PLAB 2 Marking Criteria Explained: What Examiners Are Looking For in Every Station
A Deep Dive Into the Three PLAB 2 Domains — What They Test, How to Pass Each One, and What Causes Candidates to Fail
How PLAB 2 Is Marked
Every clinical station in PLAB 2 is marked by a trained GMC examiner across the same three domains. The marking is not a simple checklist — the examiner makes a judgement about your overall performance within each domain throughout the 8-minute station.
| Domain | Abbreviation | When It Applies |
|---|---|---|
| Data Gathering, Technical and Assessment Skills | DG&T | Primarily during history taking, examination, and investigations |
| Clinical Management Skills | CMS | When formulating a diagnosis, explaining findings, and creating a management plan |
| Interpersonal Skills | IPS | Throughout the entire station — from the moment you enter to the moment you leave |
The GMC confirms that each domain is scored out of the same total — no single domain carries more weight than the others. You must demonstrate all three consistently across every station.
How Each Domain Is Scored
Each domain in each station is scored on a scale of 0 to 4, giving a maximum total score of 12 per station. In addition to marking the three domains, the examiner records an overall global judgement of your performance in the station:
| Global Judgement | What It Means |
|---|---|
| Good | Performance clearly above the standard expected |
| Satisfactory | Performance meets the standard of a UK Foundation Year 2 doctor |
| Borderline | Performance is at the boundary of acceptable and not acceptable |
| Unsatisfactory | Performance clearly below the expected standard |
The global judgement does not directly determine whether you pass a station, and it is not included in the results you receive. It is used by the GMC to calculate the pass mark for each station using the Borderline Regression Method — a statistical process that sets the pass mark fresh for every sitting.
What You Need to Pass
To pass PLAB 2 overall, you must meet both of the following conditions:
- Meet or exceed the total minimum score — calculated by adding the cut scores for all stations, plus one standard error of measurement
- Pass the minimum required number of stations — calculated individually for each sitting using a regression method (introduced November 2024, replacing the previous fixed minimum of 10 stations)
There is no fixed pass mark. The pass mark is recalculated for every sitting. You will not be told exactly how many stations you needed to pass for your specific exam — but this calculation is applied automatically to your results.
Domain 1: Data Gathering, Technical and Assessment Skills
What It Tests
This domain assesses how you gather clinical information and perform practical assessments. According to the GMC, it covers:
- History taking — asking relevant, targeted questions to explore the patient's problem
- Physical examination — performing appropriate examinations safely and professionally
- Practical procedures — carrying out clinical procedures correctly (e.g. safe disposal of sharps, catheterisation, venepuncture)
- Investigations leading to a diagnosis — selecting and interpreting appropriate investigations
The standard you are assessed against is the level of a UK Foundation Programme Year 2 (FY2) doctor — not a consultant or specialist. You are not expected to manage complex specialist conditions; you are expected to manage common presentations safely and competently.
How to Pass This Domain
- Start with open questions to let the patient describe their problem, then use closed questions to clarify
- Follow a logical order — for pain, explore SOCRATES before moving to past history or medications
- Actively check for red flags relevant to the presentation in every station
- Use existing information from the station brief — do not ignore what you have already been told
- Request examinations purposefully — explain what you want to examine and why
- Perform practical procedures safely and professionally — treat the simulator or manikin as you would a real patient
- Always confirm your name and GMC number at the start of each station — the examiner may be watching remotely
The order of your questions matters. Starting with SOCRATES for a pain complaint before asking about medication history demonstrates that you have a structured approach to data gathering. Jumping to management questions before completing your history signals the opposite.
What Makes Candidates Fail This Domain
The most common failure in this domain is an unstructured or incomplete history. Candidates either gather too little information to safely assess the presentation, or ask questions in an illogical order that suggests they are working from a memorised list rather than thinking clinically.
- Jumping to management before gathering enough history
- Asking questions in random order rather than following a logical clinical structure
- Missing relevant red flags for the presentation
- Ignoring psychosocial context — not exploring how the problem is affecting the patient's daily life
- Performing examinations or procedures without explaining what you are doing and why
- Failing to request appropriate investigations for the clinical picture
Example
A patient presents with headache. A candidate who asks about the location, severity, onset, and character of the headache — and then moves to management — has gathered some data but not enough to assess the presentation safely. A passing candidate also checks for red flags: sudden onset, worst headache of their life, neck stiffness, visual changes, fever, and neurological symptoms. They explore how the headache is affecting the patient's life and work. Without that breadth, the examiner cannot be confident the candidate has considered serious causes such as subarachnoid haemorrhage or meningitis.
