The candidate card
Setting
Gastroenterology clinic, UK
Candidate
You are a doctor in a gastroenterology clinic in this original independent practice scenario. In this fictional case, Mrs Fatima Zubairu, aged 61, has recurrent abdominal cramps, bloating and alternating loose and hard stools; examination, blood tests, stool investigations and colonoscopy with biopsies have identified no alternative explanation, and the specialist assessment supports irritable bowel syndrome. Her symptoms remain troublesome, but she has reported no rectal bleeding or unintentional weight loss. The proposed individual plan is to begin with regular meals and a food-and-symptom diary, then review her response; she believes the diagnosis means her symptoms are being dismissed.
Task (interlocutor: patient)
- Find out how the symptoms affect Mrs Zubairu and what she understands the diagnosis and investigation results to mean
- Explain why the symptom pattern and assessment support IBS, acknowledging that her symptoms are real
- Respond to her feeling of dismissal, explaining what the reassuring findings establish without guaranteeing that future symptoms cannot have another cause
- Discuss the proposed first steps and agree a follow-up arrangement, including when new symptoms should prompt earlier assessment
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 a gastroenterology clinic in this original independent practice scenario. In this fictional case, Mrs Fatima Zubairu, aged 61, has recurrent abdominal cramps, bloating and alternating loose and hard stools; examination, blood tests, stool investigations and colonoscopy with biopsies have identified no alternative explanation, and the specialist assessment supports irritable bowel syndrome. Her symptoms remain troublesome, but she has reported no rectal bleeding or unintentional weight loss. The proposed individual plan is to begin with regular meals and a food-and-symptom diary, then review her response; she believes the diagnosis means her symptoms are being dismissed.
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 the meaning she attaches to the diagnosis before discussing management. A likely concern is whether anyone believes her symptoms; ask what felt dismissive and which effects on daily life she most wants addressed.
- Connect her cramps, bloating and alternating stools with the specialist assessment. Explain that examination, blood tests, stool investigations and colonoscopy with biopsies identified no alternative explanation; presenting this reasoning before reassurance helps avoid sounding dismissive.
- Acknowledge that her symptoms remain troublesome even though the findings are reassuring. Describe what the assessment supports now, using careful language about the information available, rather than guaranteeing that every future symptom will have the same explanation.
- Introduce regular meals and the diary as an initial, reviewable management step. Ask whether this feels manageable and meaningful to her; the usual trap is giving dietary instructions before establishing that her symptoms deserve continuing attention.
- Close by agreeing how the review will be arranged, what she wants it to assess and how to contact the clinic meanwhile. Explain that new rectal bleeding, unexplained weight loss or a hard lump or swelling in her abdomen requires an urgent GP appointment or NHS 111 advice without waiting for routine review. If time is short, preserve acknowledgement, the diagnostic explanation, a concrete next step and this safety advice.
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 Mrs Zubairu, I'm the doctor in the gastroenterology clinic. Thank you for coming; I'd like to go through your results together.”
- “How have the cramps, bloating and changes in your bowel habit been affecting your day-to-day life?”
2. Key questions
- “What do you understand the diagnosis of irritable bowel syndrome to mean?”
- “What did you take from your examination, blood tests, stool tests and colonoscopy results?”
- “Which symptoms trouble you most, and what do they stop you doing?”
- “Have you noticed any bleeding from your back passage or weight loss you didn't intend?”
3. Handling the patient's concern
Likely concern: She likely feels the diagnosis means her symptoms are being dismissed.
- “I'm sorry it feels that way. Your symptoms are real, and this diagnosis names a pattern; it isn't a way of brushing you off.”
- “The tests found no other explanation, which is reassuring, but I can't promise a new symptom could never have another cause. That's why we'll agree when to review you earlier.”
4. Explaining
- “Cramps, bloating and loose then hard stools fit irritable bowel syndrome, and your examination, blood and stool tests and colonoscopy with biopsies found no other explanation. Does that make sense?”
- “I suggest starting with regular meals and a food-and-symptom diary, then reviewing your response together. How do you feel about trying that first?”
5. Closing
- “So: regular meals, a diary, and a review of your response. When would suit you for follow-up, and what would you like us to cover then?”
- “Please contact us for earlier assessment if you notice anything new or different, such as bleeding from your back passage or unintended weight loss. Don't wait for the review. Does that feel clear?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You deserve an explanation that takes your experience seriously.
- Which part of our discussion has left you feeling unheard?
- Would it help to pause before we discuss practical changes?
- What would make the next appointment useful for you?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| irritable bowel syndrome | A bowel condition involving cramps, bloating and changes between loose and hard stools. |
| colonoscopy | An examination of the large bowel using a camera. |
| biopsies | Small tissue samples taken for examination. |
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 much detail should I suggest for the food-and-symptom diary?
Suggest brief entries recording meals and the symptoms she notices, including when they occur and how they affect her. Ask what recording method she could realistically use. Avoid presenting an entry as proof that a particular food caused a symptom.
What if she asks which foods she must stop eating?
Avoid inventing a prohibited-food list or adding an elimination diet. Ask whether she has noticed any possible associations, while keeping them tentative. Explain that the proposed first step gathers information for review rather than requiring her to identify a culprit immediately.
What earlier-assessment advice belongs in this consultation?
For new rectal bleeding or bloody diarrhoea, unexplained weight loss, or a hard lump or swelling in her abdomen, advise her to request an urgent GP appointment or contact NHS 111. She should not wait for routine follow-up or assume these symptoms are IBS, even after reassuring investigations. Seek earlier review for ongoing or severe symptoms, fever, severe diarrhoea or any concern. Severe abdominal pain needs emergency assessment: call 999 here, or 000 in Australia. Do not drive yourself during an emergency. NHS IBS symptoms and warning signs, checked on 4 November 2026; emergency guidance.
What if she keeps saying nobody has listened to her?
Pause the plan, reflect back what she has told you, and ask what she wants taken seriously. Return to the diagnosis only once she feels heard. Avoid repeating that results are normal without linking them to her real, ongoing symptoms.
How do I describe the colonoscopy result without over-promising?
State what was found: no alternative explanation after the examination, blood and stool tests, and colonoscopy with biopsies. Then be honest that reassuring results do not guarantee a future symptom could never have another cause, and that new symptoms will be assessed. Avoid saying nothing is wrong.
Sources
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