The clinical attachment
A clinical attachment is essential. It will not only give you a sound
base for your PLAB test part 2 but it will also provide you with that
all important UK reference.
How to find one You need to plan at least six months to a year before you actually start an attachment. There are several ways
to find a clinical attachment. One way is to email, fax, or telephone the human resources department and tell them you would
like to do an attachment in that hospital, mentioning any particular specialty you are interested in. Don't be too specific about
the specialty though. The consultant who is in charge of your chosen specialty may not be interested in having you. A list of
the NHS hospitals can be found at www.nhs.uk. Go
to "local services search" and choose "alternative search
Another way of arranging a clinical attachment will be through your medical school or social network. If you know someone who
is already working in a hospital, you can ask him or her to speak to the consultant or medical personnel on your behalf and
see if there is a possibility of doing an attachment. This will cut
through a lot of red tape and you may find it easier to arrange this
District general hospitals or teaching hospitals The burning question in everyone's mind is which type of hospital. Ideally,
you should try to do an attachment in both of these settings. Your first attachment should be in a big teaching hospital. It
will give you experience of working in a tertiary centre. It may also
give you an opportunity to work with a consultant who is well known
in his or her field.
Working in a district general hospital is a friendlier and generally more relaxed experience. It has an added advantage: if there is
a vacancy for a post, you may find it easier to get short listed (and
eventually selected) if the consultant you are working for is willing
to give you a good reference.
For how long Many consultants will be reluctant to give you
a reference if you have worked with his or her team for less than five or six weeks. So ideally, each of your attachments
should be at least six weeks long.
When to do an attachment There is no hard and fast rule on when
to do an attachment. You can do them after your PLAB test part 2 or you can do one before the test and the rest after. Doing
an attachment before sitting the test will put you in a better position to understand how medicine is practised in the United
Kingdom, which is so important for the part 2 objective structure clinical exams.
Research or audit and presentations To get short listed, participating in these activities is increasingly
important. Most teaching hospitals and some district general hospitals have audit or research projects going on all the time,
so it is easier to join in a project that's already up and running. Although the consultants are in charge overall, it's usually
the registrars who actively run them. Let them know that you are keen and available for such an opportunity.
If you are not doing an attachment, you could try to get on to the
audit or research ladder via a different pathway. You can ask an
academic consultant if you can help with any research project that
they may be concerned with. If you are not registered with the
General Medical Council your scope for clinical research may be
limited, but its something worth trying.
Looking for jobs after passing the PLAB test part 2
Most of the jobs in the United Kingdom start on the first Wednesday in February and August. The jobs are usually advertised four to
five months before the rotation starts. So if you want to start in
any of those posts, you need to make sure your PLAB test is at least
four months before those dates.
If you are a new senior house officer (SHO) in your own country
you may have to start at preregistration house officer (PRHO) level in the United Kingdom. PRHO posts are reserved for local
graduates and are allocated well in advance. Some graduates may drop out at the last minute, and these places become available to
graduates from other medical schools and overseas doctors. Teaching
hospitals have PRHO administrators who deal with these posts. Build a
good rapport with these people—they may be willing to direct you to a
vacant post and talk to the relevant human resources person on your
Each deanery also has human resources staff. Even though they are
not actively concerned with recruiting, they generally have a list of
positions that are vacant for PRHOs. Telephoning the different
deaneries is another option that you may want to explore. A list of
deaneries and contact addresses can be found at www.nosa.org.uk.
If you are interested in a particular specialty in a particular hospital it might be worthwhile telephoning the hospital and
asking them about it in advance. You may even be able to arrange a meeting with the consultant in charge of the department, which
may give you an edge if and when the post does become vacant.
By Mohammad Shaiyan Rahman, senior house officer in accident and emergency
Hemel Hempstead General Hospital, Hemel Hempstead HP2 4AD
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