PLAB 2 telephone consultation: how to consult safely when you can't see the patient
A telephone consultation station gives you eight minutes on the phone with a simulated patient or another caller. You can't see them, so you check identity carefully, ask more than you would face to face, say your empathy out loud, and end with clear safety-netting the caller can repeat back. The GMC's high-level principles for remote consultations put patient safety first, including identity checks, and say you should only prescribe if it is safe to do so.
Last checked Nov 1, 2026 against the GMC pages listed under Sources.
The short version
- Each PLAB 2 scenario lasts eight minutes and is marked in three domains: Data gathering, technical and assessment skills; Clinical management skills; Interpersonal skills [1][2].
- Start with identity: who is calling, who the call is about, and whether they can talk privately.
- Tell the caller your name and role [3].
- Because you can't see the patient, ask about what you would normally see: color, breathing, alertness, how they look.
- Decide early whether the phone is safe enough, or whether the person needs to be seen today or needs 999.
- Prescribe only if it is safe and you have enough information [3].
- Safety-net with specific symptoms, actions and timeframes, then ask the caller to repeat it back.
What the GMC says about remote consultations
The GMC publishes high-level principles for remote consultations and prescribing (by phone, video or online) [3]. In summary, the principles say to:
- Make patient safety the first priority, including identity checks.
- Understand how to identify vulnerable patients.
- Tell patients your name and role (and, if online, your professional registration details) and establish a dialogue.
- Prescribe only if it is safe to do so. It is not safe if you don't have sufficient information.
- Get informed consent and follow the law on mental capacity.
- Make an adequate clinical assessment, and access medical records or verify important information.
- Give patients information about all their options in a way they can understand.
- Make appropriate arrangements for after-care, and share information with other professionals unless the patient objects.
- Keep notes that fully explain and justify your decisions.
- Stay up to date with relevant training.
In a PLAB 2 station, points 1 to 8 are the ones you show out loud. Point 9 can be one sentence at the end ("I'll document this call").
Identity checks on the phone
Check these in the first 30 to 60 seconds:
| Check | Why | Example words |
|---|---|---|
| Who you are speaking to | The caller may not be the patient | "Can I check who I'm speaking to?" |
| The patient's identity | Two identifiers, such as full name and date of birth | "Can you confirm your full name and date of birth?" |
| If a third party is calling | You need the patient's consent to discuss them, unless they lack capacity or it is an emergency | "Is [name] with you? Are they happy for me to talk with you about this?" |
| Privacy | They may be at work or with others | "Are you somewhere you can talk privately?" |
| A call-back number | In case the call drops | "If we get cut off, is this the best number to call you back on?" |
How a phone station differs from a face-to-face one
| Face to face | On the phone, do this instead |
|---|---|
| You see distress, pallor, breathlessness | Ask: "How are you feeling right now?" "Are you able to finish a sentence?" "What color are your lips?" |
| Nods and eye contact show you are listening | Say it: "I'm still here." "Mm, go on." "That sounds really hard." |
| You can examine | Ask what they can check (a temperature reading, a rash under a glass), and bring them in if you need to examine |
| Silence feels natural | Short silences are fine, but check in: "Take your time. I'm still on the line." |
| A leaflet can be handed over | Offer to send information by text or post, and use teach-back |
A structure for an 8-minute telephone station
This is Confetto's practice structure, not a GMC rule.
| Time | Step |
|---|---|
| 0:00 to 1:00 | Introduce yourself and role, identity checks, privacy, call-back number, consent if a third party |
| 1:00 to 1:30 | Rapid safety check: is this an emergency? (breathing, chest pain, collapse, confusion). If so, 999 now |
| 1:30 to 4:30 | Focused history, including red flags and the things you would normally see |
| 4:30 to 5:15 | Ideas, concerns and expectations |
| 5:15 to 7:00 | Decide: manage by phone, see today, or send to A&E/999. Explain the plan |
| 7:00 to 8:00 | Safety-netting, teach-back, "Is there anything else?", close and document |
Worked example: urinary symptoms by phone
Example written by Confetto for practice. It is not a real PLAB 2 station and not a GMC sample. Medicine choices follow local guidance and the BNF; no doses are given here.
Candidate instructions (example): You are an F2 doctor in a GP surgery doing telephone appointments. Ms Amira Hassan, 29, has booked a call about pain when passing urine. Speak to her on the phone and agree a plan.
What the simulated patient knows (hidden): two days of burning on passing urine and going often; no fever, no back pain, no vomiting, no vaginal discharge; last period two weeks ago, on the combined pill, could not be pregnant as far as she knows; no allergies; she is at work and anxious because she had a kidney infection years ago and "ended up in hospital". Expectation: antibiotics today without having to come in.
