PLAB 1 GMC Questions: 10 Free Practice MCQs

Ten PLAB 1-style gmc questions with the answer and the reasoning behind it. They come from the UK.med bank, which has 17 gmc questions and many more across every topic.

1. 1 / 10

   A 16-year-old who received confidential contraceptive care asks her GP to remove an implant because of persistent spotting. Her mother sees the appointment reminder on a shared calendar and phones the practice demanding the reason for the visit and removal. The young person has not authorised disclosure and there is no known safeguarding concern.

   What should the GP do?

   • A. Decline to confirm confidential details, invite the young person to discuss whether she wants her mother involved, and assess any concern about her welfare.
   • B. Remove the implant at the mother's request because a parent can overrule contraception consent given by a competent person under 16.
   • C. Tell the mother the details because she has already discovered the implant.
   • D. Refuse to speak to the young person again unless her mother attends.
   Show answer

   Answer: A. Decline to confirm confidential details, invite the young person to discuss whether she wants her mother involved, and assess any concern about her welfare.

   Why: GMC guidance permits confidential contraceptive advice and treatment for an under-16 who meets the specified criteria. The GP should not disclose the consultation or remove treatment at a parent's demand without considering the young patient's own views and consent. The clinician should still assess safeguarding concerns if facts emerge that justify sharing information in the young person's best interests or public interest.

   • B. A parent cannot automatically overrule the decision of a young person who is competent to consent.
   • C. The mother's discovery does not itself authorise the GP to disclose information from a confidential consultation.
   • D. This would undermine access to confidential care and is not required by GMC guidance.

   Sources: GMC, 0-18 years: confidentiality and contraception, abortion and sexually transmitted infections

2. 2 / 10

   A 24-year-old woman asks her GP practice to erase a consultation entry about a termination from her record because she fears a relative who sometimes helps her with online forms may see it. The practice manager receives the request and has not yet checked the patient's online-access settings or the record-retention basis.

   What should the practice manager do first?

   • A. Acknowledge the request, arrange a review of the lawful retention basis, and help secure online access while explaining the response process.
   • B. Erase the entry permanently as soon as the patient asks, without checking the legal basis for keeping a clinical record or the online access concern.
   • C. Contact the relative to confirm whether they can see the entry.
   • D. Explain that records can never be erased and close the request without further review.
   Show answer

   Answer: A. Acknowledge the request, arrange a review of the lawful retention basis, and help secure online access while explaining the response process.

   Why: The right to erasure is not absolute, and health records may be retained where processing is necessary to provide or manage health care or meet legal obligations. The practice should review this particular record and explain its decision rather than promising deletion or refusing automatically. It should also check proxy access and other security settings, since the stated concern is that a relative may view the record.

   • B. A valid clinical entry should not be deleted before the practice assesses its retention duties and the applicable right to erasure.
   • C. A relative should not be contacted about confidential care without the patient's permission; the practice can check access controls directly.
   • D. This is too absolute: an erasure request must be considered under data-protection law, even though health-care exemptions may justify retaining the entry.

   Sources: UK GDPR, Article 17; Data Protection Act 2018; Information Commissioner's Office, Right to erasure guidance

3. 3 / 10

   An 82-year-old woman lacks capacity for a decision about urgent surgery for bowel perforation. She has no relatives, friends, attorney, or deputy. The surgeon judges that surgery offers a reasonable chance of survival, but treatment is needed within hours.

   What is the most appropriate course of action?

   • A. Wait for a Court of Protection order before treating, even if the delay is likely to cause avoidable death or serious harm.
   • B. Ask the patient to consent again after explaining the operation more slowly, despite the established finding that she cannot decide now, and make no best-interests decision.
   • C. The treating team should decide in her best interests, document the reasoning, and involve an IMCA if the statutory serious-treatment criteria apply without causing unsafe delay.
   • D. Refer her to psychiatry to determine whether dementia makes surgery appropriate.
   Show answer

   Answer: C. The treating team should decide in her best interests, document the reasoning, and involve an IMCA if the statutory serious-treatment criteria apply without causing unsafe delay.

   Why: The MCA requires a best-interests decision based on the patient's wishes, values, and the available options. When a person lacks capacity and has no appropriate person to consult about serious medical treatment, the team should involve an IMCA where the statutory criteria apply. The urgent clinical window must be respected, and lack of capacity does not by itself require a court order or psychiatric referral.

   • A. Court involvement is not routinely required for an urgent best-interests decision when the team can act lawfully under the MCA.
   • B. The team should support participation, but repeating the same explanation does not replace a best-interests decision when capacity is lacking.
   • D. A psychiatric referral does not determine surgical best interests and may delay time-critical care.

   Sources: Mental Capacity Act 2005, sections 1-4; Mental Capacity Act 2005 Code of Practice

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5. 4 / 10

   In England and Wales, a 58-year-old man with advanced motor neurone disease has capacity and asks his palliative care consultant to prescribe medication for him to end his life. He says fear of breathlessness is driving the request. He has not yet discussed anticipatory symptom medicines or his priorities for future care.

   What is the most appropriate response?

