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Understanding GUM Clinics in the UK: A Guide for PLAB 2 Candidates

Updated: Jun 26


Sexual health management are featured frequently in PLAB 2 scenarios, especially those involving STIs, confidentiality, partner notification, safeguarding, and LGBTQ+ care.


🏥 What Is a GUM Clinic?

A GUM clinic is a specialist sexual health service that provides:

  • Diagnosis and treatment of sexually transmitted infections (STIs)

  • HIV testing, PrEP/PEP access

  • Contraceptive counselling

  • Vaccinations for at-risk groups

  • Partner notification services

  • LGBTQ+ affirmative care

These services are:

  • Free of charge

  • Confidential, including for those under 16 (if Gillick competent)


💼 Common Services Provided by GUM Clinics

🔹 1. STI Diagnosis & Treatment

  • Chlamydia, Gonorrhoea, Syphilis, Trichomoniasis, Herpes, LGV, HIV, HPV, pubic lice, etc.

  • NAAT testing, RPR, TPPA, serology, microscopy

  • Rapid HIV testing

🔹 2. Partner Notification

  • Contact tracing and treatment of sexual partners for:

    • Chlamydia

    • Gonorrhoea

    • Syphilis

    • Trichomoniasis

    • LGV

    • Chancroid

    • Pubic lice

🔹 3. HIV Prevention

  • PrEP (Pre-exposure prophylaxis) for at-risk individuals (e.g. MSM, HIV-negative with HIV+ partner)

  • PEP (Post-exposure prophylaxis) for emergency situations

🔹 4. Vaccinations

  • HPV vaccine for MSM ≤45

  • Hepatitis B vaccine for at-risk groups

  • Hepatitis A vaccine if relevant

  • MMR if non-immune

🔹 5. Counselling & Support

  • Sexual health education

  • LGBTQ+ support

  • Post-assault support

  • Safe sex guidance


📌 Who Should Be Referred to GUM?

✅ Always Refer to GUM Clinic If:

  1. Suspected or confirmed syphilis

  2. Recurrent or severe genital herpes

  3. Suspected LGV (esp. rectal symptoms in MSM)

  4. Confirmed or suspected Gonorrhoea

  5. Unclear genital ulcers (e.g., chancroid vs. herpes)

  6. Request for PrEP or PEP

  7. Multiple STI co-infections

  8. High-risk sexual exposure (e.g., condom break, anonymous partner)

  9. Any STI + concern for abuse or safeguarding



❌ Not Usually Referred (Managed in Primary Care):

Condition


Simple vaginal candidiasis

❌

Bacterial vaginosis

❌

Genital warts (initial)

❌ unless refractory

Trichomoniasis (simple)

❌ unless recurrent


👥 LGBTQ+ Affirmative Care

GUM clinics are trained to:

  • Use correct pronouns and names

  • Provide non-judgmental care to LGBTQ+ individuals

  • Understand risks specific to MSM, trans people, and non-binary patients

  • Offer confidential care even to under-16s if Gillick competent


🧠 Common PLAB 2 Case Examples

📍Case 1: "My partner told me they have chlamydia"

  • Action: ✅ Refer to GUM for testing, treatment, partner notification

📍Case 2: "MSM wants HIV protection"

  • Action: ✅ Refer for PrEP and STI screening at GUM

📍Case 3: "I have painless ulcer on penis"

  • Action: ✅ Likely primary syphilis → refer to GUM

📍Case 4: "15-year-old girl discloses unprotected sex"

  • Action: ✅ STI screen at GUM + safeguarding review


🔒 Under-18s and Confidentiality

  • Can access GUM clinic without parental consent if Gillick competent

  • GUM clinic assesses capacity, risk, and safeguarding

  • If coercion or abuse is suspected → involve safeguarding team immediately



📚 Final Tips for PLAB 2

✅ Always assess:

  • Confidentiality

  • Consent & capacity (Gillick competence)

  • Safeguarding

  • Indications for partner notification

  • Need for specialist referral



📎 Summary Chart: When to Refer to GUM Clinic

Condition

Refer to GUM?

Syphilis

✅ Yes

Gonorrhoea

✅ Yes

Recurrent herpes

✅ Yes

Suspected LGV

✅ Yes

PrEP/PEP request

✅ Yes

High-risk sexual exposure

✅ Yes

Simple candidiasis

❌ No

BV, genital warts (initial)

❌ No

Trichomoniasis (first episode)

❌ No (unless recurrent)

📚 References

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