Lesson 1.3: The Three Marking Domains and How to Practise
Every station is marked across three domains — 4 marks each, 12 marks total. The weighting is strictly equal. Interpersonal skills are worth exactly the same as clinical knowledge.
| Domain | What It Covers | Where Candidates Lose Most Marks |
|---|---|---|
| Domain 1: Data Gathering, Technical & Assessment Skills (4 marks) | Focused history. Competent examination. Appropriate investigations. Safe differential. | Disorganised history. Missing red flags. Examination steps out of sequence. |
| Domain 2: Clinical Management Skills (4 marks) | Working diagnosis. Clear explanation. Management plan aligned with current UK guidelines. Shared decision-making. | Correct diagnosis in jargon. Paternalistic plan. Management not aligned with NICE guidance. |
| Domain 3: Interpersonal Skills (4 marks) | Rapport, empathy, open and closed questions, patient involvement, plain language, professionalism. | This is where most IMGs lose most marks — not from lack of empathy as people, but from never having learned to express it within the UK consultation framework. |
How Passing Is Determined
- The GMC uses borderline regression scoring. The pass mark is calculated after the exam — the examiner does not know the passing score when marking you.
- Each station has its own pass mark based on its difficulty.
- From November 2024: the minimum number of stations required to pass is dynamically calculated — it is no longer fixed at 10. You will not be told exactly how many stations were required for your exam.
- Each test centre operates independently with a different set of stations and distinct passing criteria. Two candidates taking the exam on the same day at different venues may face different pass marks.
- The GMC may exclude individual stations for quality assurance purposes — the pass mark is recalculated accordingly.
The 10 Feedback Statements — from the Official GMC
After each station, examiners indicate which of 10 pre-set feedback statements apply to your performance. They must do this if their overall judgement was Unsatisfactory or Borderline, but they may also do so if you were Satisfactory or Good. These statements tell you exactly what examiners are watching for.
| Statement | Full GMC Description |
|---|---|
| Consultation | Disorganised or unstructured consultation. Your history taking appeared disjointed, with questioning erratic and not following reasoned thinking. You may have performed tasks in an illogical order that suggested you lacked a plan. |
| Issues | Does not recognise the issues or priorities. You did not recognise the key element of importance in the station — for example, giving lifestyle advice to an acutely ill patient. |
| Time | Shows poor time management. You probably spent too long over some elements at the expense of other, perhaps more important, areas. |
| Findings | Does not identify abnormal findings or results, or fails to recognise their implications. You did not identify or act on significant findings in the history, examination, or data interpretation. |
| Examination | Does not undertake physical examination competently, or use instruments proficiently. |
| Diagnosis | Does not make the correct working diagnosis or identify an appropriate range of differential possibilities. |
| Management | Does not develop a management plan reflecting current best practice, including follow-up and safety netting. |
| Rapport | Does not develop rapport or show sensitivity for the patient's feelings. You did not demonstrate patient-centred consulting. You may have used stock phrases that showed you were not sensitive to the patient as an individual. |
| Listening | Does not make adequate use of verbal and non-verbal cues. You did not demonstrate that you were paying full attention to the patient's agenda — asking questions but not listening to or acting on the answers. |
| Language | Does not use language or explanations that are relevant and understandable to the patient. This includes medical jargon, speaking too quickly, or not checking understanding. |
Rapport, Listening, and Language together account for the three most common feedback statements given to failing candidates. All three are entirely fixable. That is what this course builds.
How to Practise Effectively
Reading about PLAB 2 is not the same as practising PLAB 2. These principles apply to every practice session:
- Always use a timer. Set it for 7 minutes 30 seconds. Stop when it goes off — no matter what. Review your performance rather than finishing the case.
- After every case, ask yourself: (1) Did I reach a working diagnosis? (2) Did I reach management? (3) Where did time run out? (4) Did I explore ICE? (5) Did I include safety netting? (6) What could I phrase better or quicker?
- Aim to start management by 5 minutes 30 seconds. At 6 minutes (the audible warning bell), move to management immediately — even if history gaps remain.
- Include short drills alongside full cases: 5-minute history-only drills for red flag extraction; 3-minute management-only drills for structuring shared decisions.
- Keep a simple log: what case, did I finish on time, where did time run out, what to phrase better. Progress is built by reviewing delivery, not just repeating content.
PLAB 2 tests whether you can behave like a safe, patient-centred FY2 doctor within an 8-minute structure — not perfect knowledge. Master the frameworks (ICE, the 4-minute rule, the three marking domains), practise with a timer against the 10 GMC feedback statements, and you build the exact skills examiners are trained to look for.