examination.
At the end of the article you can download two examples of our NICE summary guidelines!
What are guidelines?
Guidelines are clinical pathways that include recommendations on how to best optimise patient care and are based upon a systematic review of the evidence available. In the UK, the major body which publishes guidelines is called NICE. We spoke about guidelines during our PLAB Secrets Online Webinar and we will elaborate some more on them today.
Why are guidelines important for the PLAB?
Guidelines underpin how we investigate and manage patients in the UK. They are a trustworthy source to turn to when deciding upon the best way to approach patient care.
To understand the importance of guidelines for the PLAB, let’s look at this quote from the GMC regarding the examination:
“The exam tests your ability to apply your knowledge for the care of patients. It doesn’t test how well you can remember and recite facts. Questions relate to current best practice in the UK, and equipment routinely available in UK hospitals. You’ll need to answer the questions in relation to published evidence and not according to your local arrangements.”
In a nutshell, this means that you should answer the questions according to best practice in the United Kingdom. It just so happens, that clinical guidelines are based upon best practice! What better resource to turn to?
Guidelines in Action
Imagine that you are confronted with the following question during your PLAB 1 examination:
An 18 year old woman thinks she is overweight and has a mildly depressed mood. For the last 18 months she has reduced her food intake and has been exercising for two hours each day. She has amenorrhoea. Her body mass index is 15.5 kg/m2 and her blood pressure is 90/60 mmHg.
What is the SINGLE most appropriate management?
- Prescribe antidepressants
- Refer for psychodynamic therapy
- Refer to acute medical services
- Refer to dietician
- Refer to eating disorder service
First of all, it helps to know what BMI is a clinical feature of anorexia nervosa; according to the NICE CKS guidelines it is a BMI of less than 17.5 kg/m2.
To get the correct answer here, it is useful to be acquainted with the NICE guidelines on Eating Disorders. These guidelines tell us that referral to a community-based ‘eating disorder service’ (1.2.10) is recommended, unless the patient shows or is at risk of severe emaciation, in which case they are referred to acute medical services first. In this question the correct answer is (5) Refer to eating disorder service. There is no indication of severe emaciation in this question.
The beauty of guidelines does not just end there. In fact, they form the basis of the investigation and management section of your PLAB 2. A good knowledge of guidelines will help you structure an outstanding investigation and management plan, which is an essential component of many of your PLAB 2 stations.
But John, guidelines are so long! I can’t possibly read them all.
I agree. They are very long, boring and you really have to dig for the important information. Which is why at Docty, we have created summary briefs for every single guideline that you need to know and use them during our PLAB 1 and PLAB 2 course. At the end of the course, you get a folder full of these documents on each condition to aid you for the exam and beyond.
Spending your precious revision time trying to figure out super long guidelines is not a great way to spend that time!
But John, why can’t I just use MCQ books?
Sure you can, if you wish. But be aware, many MCQ books for the PLAB are outdated and not in line with the latest guidelines. Make sure you consult an up to date book and be on the look out for any wrong answers.
Guidelines will give you an edge during your PLAB examinations. They will help you quickly spot the write answer during the PLAB 1 and tell your examiner that you will be a competent doctor on the wards of a UK hospital. Don’t ignore them.
You can download two examples of our guidelines below!