Concern about a struggling colleague
PLAB 2 practice station

The task

You are a doctor on a medical ward. Over the past fortnight you have noticed that a colleague, Dr Sanjay Varma, a foundation doctor, has looked exhausted, has missed handovers, and made two errors on drug charts that were picked up by nurses. This morning you found him in the doctors' room with trembling hands. You have asked to speak to him privately. Talk with him and agree what happens next. The examiner will not take part in the conversation.

What this station tests

• Raise concerns about a colleague early, privately, kindly and with specific observations.
• Patient safety comes first; you cannot promise secrecy if patients may be at risk.
• Ask directly about alcohol, mood and self-harm; do not assume.
• Signpost occupational health, GP and supervisor support; encourage him to speak up himself, but make sure a senior knows the same day if patients are at risk.
• Document factually and follow up.
• Morning shakes can mean alcohol withdrawal: advise medical help rather than stopping suddenly.

Sources for the clinical content

• GMC Raising and acting on concerns about patient safety
• GMC Good medical practice
• NHS Practitioner Health: confidential service for doctors

An original practice scenario with invented patients. Not an exam question.

Practise next

• A woman with an infected foot who wants to go home
• Follow-up after an emergency hospital visit
• Young teenager seeing the GP alone
• Itching during an intravenous antibiotic