The candidate card
Setting
Haematology clinic, UK
Candidate
You are a doctor; this is original independent practice, and the following patient-specific details are invented case facts. Mr Panfilo Mendizabal, aged 44, accompanies his wife, aged 48, whose blood tests confirm iron-deficiency anaemia with no established cause; you have assessed her as clinically stable and recommended further investigation, starting with a gastroenterology consultation to discuss appropriate tests. She has capacity for this decision, currently declines investigation of the cause, and has explicitly permitted you to discuss her condition and choices with her husband alone while she waits nearby. She accepts her existing prescribed oral iron and blood-count monitoring; your proposed individual plan is to arrange these through the haematology clinic, agree review arrangements with her before departure, and offer another discussion of investigation, but her husband wants you to force her to proceed.
Task (interlocutor: relative)
- Find out what Mr Panfilo Mendizabal understands about the anaemia, what his wife has said about declining investigation, and what worries him most
- Explain why investigating the cause remains recommended, distinguishing iron replacement and monitoring from finding the cause; outline the offered specialist discussion without implying agreement to a procedure
- Acknowledge his wish to protect his wife and explain why her informed decision must be respected; explore how he could support her without pressure
- Agree a proposed plan to confirm directly with his wife: explore her reasons privately, continue accepted care and arrange review; explain the supplied urgent-help advice (contact NHS 111 for increased breathlessness that is not severe; call 999 for severe difficulty breathing and do not drive to A&E)
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; this is original independent practice, and the following patient-specific details are invented case facts. Mr Panfilo Mendizabal, aged 44, accompanies his wife, aged 48, whose blood tests confirm iron-deficiency anaemia with no established cause; you have assessed her as clinically stable and recommended further investigation, starting with a gastroenterology consultation to discuss appropriate tests. She has capacity for this decision, currently declines investigation of the cause, and has explicitly permitted you to discuss her condition and choices with her husband alone while she waits nearby. She accepts her existing prescribed oral iron and blood-count monitoring; your proposed individual plan is to arrange these through the haematology clinic, agree review arrangements with her before departure, and offer another discussion of investigation, but her husband wants you to force her to proceed.
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
- Begin with his understanding before addressing his demand for compulsory investigation. Ask what his wife has actually said and what outcome worries him most. He is likely seeking reassurance, but explore this rather than assigning either spouse a motive.
- Make the unresolved question clear before describing the referral: replacing iron and checking blood counts do not establish why the deficiency occurred. Keep explanations brief and avoid naming an assumed cause; uncertainty is the reason for recommending investigation.
- Acknowledge his wish to protect her before explaining that she can make this decision and must not be forced. Describe her choice as declining investigation, rather than refusing care, because she accepts treatment and monitoring; avoid blame or an adversarial tone.
- Present gastroenterology as an opportunity to discuss appropriate tests, with a separate decision about any procedure. Her current clinical stability should not become reassurance that the cause is harmless. Avoid letting detailed hypothetical procedures displace discussion of her actual concerns.
- Close by distinguishing proposals from arrangements she has accepted. Before departure, speak with her privately about her reasons, confirm clinic-managed iron and blood-count monitoring, agree review, offer further discussion and explain urgent-help advice. If time is short, prioritise this direct agreement over further persuasion.
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
- “Hello Mr Mendizabal, I'm one of the doctors in the haematology clinic. Thank you for speaking with me while your wife waits nearby.”
- “She has kindly agreed that I can discuss her care with you. What is your understanding of her anaemia?”
2. Key questions
- “What has your wife told you about her decision not to have the cause investigated?”
- “What worries you most about her not going ahead at the moment?”
- “What have you understood about the iron tablets and blood tests she has agreed to?”
- “How have you and your wife been talking about this together?”
3. Handling the patient's concern
Likely concern: He likely feels afraid for his wife and wants her to be made to have the tests.
- “It's clear how much you care about her, and it must be frightening to feel she's at risk. I can hear how much you want to protect her.”
- “She has the right to make this decision for herself, and I can't force her to proceed. What I can do is keep offering support and another discussion.”
4. Explaining
- “Her iron tablets and blood-count checks treat the low iron, but they don't tell us why it's low. Finding the cause is still recommended, and that starts with a specialist discussion about which tests may be suitable.”
- “That discussion doesn't mean she agrees to any procedure. We'll keep her current treatment going, review her, and offer another conversation. Is that clear so far?”
5. Closing
- “I'd like to check this plan with your wife privately: understand her reasons, continue her iron and monitoring, and arrange reviews. You can support her by listening without pressure.”
- “If she becomes more breathless but not severely, contact NHS 111. If she has severe difficulty breathing, call 999 and don't drive to A&E. May I clarify anything before I speak with her?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- This sounds difficult for you as her husband.
- May I check that I have understood your main concern?
- Would it help to pause before we discuss the next step?
- What would you like me to clarify before I speak with her?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| iron-deficiency anaemia | A shortage of iron affecting her blood. |
| gastroenterology consultation | An appointment with a specialist in the digestive system. |
| capacity | Being able to understand, consider and communicate a decision about her care. |
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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All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
How should I respond if he asks for a percentage risk of a serious cause?
No individual risk estimate is supplied, so do not invent one or substitute a population statistic. Explain that the available information does not establish the cause or justify a personalised percentage. Ask what knowing that figure would help him understand, then address that question without speculation.
What if he says her permission to discuss things means I can act on his instructions?
Separate permission to share information from permission to make decisions. Her consent allows this conversation with him; it does not transfer her decision to him. Do not treat his agreement as consent for a referral or procedure, or extend the conversation into unrelated confidential matters.
What urgent-help advice should I give in this UK setting?
Use the advice supplied on the candidate card: contact NHS 111 for increased breathlessness that is not severe; call 999 for severe difficulty breathing and do not drive to A&E. Check his understanding and explain that you will confirm the advice directly with his wife before departure. Source: NHS breathlessness advice. Checked 5 November 2026.
What if he keeps insisting I should force her?
Stay calm and repeat gently that she has capacity and her informed decision must be respected. Acknowledge his fear each time, then redirect to what can be done: continuing her accepted care, reviews, and another discussion of investigation.
How much can I tell him about her condition?
Only discuss what she has permitted, which here is her condition and choices. Do not speak for her or share her private reasons. Tell him you'll check the plan directly with her before agreeing to anything.
Sources
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