The candidate card
Setting
General practice, UK
Candidate
You are a GP in this original independent practice scenario. In this fictional case, Mr Henryk Uittenbosch, aged 64, recently attended the emergency department with painful inability to pass urine; catheter drainage relieved the pain, and the cause remains under investigation. His documented individual discharge plan is to keep the catheter until a supervised trial without catheter in the urology clinic, where staff will remove it, assess urine passed and check bladder emptying with a scan, with further drainage arranged if necessary; the appointment has not yet been confirmed, and you can contact urology today. He reports that the catheter is draining and he has no current pain or fever, but wants it removed immediately because he feels better.
Task (interlocutor: patient)
- Find out why Mr Uittenbosch wants immediate removal, how he is managing the catheter and whether he has any new symptoms
- Explain why relief after drainage does not establish that he can now empty his bladder without the catheter; pause to hear his response and adapt the explanation
- Explain the documented supervised trial and address his concerns without assuming that retention means cancer
- Agree how to confirm the urology appointment and support him meanwhile, including when catheter problems need urgent 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 GP in this original independent practice scenario. In this fictional case, Mr Henryk Uittenbosch, aged 64, recently attended the emergency department with painful inability to pass urine; catheter drainage relieved the pain, and the cause remains under investigation. His documented individual discharge plan is to keep the catheter until a supervised trial without catheter in the urology clinic, where staff will remove it, assess urine passed and check bladder emptying with a scan, with further drainage arranged if necessary; the appointment has not yet been confirmed, and you can contact urology today. He reports that the catheter is draining and he has no current pain or fever, but wants it removed immediately because he feels better.
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
- Explore what makes immediate removal important to him and how he is managing the catheter. A likely concern is its effect on everyday life; ask directly rather than assuming discomfort, embarrassment or a particular fear explains his request.
- Acknowledge the relief he experienced, then distinguish drainage through the catheter from passing urine independently. Pause, invite his response and listen before continuing; use what he says to clarify any misunderstanding or adjust the explanation. Make this connection before explaining the appointment, because otherwise continued catheter use may sound like an unexplained delay despite his feeling better.
- Use clear signposts to organise the explanation into three parts: why the catheter needs to stay, what happens during the supervised trial and how to obtain help while waiting. Explain the trial as a sequence: staff remove the catheter, assess urine passed, scan for remaining urine and arrange further drainage if needed. Explain the purpose of checking emptying rather than presenting removal alone as the whole appointment.
- Offer to contact urology today and agree how he will receive the response. The appointment remains unconfirmed, so avoid promising a date or successful removal. Address the particular difficulty he identifies without changing the documented discharge plan.
- Close with a named contact route and what will happen if appointment confirmation does not arrive. Check his understanding of the agreed booking action, catheter safety and when and how to seek urgent help. If time is short, prioritise why feeling better cannot establish independent emptying and who will resolve the outstanding booking; a vague referral leaves his request unresolved.
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 Uittenbosch, I'm the GP. I understand you were in the emergency department recently, and I'd like to see how you're getting on.”
- “Please tell me how things have been since then, and what you'd like from today.”
2. Key questions
- “What is making you want the catheter out straight away?”
- “How are you managing the catheter day to day, and is it draining well?”
- “Have you had any pain, fever or other new symptoms since you left hospital?”
- “What worries you about the catheter, or about what caused the problem?”
3. Handling the patient's concern
Likely concern: He likely wants it out now because he feels better, and may worry about the cause.
- “I can understand wanting it gone when you feel well, and I'm glad you're comfortable. May I explain why we shouldn't take it out just yet?”
- “The cause is still being investigated. Being unable to pass urine doesn't by itself tell us it's cancer, so please try not to assume that.”
4. Explaining
- “You feel better because the catheter is draining your bladder, so that doesn't yet show your bladder can empty without it. What are your thoughts on that?”
- “The plan is a supervised trial without catheter at the urology clinic: staff remove it, check the urine you pass and scan how well your bladder empties. They arrange more drainage if needed. What questions do you have?”
5. Closing
- “I'll contact urology today to confirm your appointment, since it isn't confirmed yet. How would you like me to reach you, and what else would help meanwhile?”
- “Get urgent help if urine stops draining, you have new pain, fever or shivering, bleeding, leaking around the catheter, or it comes out. Go to the emergency department if needed. Is that clear?”
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- What would you most like to be different today?
- I can understand why waiting feels frustrating.
- May I explain what the clinic needs to check?
- What is your main question before I contact urology?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| urinary retention | Being unable to pass urine and empty your bladder. |
| catheter | The tube draining urine from your bladder. |
| trial without catheter | A supervised check of whether you can pass urine and empty your bladder after tube removal. |
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
What if he asks whether urinary retention means cancer?
Explain that the cause remains under investigation and that this episode does not establish a cancer diagnosis. Ask what has prompted the question, then answer within the available information. Avoid naming an assumed cause or guaranteeing that cancer has been excluded.
What if he still refuses to keep the catheter?
Explore what he understands about the proposed plan and what remains unacceptable to him. Discuss his request with the appropriate clinician or urology service rather than improvising removal. Respect his decision-making, explain the clinical recommendation clearly and document the discussion and agreed next action.
Which catheter problems need urgent assessment?
Contact the community nurse, GP or catheter-care team immediately if drainage stops, the lower abdomen becomes painful or feels full, the catheter becomes displaced or falls out, or fever, shivering, blood or clots in the urine, or persistent leakage develops. Seek immediate advice if cloudy or foul-smelling urine raises concern about infection. If these services cannot be reached, call NHS 111. Do not wait until later in the day or for the urology appointment. Do not remove, reinsert or flush the catheter yourself. Call 999 here, or 000 in Australia, for collapse, breathing difficulty or rapid deterioration; do not drive yourself. Sources checked on 4 November 2026: NHS catheter care and immediate-help advice; Healthdirect catheter problems.
What if he insists on removing the catheter himself or refusing the trial?
Advise strongly against removing it himself, and respect that the decision is his. Explain that the clinic trial is where staff can check emptying and arrange more drainage if needed. Ask what is behind his wish, and offer to raise it with urology today.
How do I handle the appointment not being confirmed yet?
Say plainly that the date isn't confirmed and that you will contact urology today. Agree how and when he'll hear back and who to contact if he doesn't. Avoid guessing a date or promising it will be soon.
Sources
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