The walkthrough
Opening and identity (0:00 to 1:00)
Doctor: Hello, this is Dr Silva, one of the doctors at the surgery, returning your call. Am I speaking to Amira Hassan? Can you confirm your date of birth for me? ... Thank you. Are you somewhere you can talk privately? And if we get cut off, is this the best number to call you back on?
Patient: Yes, I've stepped out of the office.
Safety check (1:00 to 1:30)
Doctor: Before we go into detail, are you feeling very unwell right now, with a high temperature, shivering or being sick?
Patient: No, it's just the stinging. And I keep needing to go.
Focused history (1:30 to 4:30): onset, frequency, urgency, blood in urine, fever, loin or back pain, vomiting, vaginal discharge or itching, new sexual partner, last period and chance of pregnancy, previous infections, medicines, allergies. Because you can't see her:
Doctor: How are you in yourself? Are you managing to eat and drink normally?
ICE (4:30 to 5:15)
Doctor: Have you had any thoughts about what this might be?
Patient: A water infection. But I had a kidney infection once and ended up in hospital. I'm worried it'll happen again.
Doctor: That sounds like it was really frightening. It makes sense you want to get on top of it quickly.
Plan (5:15 to 7:00)
Doctor: From what you've told me, this sounds like a bladder infection. There are no signs at the moment that it has spread to your kidneys. I'm happy to prescribe a short course of antibiotics today, and I'll send it to your pharmacy. Which pharmacy would you like? Drinking enough fluids and taking paracetamol can help with the discomfort.
Safety-netting and close (7:00 to 8:00)
Doctor: Because you had a kidney infection before, here's what to look out for. If you get a high temperature, shivering, pain in your back or side, or you start being sick, please call us the same day, or 111 if we're closed. If you feel very unwell or faint, call 999. If you're not starting to feel better within two days of the antibiotics, call us back. Can you tell me in your own words when you would get in touch?
Patient: If I get a temperature, back pain or I'm sick, the same day. Or if it's not better in two days.
Doctor: That's exactly right. I'll write this up in your notes. Is there anything else I can help with today?
What scores in each domain (labelled practice breakdown)
Sample breakdown written by Confetto for practice. It is not the GMC marking sheet.
| GMC domain | Strong performance | Weak performance |
|---|---|---|
| Data gathering, technical and assessment skills | Two identifiers, privacy check; asked fever, back pain, vomiting, discharge, pregnancy, allergies; asked how she is in herself | No identity check; prescribed without asking about pregnancy, allergies or kidney symptoms |
| Clinical management skills | Safe decision to treat by phone, a prescription in line with local guidance, specific safety-netting with timeframes, documentation | Prescribed with no red-flag screen; vague "call if worse"; or brought her in with no reason |
| Interpersonal skills | Said empathy out loud, found and answered the kidney-infection worry, plain words, teach-back | Long silences with no check-in; ignored the worry; jargon ("pyelonephritis") |
Checklist for a telephone station
- Introduced myself and my role
- Confirmed who I am speaking to and the patient's identity (two identifiers)
- Checked privacy, and consent if a third party is calling
- Took a call-back number
- Asked early whether this is an emergency
- Asked about what I would normally see (breathing, color, alertness, eating and drinking)
- Asked red flags, medicines, allergies and pregnancy where relevant
- Explored ideas, concerns and expectations
- Decided safely: phone, see today, or emergency, and explained why
- Prescribed only with enough information, and checked allergies
- Safety-netted with symptoms, actions and timeframes (own team, 111, 999)
- Used teach-back
- Said I would document the call
Practice this station
Confetto isn't affiliated with the GMC.
Frequently asked questions
How do I start a PLAB 2 telephone consultation?
Introduce yourself and your role, confirm who you are speaking to and the patient's identity, check they can talk privately, and take a call-back number. The GMC's remote consultation principles put patient safety first, including identity checks, and say to tell patients your name and role [3].
Can I prescribe in a telephone station?
The GMC's principles say you should only prescribe if it is safe to do so, and that it is not safe if you don't have sufficient information [3]. Ask about red flags, allergies, other medicines and pregnancy where relevant before you prescribe.
What if a relative calls about the patient?
Check whether the patient is with them and agrees to you discussing their care. If it sounds like an emergency, give emergency advice first (999).
How do I show empathy when the patient can't see me?
Say it out loud ("That sounds really worrying"), use the caller's name, check in during pauses, and summarize often so they know you are listening.
How should I safety-net on the phone?
Name the symptoms to look out for, say exactly what to do (call the surgery, 111 or 999) and how soon, and ask the caller to repeat it back. NICE's guidance on suspected cancer, for example, says to explain which symptoms to look out for and when to return [4].
How long is a telephone station?
Each PLAB 2 scenario lasts eight minutes [1]. The GMC pages we read don't give the length of the reading time.
Sources
Read on November 1, 2026.