The candidate card
Setting
Renal outpatient clinic
Candidate
You are a doctor in this original independent practice scenario; the following findings and arrangements are fictional case facts. Mrs Virginia Healey, aged 65, had an abdominal ultrasound for bloating, which has since settled; the report describes a solitary simple right renal cyst with a thin, smooth wall, clear fluid and no internal partitions or solid component, with no obstruction. Her kidney function blood test was reported as normal, and the renal team's documented recommendation is no treatment or scheduled imaging for this finding, discharge to her GP and reassessment if relevant symptoms develop. She has read the word cyst in her report and wants it removed because she believes it means cancer.
Task (interlocutor: patient)
- Find out what Mrs Healey understands about the report, why she wants surgery and whether she has any current urinary symptoms or pain
- Explain the actual ultrasound findings in plain language, distinguishing this simple cyst from findings that need further investigation
- Address her cancer fear and request for removal, explaining why treatment is not recommended for her current finding
- Agree how to communicate the individual follow-up plan to her GP and check her understanding of when to seek reassessment
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.
Prepare this card, then say it out loud.
Plan your opening and the tasks below. Keep these notes when you move to the AI role-play.
You are a doctor in this original independent practice scenario; the following findings and arrangements are fictional case facts. Mrs Virginia Healey, aged 65, had an abdominal ultrasound for bloating, which has since settled; the report describes a solitary simple right renal cyst with a thin, smooth wall, clear fluid and no internal partitions or solid component, with no obstruction. Her kidney function blood test was reported as normal, and the renal team's documented recommendation is no treatment or scheduled imaging for this finding, discharge to her GP and reassessment if relevant symptoms develop. She has read the word cyst in her report and wants it removed because she believes it means cancer.
Getting your plan ready…
Preparation is free without an account. AI conversation and marking need sign-in; your first role-play is free. Notes are saved on this device when available. This checklist is your plan, not a score.
How to approach this card
- Start with her interpretation of the report rather than immediately correcting it. Ask which words concern her and what she expects removal to achieve; this identifies the reassurance she needs without assuming there is another motive behind her request.
- Avoid leading with the normal kidney blood test: it describes kidney function, whereas the ultrasound describes the finding itself. Explain the imaging before the recommendation, so the decision feels grounded in her report rather than an unexplained refusal.
- Keep reassurance specific to this finding. Distinguish the reported simple appearance from features needing further investigation, without promising that a normal blood test excludes cancer or implying that every kidney cyst receives the same management.
- Present discharge as an agreed handover, using the renal team's documented recommendation rather than inventing a general surveillance rule. Ask how she would like the explanation communicated to her GP and identify any question she wants included.
- Close by asking her to explain the decision in her own words, then check whether it addresses her original fear. If time is short, protect this understanding check rather than adding technical classifications or describing procedures she has not been offered.
Model route: what a strong candidate might say
Example lines in a workable order for about 5 minutes: opening, key questions, the patient's concern, explaining, then the close. Use them to plan, not to memorise: the patient's replies are not scripted here, and your next line should follow what they actually say.
1. Opening
- “Good morning, Mrs Healey. I'm the doctor in the renal clinic today. Please have a seat.”
- “I've got your ultrasound report here. Before I go through it, what has your understanding of it been so far?”
2. Key questions
- “What was it about the report that made you want the cyst taken out?”
- “What did you think the word 'cyst' meant when you read it?”
- “Have you had any pain, or any changes when you pass urine, recently?”
- “Is the bloating that led to the scan still troubling you?”
3. Handling the patient's concern
Likely concern: She is likely to say she fears the cyst is cancer and wants it removed.
- “It sounds as though you were worried that this might be cancer. Is that right? Thank you for telling me. I'd like to explain what the scan actually shows.”
- “The features described are those of a simple cyst, which is a smooth, fluid-filled sac. It is not a cancer, and removing it would not bring you benefit.”
4. Explaining
- “Your scan shows one cyst on the right kidney. Its wall is thin and smooth, the fluid is clear, and there are no internal walls or solid parts. Your kidney blood test was normal too.”
- “Findings that need more tests would look different, such as dividing walls inside or a solid area. Yours has none of those, so the renal team recommends no treatment and no repeat scans. Does that make sense?”
5. Closing
- “So, no surgery and no scheduled scans. We'll discharge you to your GP, and I'll write explaining the findings. If any new symptoms develop, particularly pain or urinary changes, please see your GP to be reassessed.”
- “Is there anything you'd like me to include in the letter, or anything still worrying you about the cyst?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- That word can sound frightening when you first see it.
- Which part of the report would you like us to look at together?
- Does leaving it alone feel different from what you expected?
- What question would you most like your GP to understand?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| renal cyst | a fluid-filled sac in the kidney |
| internal partitions | walls dividing the inside into separate spaces |
| obstruction | a blockage |
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). See the AI Speaking practice guide for what each criterion looks for.
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Questions about this role-play
Which ultrasound details should I translate into everyday language?
Describe one sac in the right kidney containing clear fluid, with a thin, smooth wall, no internal dividing walls or solid part, and no blockage. Explain that internal divisions, solid tissue or an irregular wall would raise different questions; those features are not described here. RadiologyInfo.
What if she still requests removal after hearing the explanation?
Ask her to identify the specific question that remains unanswered and offer to clarify it with the renal team. Record her continuing request rather than claiming she agrees. Do not promise a procedure or invent procedural risks merely to persuade her.
What reassessment advice should I make explicit?
Seek GP reassessment for new pain, urinary changes or blood in urine; do not assume these are caused by the cyst. If you develop kidney-area or flank pain together with fever, feeling very unwell or inability to pass urine, see a doctor immediately or go to an emergency department. Kidney-area or flank pain also needs immediate assessment if it affects both sides, remains difficult to cope with despite pain relief, or occurs when you have only one kidney or chronic kidney disease. Call 000 for collapse or life-threatening illness. Healthdirect guidance, checked 4 November 2026.
How do I fit everything into five minutes?
Spend about a minute on her understanding and symptoms, then name the cancer fear early so it doesn't hang over the rest. Give the findings in two short chunks, then keep the final minute for the GP plan and a check of understanding.
What if she still insists on surgery after my explanation?
Acknowledge that she still feels uneasy without changing the recommendation. Restate calmly that the scan shows no features needing treatment, and offer to put her concerns in the GP letter. Don't agree to surgery to end the discussion.
Sources
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