The candidate card
Setting
General practice
Candidate
You are a GP. Mrs Helen Ashworth, aged 63, had a colonoscopy last week after a positive bowel screening test. The gastroenterologist's report shows a 3 cm tumour in the sigmoid colon; the biopsy confirms adenocarcinoma (bowel cancer). A staging CT scan has not yet been done. The gastroenterologist has asked you to tell her the result and arrange urgent referral. She has come in alone, believing the appointment is 'just routine'.
Task (interlocutor: patient)
- Find out what Mrs Ashworth already knows and expects about her results
- Prepare her for bad news and explain the result clearly and sensitively
- Respond to her emotional reaction and find out her main concerns
- Explain the next steps (CT scan to see if it has spread, urgent appointment with a bowel surgeon within two weeks, team approach to treatment)
- Explain the support available and arrange follow-up
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- She expects a routine visit and is alone, so first ask what she thinks the results might show. Her answer tells you how big a gap you must bridge, and you can offer to contact someone to join or collect her.
- Give a short warning that the news is serious, then say it once in plain words, using the word cancer, and stop. Euphemisms or long explanations before the headline leave her guessing. After it, silence is more useful than information.
- Respond to emotion before information. Name what you see, allow silence, and ask what worries her most; find out rather than assuming it is survival. She may stop absorbing detail after the headline, so keep early facts few.
- Be exact about what is known and not known: a tumour in the sigmoid colon, biopsy confirming adenocarcinoma, CT not yet done so spread is unknown. Do not guess at stage or outlook. Then give the urgent bowel surgeon appointment within two weeks.
- Close with what happens next in order, who to contact, and a booked follow-up. Offer written information and ask whether a family member could come to the next visit. Typical error: rushing logistics while she is still in shock.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I am afraid the results are more serious than we hoped.
- Take as long as you need. I am not going anywhere.
- What is going through your mind right now?
- Would you like me to go over any of that again?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| adenocarcinoma | A type of cancer that starts in the cells lining the bowel. |
| sigmoid colon | The last curved part of the large bowel, before the back passage. |
| staging CT scan | A scan to see whether the cancer has spread anywhere else. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
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All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
She asks Is it cancer? before I finish the warning. What do I do?
Answer directly and gently. Do not hold back the word because you planned a different order. You can say yes, I am sorry, it is, then pause. Evading the question once she has asked it damages trust more than being early.
She asks what her chances are. What can I honestly say?
Say the scan to see whether it has spread has not been done, so nobody can give a reliable answer yet. Promise that the surgeon and team will explain more once they know. Do not offer figures or hopeful guesses that the card does not support.
What if she wants to leave before hearing the plan?
Offer to pause. Give a one-sentence summary of what happens next, offer written information and book a close follow-up. Ask whether someone can be with her. Make sure she leaves knowing the urgent surgeon appointment is being arranged.
Sources
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