The candidate card
Setting
General practice, UK
Candidate
In this original independent practice role-play, you are a GP seeing Ms Ropafadzo Mabika, aged 59, for recurrent burning when passing urine and urinary urgency over three months. Two previous laboratory urine cultures, collected before antibiotics, showed no bacterial growth, and an earlier empirical antibiotic course did not noticeably help; she is currently clinically well, but her symptoms continue. These fictional findings have not established the cause, and the proposed next steps are a fuller symptom review, a repeat properly collected urine sample while symptomatic, discussion of an examination with her consent, and a results review to decide whether specialist assessment is needed. She believes the negative tests mean her symptoms must be imagined.
Task (interlocutor: patient)
- Explore her symptom pattern, daily impact and interpretation of the results; briefly check for fever or shivering, pain under the ribs or in the lower abdomen, visible blood in urine or rapid worsening
- Validate her symptoms and explain what the tests have and have not established without diagnosing an unconfirmed condition
- Explain why the next step is reassessment rather than automatically prescribing another antibiotic
- Agree the proposed assessment and results-contact arrangements, checking her preferences about an examination
- Explain that the warning symptoms listed above require urgent GP or NHS 111 help, while new confusion, drowsiness or difficulty speaking requires calling 999 immediately; check her understanding of the plan
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.
In this original independent practice role-play, you are a GP seeing Ms Ropafadzo Mabika, aged 59, for recurrent burning when passing urine and urinary urgency over three months. Two previous laboratory urine cultures, collected before antibiotics, showed no bacterial growth, and an earlier empirical antibiotic course did not noticeably help; she is currently clinically well, but her symptoms continue. These fictional findings have not established the cause, and the proposed next steps are a fuller symptom review, a repeat properly collected urine sample while symptomatic, discussion of an examination with her consent, and a results review to decide whether specialist assessment is needed. She believes the negative tests mean her symptoms must be imagined.
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
- Address her belief that negative tests make the symptoms imagined before giving another investigation plan. Ask what the results have meant to her; a likely concern is that continued symptoms will no longer be taken seriously.
- Let her describe the pattern and daily disruption, while briefly checking the warning symptoms supplied on the candidate card. Although she is clinically well today, do not let that description replace the requested safety assessment or turn hypothetical warning signs into findings.
- Signal the move to discussing what the results mean. Explain that neither pre-antibiotic culture grew bacteria and the earlier antibiotic did not noticeably help. Pause for her response and use it to decide what needs clarifying before continuing. Keep those observations separate from conclusions about cause; the trap is replacing an unconfirmed infection with another confident, unsupported diagnosis.
- Present reassessment as purposeful rather than simply repeating unsuccessful treatment. Discuss the symptomatic urine sample and what an examination would involve, invite her feelings about these steps and respond to them. Ask permission and preferences, check her understanding, and avoid assuming either agreement or refusal before she responds.
- Organise the closing explanation into assessment steps, results follow-up and earlier help. Agree who will communicate results, how contact will happen and what she should do if contact fails. Ask what further information she needs and address it. Use the warning symptoms and escalation routes supplied on the candidate card, then check her understanding. Prioritise this ownership and the complete urgent-help advice over a speculative list of possible diagnoses.
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 Ms Mabika, I'm the GP you're seeing today. Please take a seat; I'd like to give this the time it needs.”
- “I understand the burning and urgency have continued for about three months. Could you tell me how it has been for you?”
2. Key questions
- “Can you describe when the burning and urgency happen, and what you do about them during a normal day?”
- “How have the symptoms affected your sleep, work or going out?”
- “What do you make of the two urine tests coming back without any growth?”
- “Have you had fever or shivering, pain under your ribs or in your lower tummy, visible blood in your urine, or a sudden worsening?”
3. Handling the patient's concern
Likely concern: She may feel the negative tests mean her symptoms are imagined or not believed.
- “I can hear how frustrating this is, and I don't think you're imagining anything. Your symptoms are real, even though the tests haven't shown the cause.”
- “No growth means no bacteria grew in those samples. It doesn't mean nothing is wrong; it means we haven't found the cause yet.”
4. Explaining
- “The tests showed no bacterial growth and the earlier antibiotics didn't clearly help, so the cause isn't established. I don't want to give you a label that isn't confirmed. Does that make sense so far?”
- “Rather than automatically prescribing another antibiotic, I'd suggest a fuller symptom review, a properly collected urine sample while symptomatic, and, if you consent, an examination. Does that feel reasonable?”
5. Closing
- “To summarise: a fuller review, a repeat sample while symptomatic, and a results review to decide on specialist assessment. How would you prefer to receive results, and how do you feel about an examination?”
- “Urgent GP or NHS 111 help: fever or shivering, pain under the ribs or lower abdomen, visible blood in urine, rapid worsening. Call 999 for new confusion, drowsiness or difficulty speaking. Can you repeat that?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- You do not need a positive test for me to take this seriously.
- What would you most like us to understand today?
- Would you like me to explain the examination before you decide?
- What questions would you like answered when we discuss the results?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| urine culture | A laboratory test that checks whether bacteria grow from a urine sample. |
| empirical antibiotic | An antibiotic given before test results confirm a bacterial infection. |
| urinary urgency | A sudden need to pass urine that is hard to put off. |
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
- Recurrent falls: explore different acceptable-risk preferences Geriatric outpatient clinic, UK
- Irritable bowel syndrome after assessment: discuss symptom management and safety-netting Gastroenterology clinic, UK
- Bronchiectasis: explore airway-clearance support Respiratory clinic, UK
All sets: nurses, doctors, other professions. Your profession's guide: OET Medicine.
Questions about this role-play
Can I say the previous antibiotics caused the negative cultures?
No. Both samples were collected before antibiotics, so that explanation contradicts the notes. State the collection timing accurately if it matters to her question. The results did not establish the cause of her symptoms, and the previous treatment did not noticeably help.
What if she wants another antibiotic while awaiting reassessment?
Ask what she hopes another course would achieve and acknowledge the wish for relief. Explain that the available findings have not confirmed a bacterial cause, so repeating treatment automatically would bypass the unresolved question. Agree the assessment steps without promising a particular result or later prescription.
Which warning symptoms and actions should I cover together?
Use the list supplied on the candidate card: fever or shivering, pain under the ribs or in the lower abdomen, visible blood in urine or rapid worsening requires urgent GP or NHS 111 help. New confusion, drowsiness or difficulty speaking requires calling 999 immediately. Do not drive yourself in an emergency. Guidance checked on 4 November 2026: NHS urinary tract infection guidance and NHS kidney infection guidance.
What if she says she would rather just have another antibiotic?
Acknowledge the wish, then explain that the earlier course did not noticeably help and that you want to understand the cause first. Ask what she hopes an antibiotic would do. Keep to the plan and offer a prompt review, so she doesn't feel you are refusing to help.
How do I raise the examination without pressuring her?
Offer it as a choice. Explain in general terms what it involves, that it only happens with her consent, and that she can decline or pause at any time. Ask about her preferences, then record and respect her decision.
Sources
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