   • A. Explore what is driving the request, assess and treat distressing symptoms, and discuss palliative options and future-care planning without prescribing a lethal dose.
   • B. Prescribe a lethal dose because the patient has capacity and the request is documented after a detailed discussion of prognosis and available palliative care options.
   • C. Refer urgently to psychiatry solely because requesting assisted death proves incapacity.
   • D. End the consultation because no further care can be offered.
   Show answer

   Answer: A. Explore what is driving the request, assess and treat distressing symptoms, and discuss palliative options and future-care planning without prescribing a lethal dose.

   Why: The clinician should explore the patient's fears, assess treatable symptoms such as breathlessness, and discuss palliative care and advance care planning. In England and Wales, intentionally encouraging or assisting another person's suicide is an offence under section 2 of the Suicide Act 1961. A competent patient's request should be heard respectfully, but it does not authorise a lethal prescription.

   • B. Respect for autonomy does not permit a clinician to intentionally assist suicide; capacity does not make this prescription lawful.
   • C. A request for assisted death does not by itself establish incapacity; capacity is presumed and assessed only if there is reason to doubt it.
   • D. Palliative and supportive care remain appropriate even when the clinician cannot comply with the request.

   Sources: Suicide Act 1961, section 2; GMC, Treatment and care towards the end of life: good practice in decision making

6. 5 / 10

   A 40-year-old man with anxiety tells his GP that he does not want a talking-therapy referral yet. He would prefer to try guided self-help first, understands the options, and reports no immediate risk to himself or others.

   What is the most appropriate response?

   • A. Make the referral without discussing it because the GP believes counselling will help, even though the patient understands the options and prefers self-help.
   • B. Tell him that declining a referral means the practice cannot offer further support.
   • C. Explore his preference, discuss guided self-help and safety-netting, and agree how he can seek further help if symptoms persist or worsen.
   • D. Ask his family to decide whether he should accept the referral.
   Show answer

   Answer: C. Explore his preference, discuss guided self-help and safety-netting, and agree how he can seek further help if symptoms persist or worsen.

   Why: The GP should explore the patient's reasons, explain suitable options such as guided self-help, and agree follow-up or safety-netting. A capacitous adult can decline a referral, and the GP should not override that choice or withdraw all support. If symptoms persist or worsen, the patient should be able to revisit treatment options.

   • A. A capacitous adult's preference should not be overridden simply because the clinician favours a different option.
   • B. Declining one option does not prevent the GP from offering other appropriate support and follow-up.
   • D. A capacitous adult makes his own health-care decisions; family involvement requires his agreement.

   Sources: GMC, Good medical practice (2024); Mental Capacity Act 2005, sections 1-3

7. 6 / 10

   A 29-year-old patient asks a hospital records team to erase an accurate entry about a past termination. She says she understands the clinical record may need to be retained but wants to know whether the entry can be hidden from a family member who has helped her access the patient portal.

   What is the most appropriate response?

   • A. Delete the entry immediately because the patient controls all information in her record.
   • B. Explain that the request will be assessed under data-protection law and help her review any proxy or portal access.
   • C. Tell the family member that the patient is worried about the record so they can reassure her.
   • D. Refuse the request without explaining whether any access restriction is available.
   Show answer

   Answer: B. Explain that the request will be assessed under data-protection law and help her review any proxy or portal access.

   Why: The right to erasure is not absolute, and a health-care provider may have grounds to retain an accurate clinical record. The organisation should assess the request and explain its decision rather than assume that every record must either be erased or retained without review. Proxy access should be checked separately and changed in line with the patient's wishes and applicable policy.

   • A. Patients can request erasure, but this right is not absolute and the record must be reviewed before deletion.
   • C. The family member should not be told about confidential concerns without the patient's permission.
   • D. Even where retention is justified, the practice should give a reasoned response and address the separate access concern.

   Sources: UK GDPR, Article 17; Data Protection Act 2018; Information Commissioner's Office, Right to erasure guidance

8. 7 / 10

   A 72-year-old man is admitted to a medical ward after a stroke and has new dysphagia. The speech and language therapist recommends temporary nasogastric feeding. He can communicate and says he would rather wait, but has not yet had an accessible explanation of the benefits, risks, or alternatives.

   What should the team do before deciding whether to insert the tube?

   • A. Insert the tube without consent because the team believes nutrition is beneficial, without first assessing capacity or the legal basis.
   • B. Explain the proposed feeding and alternatives accessibly, explore his reasons, and assess his capacity for this specific decision.
   • C. Ask her carers to consent instead of speaking with her.
   • D. Assume she lacks capacity because she has a learning disability and has refused food.
   Show answer

   Answer: B. Explain the proposed feeding and alternatives accessibly, explore his reasons, and assess his capacity for this specific decision.

   Why: The team should explain the expected benefits and burdens of temporary feeding and discuss alternatives in a way the patient can understand. Capacity is decision-specific and should be assessed only after practicable support has been provided. If he has capacity, his informed decision must be respected; if he lacks capacity, treatment must be based on his best interests and the relevant legal framework.

