PLAB 1 NHS Protocols & Professional Practice

Question 1

A patient under your care develops a serious unexpected complication after surgery that may have been caused by a system failure. What is the most appropriate action under NHS duty of candour?

Accepted Answer

Be open and honest with the patient and family, acknowledge what happened, offer an apology, provide information about any investigation, and explain what steps are taken to prevent recurrence

Answer

Document the complication in the notes and await the patient's complaint

Answer

Seek legal advice before disclosing anything to the patient

Answer

Inform the ward sister but not the patient until an internal review is completed

Question 2

According to the GMC's Good Medical Practice, what are the four domains of Good Medical Practice?

Accepted Answer

Knowledge, skills, and performance; safety and quality; communication, partnership, and teamwork; maintaining trust

Answer

Clinical competence, communication, ethics, and research

Answer

Clinical expertise, professionalism, leadership, and education

Answer

Patient care, self-care, team care, and organisational care

Question 3

A 14-year-old discloses during a consultation that she is being physically abused by a parent. She asks you to keep it confidential. What should you do?

Accepted Answer

Explain that you cannot guarantee confidentiality in child protection matters, and refer to the child safeguarding team — child protection takes priority over patient confidentiality

Answer

Maintain confidentiality as promised

Answer

Document it but take no further action

Answer

Tell the parents immediately

Question 4

A foundation year doctor prescribes a medication and realises they have made an error that has not yet reached the patient. What should they do?

Accepted Answer

Report the error through the hospital incident reporting system, inform the supervising consultant, document the near-miss, and take steps to prevent recurrence

Answer

Cancel the prescription quietly and say nothing

Answer

Ask a colleague to take over care to distance themselves from the error

Answer

Await the patient's discharge before reporting

Question 5

Which of the following best describes the GMC's guidance on social media use for doctors?

Accepted Answer

Doctors must maintain professional standards, protect patient confidentiality, clearly identify themselves as doctors where relevant, and not post anything that could bring the profession into disrepute

Answer

Doctors should not use any social media

Answer

All social media posts about medicine must be peer-reviewed

Answer

Doctors can share anonymised case details on social media without restriction

Question 6

A patient asks you to provide them with a medical certificate stating they are unfit for work for a month when you believe they are fit for work in two weeks. What should you do?

Accepted Answer

Decline to certify a longer period than clinically justified — issuing a dishonest certificate is professional misconduct and may constitute fraud

Answer

Provide the certificate as the patient is the expert on their own health

Answer

Compromise and issue a 3-week certificate

Answer

Refer to a colleague to avoid conflict