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English Exam
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UK vs PH Medicine
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The IMG Route to UK Practice
1
English Language Test
Pass OET (Grade B in all sections) or IELTS Academic (7.5 overall, 7.0 in each section)
2
PLAB 1
180 single best answer questions covering clinical knowledge. Pass mark ~65%.
3
PLAB 2
Objective Structured Clinical Examination (OSCE) with 16 stations testing clinical & communication skills.
4
GMC Registration
Apply for full GMC registration and licence to practise medicine in the UK.
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Exam Format
- 180 Single Best Answer (SBA) questions
- 3 hours duration
- No negative marking
- Answer ALL questions - never leave blanks
High-Yield Topics
- Medicine (especially cardiology, respiratory, gastro)
- Surgery (acute abdomen, trauma)
- Obstetrics & Gynaecology
- Paediatrics
- Psychiatry
- Pharmacology & therapeutics
Study Strategy
- Use NICE/BNF guidelines as your primary reference
- Practice with SBA question banks daily
- Focus on UK-specific management (differs from PH practice)
- Learn the "most appropriate next step" approach
- Review Oxford Handbook of Clinical Medicine
Common Pitfalls for Filipino IMGs
- Drug brand names differ - learn generic names
- UK uses NICE guidelines, not US/PH guidelines
- Antibiotic choices differ from PH practice
- NHS pathway referrals are tested
- Mental health & safeguarding questions are common
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Exam Format
- 16 OSCE stations, 8 minutes each
- Mixture of: history, examination, communication, practical skills
- Assessed on clinical knowledge, communication, and professionalism
- Standardised patients (actors) at each station
Communication Framework
- ICE: Ideas, Concerns, Expectations - ask every patient
- Signposting: "I'd like to ask about..." / "Moving on to..."
- Summarising: Repeat back to confirm understanding
- Shared decision making: "What do you think about...?"
- Safety netting: "If symptoms worsen, please come back"
Station Types
- History taking (acute & chronic presentations)
- Clinical examination (cardiovascular, respiratory, abdo, neuro)
- Communication (breaking bad news, consent, angry patient)
- Practical skills (suturing, catheter, IV cannulation)
- Teaching/counselling stations
Tips for Filipino Doctors
- Practice speaking at a measured pace - clear English
- UK patients expect shared decision-making, not directive
- Always introduce yourself: name, role, confirm patient identity
- Show empathy explicitly: "I understand this must be difficult"
- Practice with a timer - 8 minutes goes quickly
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OET Overview
The Occupational English Test is the recommended English test for healthcare professionals. It uses medical scenarios throughout.
- Listening: Medical consultations and lectures
- Reading: Healthcare texts and passages
- Writing: Referral/discharge letter from case notes
- Speaking: Simulated medical role-play
OET Writing - Referral Letter
- Follow UK letter format (date, address, Re: patient details)
- Transform case notes into flowing letter prose
- Include relevant history, findings, and purpose of referral
- Use appropriate register - formal but not overly complex
- Stay within 180-200 words
OET Speaking Tips
- 5 minutes per role-play, medical scenarios
- Use the same ICE framework as PLAB 2
- Show empathy and use appropriate tone
- Avoid Filipino English idioms (e.g., "for a while" meaning "wait")
- Practice pronunciation of common medical terms
Why OET over IELTS?
- Content is medically focused - uses your existing knowledge
- Writing task (referral letter) is clinically relevant
- Speaking uses medical role-plays you'll encounter in practice
- Many Filipino doctors find OET more natural than IELTS
- GMC accepts both equally
Common Filipino English Issues for OET/IELTS
- "For a while" - In PH means "please wait", in UK means "for some time"
- "Comfort room" - Say "toilet" or "bathroom" in UK
- "Irregular" (as in absent) - Not used this way in UK English
- F/P sounds - Practice distinguishing "f" and "p" pronunciation
- V/B sounds - Practice "very" vs "berry" distinction
Medical Terminology Differences
- PH: "Dextrose" → UK: "Glucose" / "5% dextrose"
- PH: "Clearance" → UK: "Fit note" / "Medical certificate"
- PH: "OR" → UK: "Theatre" (operating theatre)
- PH: "ER" → UK: "A&E" or "Emergency Department"
- PH: "Intern" → UK: "Foundation Year 1 (FY1)"
Daily Practice Routine
- Listen to BBC Radio 4 or medical podcasts daily
- Read BMJ or NICE guidelines for medical English
- Practice writing one referral letter per day
- Record yourself speaking and review pronunciation
- Use flashcards for medical vocabulary differences
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| Aspect |
Philippines |
United Kingdom |
| Healthcare System |
Mixed public/private; PhilHealth insurance; many patients pay out-of-pocket |
NHS - free at point of care; funded by taxation; universal coverage |
| Primary Care |
Patients often go directly to specialists or ER |
GP gatekeeping system - patients must see GP first for referral |
| Prescribing |
Many drugs available OTC; brand names common |
Strict prescribing; generic names required; BNF guidelines |
| Doctor-Patient Relationship |
Often paternalistic; doctor-led decisions |
Shared decision-making; patient autonomy emphasized |
| Consent |
Often verbal or family-involved |
Written informed consent; patient decides (not family); Gillick competence for minors |
| Confidentiality |
Family often involved in discussions |
Strict confidentiality; information only shared with patient consent (GMC guidelines) |
| Mental Health |
Less integrated; stigma common |
Integrated into primary care; Mental Health Act; capacity assessments common |
| Safeguarding |
Less formalised systems |
Mandatory safeguarding for children and vulnerable adults; strict reporting duties |
| Training Pathway |
MD/residency → fellowship → consultant |
FY1 → FY2 → Specialty Training (ST1-ST8) → Consultant/GP |
| Clinical Guidelines |
Mix of US/WHO guidelines |
NICE guidelines; SIGN guidelines (Scotland); BNF for prescribing |
| Emergency Terminology |
ER (Emergency Room) |
A&E (Accident & Emergency) or ED (Emergency Department) |
| Working Hours |
Often 24-36hr duties; limited regulation |
European Working Time Directive; max 48hr/week; mandatory rest periods |
NHS Structure
- Primary Care: GP surgeries, walk-in centres, pharmacies
- Secondary Care: District general hospitals, specialist referrals
- Tertiary Care: Specialist centres (e.g., cancer, cardiac surgery)
- NHS England commissions services nationally
- Integrated Care Boards (ICBs) manage local services
Medical Training Grades (UK)
- FY1: Foundation Year 1 (like PH internship)
- FY2: Foundation Year 2
- CT/ST1-2: Core/Specialty Training (like PH residency start)
- ST3-8: Higher Specialty Training (like PH senior residency + fellowship)
- Consultant: Fully qualified specialist
- GP: General Practitioner (3 years specialty training after FY2)
Key UK Medical Bodies
- GMC: General Medical Council - registers all doctors
- NICE: National Institute for Health and Care Excellence
- BMA: British Medical Association (doctors' union)
- Royal Colleges: Set specialty training standards
- CQC: Care Quality Commission (inspects services)
- HEE: Health Education England (training oversight)
Important UK Medical Legislation
- Mental Health Act 1983: Sectioning, capacity
- Mental Capacity Act 2005: Best interests decisions
- Children Act 1989/2004: Safeguarding children
- Data Protection Act 2018: Patient data (GDPR)
- Equality Act 2010: Non-discrimination
- Human Rights Act 1998: Patient rights