   • A. A clinician's view of benefit does not itself authorise treatment without consent or a lawful best-interests basis.
   • C. The patient must be involved as fully as possible, and carers have no automatic authority to consent for an adult.
   • D. Neither diagnosis nor an unwise-seeming decision proves incapacity; the assessment must be specific to the decision.

   Sources: Mental Capacity Act 2005, sections 1-4; Mental Capacity Act 2005 Code of Practice

9. 8 / 10

   An 82-year-old man with advanced dementia lacks capacity for a decision about emergency surgery for a perforated bowel. He has no family, friends, attorney, or deputy who can be consulted. The surgeon believes the operation is likely to prevent death, and there is enough time to contact an advocate without a clinically unsafe delay.

   What should the responsible clinician do?

   • A. Proceed with surgery without documenting best interests or contacting an advocate because the surgeon considers it beneficial, even though time permits consultation.
   • B. Wait indefinitely for a relative to be found before treating the perforation.
   • C. Make and record a best-interests decision, involve an IMCA because this is serious treatment and no appropriate person is available, and proceed within the clinical time available.
   • D. Ask a psychiatrist to certify incapacity again before the surgeon can act.
   Show answer

   Answer: C. Make and record a best-interests decision, involve an IMCA because this is serious treatment and no appropriate person is available, and proceed within the clinical time available.

   Why: Under the Mental Capacity Act 2005, the decision-maker must consider the patient's wishes, values, and circumstances and choose the option in his best interests. For serious medical treatment when no appropriate person can be consulted, an IMCA should be instructed where the statutory criteria apply. The team should act within the available clinical window and should not delay lifesaving care unsafely.

   • A. Clinical indication alone does not remove the duty to make and document a best-interests decision for a person who lacks capacity.
   • B. There is no available relative, and an unsafe delay would not protect the patient's interests.
   • D. Capacity is decision-specific and already established; a psychiatrist's certificate is not a general prerequisite for best-interests treatment.

   Sources: Mental Capacity Act 2005, sections 1-4; Mental Capacity Act 2005 Code of Practice

10. 9 / 10

    A 15-year-old who is Gillick competent has received confidential contraceptive care. Her father calls the GP asking whether she attends the practice and requests a copy of her notes. The young person has not consented to disclosure, and the father gives no reason to suspect that she is at risk of harm.

    How should the GP respond to the father?

    • A. Explain that the practice cannot confirm or disclose the young person's confidential care without her agreement, and offer to pass on his concerns.
    • B. Send the complete notes to the parent because parental responsibility gives automatic access to all records for anyone under 16.
    • C. Tell him the contraceptive details but ask him not to share them with anyone else.
    • D. Tell him the young person cannot receive confidential contraception until age 16.
    Show answer

    Answer: A. Explain that the practice cannot confirm or disclose the young person's confidential care without her agreement, and offer to pass on his concerns.

    Why: GMC guidance recognises confidentiality for young people, including those under 16 who meet the criteria for confidential contraceptive care. The GP should not confirm attendance or disclose records without the young person's agreement unless a legal requirement or justified safeguarding exception applies. The GP can offer to relay the parent's concern and assess any new information about risk.

    • B. Parents do not have automatic access to a competent young person's confidential records.
    • C. A request for secrecy after disclosure does not make an unauthorised disclosure appropriate.
    • D. Competent under-16s may receive confidential contraceptive advice and treatment under GMC guidance when its criteria are met.

    Sources: GMC, 0-18 years: confidentiality and contraception, abortion and sexually transmitted infections

11. 10 / 10

    A 14-year-old who was assessed as competent to consent to contraception received an implant after a confidential consultation. Her mother later notices the implant and phones the GP demanding details and removal. The young person has not authorised disclosure, and there is no safeguarding concern in the information available.

    What is the most appropriate response to the mother?

    • A. Confirm the consultation and contraceptive details because she is under 16 and her mother has parental responsibility.
    • B. Arrange removal immediately because the patient is under 16.
    • C. Explain that the practice cannot discuss the young person's care without her permission, and encourage the mother to speak with her daughter.
    • D. Tell the mother that the implant can never be removed before the patient turns 16.
    Show answer

    Answer: C. Explain that the practice cannot discuss the young person's care without her permission, and encourage the mother to speak with her daughter.

    Why: GMC guidance says that competent young people can receive contraceptive advice and treatment confidentially, and that their information should not routinely be shared with parents. The GP should not confirm confidential details without the patient's agreement, but can invite the mother to encourage her daughter to discuss her concerns. If new information suggests a risk of harm, confidentiality must be reconsidered under safeguarding guidance.

    • A. Parental responsibility does not automatically entitle a parent to confidential information about a competent young person's sexual health care.
    • B. A parent cannot require removal of treatment that the competent young person agreed to; the GP should first speak with the patient.
    • D. This gives false information: the young person can discuss removal with her clinician, and her age does not impose a fixed minimum duration.

    Sources: GMC, 0-18 years: confidentiality and contraception, abortion and sexually transmitted infections

Exam-style questions written by MedHub for practice. They are not official exam questions.