The hierarchy of your questions tells the examiner everything about how you think as a clinician — not just what you know.
Domain 2: Clinical Management Skills
What It Tests
This domain assesses what you do with the information you have gathered — how you formulate a diagnosis, explain it to the patient, and construct and communicate a management plan. The GMC defines this domain as covering:
- Formulating a diagnosis — reaching an appropriate clinical conclusion based on the history and examination
- Explaining something to the patient — communicating your findings, diagnosis, or plan in clear, accessible language
- Formulating a management plan — a safe, evidence-based, UK guideline-aligned plan appropriate for the clinical scenario
Management does not always mean prescribing medication or arranging urgent investigations. In many PLAB 2 stations you are acting as an FY2 doctor, and the correct management includes exploring the patient's ICE (ideas, concerns, and expectations), explaining your findings, safety-netting, and escalating appropriately to a senior — not resolving the entire clinical problem yourself.
How to Pass This Domain
- Offer a clear, appropriate diagnosis or working diagnosis — do not leave the patient without a conclusion
- Explain your findings in plain language — avoid clinical jargon or translate it immediately
- Tailor the management plan to the individual patient, not a textbook template
- Check for contraindications and interactions before suggesting any treatment
- Safety-net clearly — tell the patient what to look out for, when to seek help, and who to contact
- Escalate appropriately — in an FY2 role, recognise when you need senior support and say so
- Explore the patient's ICE as part of management — what are they worried about, what were they hoping for?
Clinical management in PLAB 2 is assessed at FY2 level. You are not expected to independently manage a complex specialist presentation — you are expected to recognise it, initiate appropriate basic management, and escalate safely. Demonstrating this clearly is a mark of competence, not weakness.
What Makes Candidates Fail This Domain
- Offering no management plan — running out of time because the history took too long
- Offering a management plan that is clinically unsafe — prescribing contraindicated medications, missing drug interactions, or failing to escalate a genuinely urgent presentation
- Giving a generic plan that does not account for the individual patient's circumstances
- Failing to explain the plan to the patient in understandable terms
- Not safety-netting — leaving the patient with no clear instruction on what to do if things worsen
- Trying to manage at a specialist level rather than recognising the limits of the FY2 role
Example
A patient with a known penicillin allergy presents with a lower respiratory tract infection. A candidate who prescribes amoxicillin has made an unsafe prescribing decision — a clear failure in this domain regardless of how good the rest of the station was. A passing candidate checks allergy status, selects an appropriate alternative based on UK guidelines, explains the diagnosis clearly, discusses the plan collaboratively, and safety-nets — advising the patient to return or attend A&E if they develop breathlessness, high fever, or do not improve within a specific timeframe.
Patient safety errors in Clinical Management Skills — such as prescribing a contraindicated drug, missing a drug allergy, or failing to escalate a time-critical emergency — can result in a very low score for the entire station, even if the other two domains were strong.
Domain 3: Interpersonal Skills
What It Tests
Interpersonal Skills assesses how you interact with and relate to the patient throughout the entire station. It is not a phase of the station — it runs from the moment you enter the room to the moment you leave. The GMC defines this domain as assessing:
- Whether you establish a rapport with the patient
- How you use open and closed questioning
- How you involve the patient throughout the consultation
- Your demonstration of professionalism
- Your understanding and application of ethical principles
The GMC is explicit: the examiner assesses your approach to the patient throughout the station — even when they are not physically present in the room. In telephone stations and remotely invigilated stations, your tone, word choice, and listening behaviour are being assessed just as closely as in face-to-face stations.
