Breaking bad news in PLAB 2: six steps

Six steps

1. Prepare: introduce yourself with your name and GMC number, check you have the right person, and ask who else they want present.
2. Find out what they already know and what they expect.
3. Give a warning: "I am afraid the results are not what we hoped."
4. Say the news in plain words and in short sentences. Avoid jargon.
5. Pause. Stay quiet for a moment, and respond to the emotion before the facts.
6. Plan: explain next steps, offer support, check understanding, and agree when you will speak again.

Pace and wording

Do not rush into the explanation. A common mistake is to fill the silence. Do not use euphemisms such as "passed away" without making clear the person has died if that is the news. Do not offer false reassurance or give a prognosis you cannot know.

If a relative asks you to hide a diagnosis from the patient, the GMC's guidance on consent and confidentiality applies. See PLAB 2 ethical scenarios.

How it is marked

Interpersonal skills carry about one third of the marks in every station. Data gathering and management still count, since you must check understanding and give a safe plan. See PLAB 2 mark scheme. You can practise this theme with an AI patient, see PLAB 2 AI practice.

Common questions

How do I break bad news in PLAB 2?

Check what the patient knows, give a warning, say the news plainly, pause, respond to emotion, then explain next steps and support.

Is breaking bad news in every PLAB 2 exam?

The GMC does not publish which scenarios appear, so practise it as one of several communication themes.

What should I avoid when breaking bad news?

Jargon, euphemisms, false reassurance and filling silence too quickly.