The candidate card
Setting
Family planning clinic (community clinic, UK)
Candidate
You are a doctor in this original independent practice scenario, seeing Mr Onofre Narvaez, aged 42, who requests the combined pill after a friend's positive experience. He is a transgender man who retains his uterus and ovaries, takes no testosterone and uses condoms. Your initial assessment confirms longstanding migraine with visual aura, no symptoms today and no recent unprotected sex or condom failure. Combined contraception is unsuitable because of increased stroke risk; alternatives for assessment include the daily progestogen-only pill and an arm implant, both without oestrogen but with possible bleeding changes.
Task (interlocutor: patient)
- Explore what Mr Narvaez hopes contraception will achieve and briefly clarify what his usual visual aura is like
- Explain why the combined pill is unsuitable despite his friend's experience
- Outline the progestogen-only pill and arm implant, including possible bleeding changes
- Address his concern about receiving an inferior option and invite his preference
- Agree a full contraceptive assessment and continued condom use meanwhile
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, seeing Mr Onofre Narvaez, aged 42, who requests the combined pill after a friend's positive experience. He is a transgender man who retains his uterus and ovaries, takes no testosterone and uses condoms. Your initial assessment confirms longstanding migraine with visual aura, no symptoms today and no recent unprotected sex or condom failure. Combined contraception is unsuitable because of increased stroke risk; alternatives for assessment include the daily progestogen-only pill and an arm implant, both without oestrogen but with possible bleeding changes.
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
- Ask what appealed to him about his friend's pill and what he hopes it would achieve. Explore his priorities rather than assuming pregnancy prevention is his only concern.
- Use his name and pronouns naturally. Briefly ask him to describe his usual visual changes and how they relate to his headache. The card supplies the initial assessment: established migraine with visual aura, no symptoms today and no recent unprotected sex or condom failure. This brief clarification explores his experience of aura; it does not require a full migraine history, repeat pregnancy-risk screening or routine emergency counselling. Source checked 2026-11-03: https://www.nhs.uk/conditions/migraine/
- Explain that the oestrogen-containing combined pill is unsuitable because of increased stroke risk with migraine with aura. Acknowledge his disappointment and explain that an alternative is chosen for his individual circumstances, rather than because he deserves a lesser option. Source: https://www.nhsinform.scot/?illnesses=migraine-treatment-and-prevention
- Briefly outline the daily progestogen-only pill and an implant under the arm's skin. Explain that either can change bleeding patterns, then ask which approach fits his preferences. Further assessment is needed before confirming suitability.
- Agree a full contraceptive assessment and continued condom use meanwhile. Check his understanding and allow him to defer a choice. The aim is a focused discussion of suitability and preferences, rather than a complete prescribing consultation.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- It makes sense to ask about something that helped your friend.
- You can take time to consider the options.
- Would you like to pause before we compare them?
- Which part would you like me to explain differently?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| visual aura | The visual symptoms that occur as part of your migraine. |
| combined contraception | Contraception containing oestrogen as well as progestogen. |
| progestogen-only pill | A daily contraceptive pill containing progestogen without oestrogen. |
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.
More Medicine role-play cards
- Gestational diabetes: discuss a shared care plan Antenatal clinic (UK)
- Pulmonary embolism on anticoagulation: discuss follow-up and bleeding concerns Hospital follow-up clinic (UK)
- Eczema: discuss topical treatment worries General practice
All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
What should I do if he reports a recent condom failure?
The supplied initial assessment establishes that there has been no recent condom failure or unprotected sex, so another screening task is not required. If genuinely new information changes that finding, establish what happened and when, then arrange prompt emergency-contraception assessment. Do not let the routine method discussion delay it or assume that selecting ongoing contraception resolves the recent event. Source checked 2026-11-03: https://www.nhs.uk/contraception/emergency-contraception/
Can I give starting instructions for a replacement method during this discussion?
The card provides options for assessment, not a completed prescription or method-specific starting plan. Do not invent a start date, a period of additional protection or instructions for missed pills. Those details should follow the complete assessment and selection of a suitable method.
Is emergency neurological advice a required task in this discussion?
No. The initial assessment confirms established visual aura and no current symptoms; emergency counselling is not an additional required task. If new warning symptoms arise, prioritise urgent care: sudden one-sided weakness, new speech difficulty or a sudden extremely severe headache requires calling 999 immediately rather than assuming migraine. Advise him not to drive himself and to follow the emergency operator's advice. Source checked 2026-11-03: https://www.nhs.uk/conditions/migraine/
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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