How to Pass This Domain
- Introduce yourself, confirm the patient's name and date of birth, and explain your role at the start of every station
- Use open questions to invite the patient to tell their story before moving to focused questioning
- Listen actively — respond to what the patient actually says, not what you expected them to say
- Explore ICE (Ideas, Concerns, and Expectations) naturally and early — not as a box-ticking exercise at the end
- Respond to emotional cues — if the patient shows distress, acknowledge it before moving on
- Involve the patient in decision-making — shared decision-making is part of this domain, not just Clinical Management
- Demonstrate professionalism and an understanding of ethical principles throughout — consent, confidentiality, capacity
- Check understanding at the end — summarise, invite questions, confirm the patient is comfortable with the plan
ICE is most effective when explored conversationally and early. A natural opener: "Before I ask you some questions, can I ask what you were hoping we'd be able to help with today?" or "Is there anything in particular you were worried this might be?" — then genuinely listen and respond to the answer before moving on.
What Makes Candidates Fail This Domain
Interpersonal Skills is the domain where failure is most common among international medical graduates sitting PLAB 2. Clinical knowledge alone cannot compensate for poor communication in this domain.
The most common interpersonal failure in PLAB 2 is robotic, formulaic consulting — candidates who use rehearsed phrases that sound scripted and do not respond to what the patient actually says. Examiners and role players recognise this immediately, and it scores very poorly.
- Using scripted or rehearsed phrases that do not fit the patient's actual response — for example, saying "I understand how you feel" to a patient who has not expressed any feeling
- Exploring ICE mechanically as a checklist item rather than responding genuinely to the patient's concerns
- Missing or ignoring emotional cues — the patient becomes upset or distressed and the candidate continues taking a history
- Dominating the consultation with questions, not leaving space for the patient to speak
- Using medical jargon without checking understanding
- Making decisions for the patient rather than with them
- Appearing disengaged, rushed, or not maintaining appropriate eye contact
Example
A patient presents with chest pain. Midway through the history, they mention they are terrified it might be a heart attack because their father died of one last year. A candidate who says "I understand, let's continue with some more questions" and moves on has missed the cue. A passing candidate pauses, acknowledges the fear directly — "That must be really frightening, especially given what happened to your father" — explores it briefly, and then continues the history with that context now informing the rest of the consultation. The examiner has noticed both responses.
Interpersonal Skills is not about what you say — it is about whether the patient in front of you feels genuinely heard, respected, and involved.
How the Three Domains Work Together in a Station
The three domains are not three separate phases of the station. They are three simultaneous lenses through which the examiner observes the same 8-minute interaction.
| Stage of Station | Primary Domain Active | What Examiner Is Watching |
|---|---|---|
| Opening and history | DG&T + IPS | Structure and quality of questioning; rapport and listening |
| Examination or procedure | DG&T + IPS | Technique and safety; consent, explanation, and professionalism |
| Diagnosis and management | CMS + IPS | Safety and appropriateness of plan; how it is communicated and agreed with patient |
| Throughout entire station | IPS | Tone, empathy, patient involvement, professionalism, response to cues |
A strong performance in one domain does not compensate for a weak one. Each domain is scored independently. A candidate who takes an excellent history but communicates poorly throughout, or who has good interpersonal skills but offers an unsafe management plan, will not pass on the strength of one domain alone.
Understanding Your Feedback After the Exam
Results are released approximately 4 weeks after the exam. Every candidate receives two types of feedback:
- Quantitative feedback — your scores in each of the three domains across all stations. Each domain is scored out of the same total, so you can identify which domains you performed stronger or weaker in.
- Qualitative feedback — examiner-selected feedback statements for each station, indicating specific areas for development. Examiners must select statements if their global judgement was Unsatisfactory or Borderline, and may also do so for Satisfactory or Good performances.
Review your domain scores carefully across all stations. If the same domain is consistently weak — particularly Interpersonal Skills — that is a pattern, not a coincidence. Target that domain specifically in your preparation for any resit, rather than increasing overall revision time evenly.
PLAB 2 is marked across three domains in every station: Data Gathering, Technical and Assessment Skills; Clinical Management Skills; and Interpersonal Skills. Each domain is scored 0 to 4, with all three carrying equal weight. The pass mark is set fresh for each sitting using the Borderline Regression Method. DG&T failures typically involve unstructured or insufficient history taking. CMS failures often involve unsafe or incomplete management. IPS is the most commonly failed domain among international medical graduates — robotic, scripted consulting scores very poorly. Strong performance in one domain does not compensate for failure in another.