The candidate card
Setting
Community pharmacy
Candidate
You are a community pharmacist. Ms Revathi Vasudevan, aged 54, was diagnosed with type 2 diabetes about six weeks ago, and her GP started her on immediate-release metformin 500 mg tablets: one tablet once a day with the evening meal for the first week, then one tablet twice a day with meals. She has come in to collect her second month's supply. She has just told you she stopped taking it because of nausea and diarrhoea, and that she plans to manage her diabetes with diet alone.
Task (interlocutor: patient)
- Find out how Ms Vasudevan has been taking her metformin and about her symptoms (timing, food, how long, how severe)
- Explain that stomach side effects are common when starting metformin and describe ways to reduce them (taking it with or straight after meals, increasing the dose slowly)
- Persuade her not to give up her diabetes medication long term without first discussing it with her GP (diet alone may not be enough, other options may be available)
- Agree a plan for the next few days (what to do about her tablets until she speaks to her GP, when to stop them temporarily and get urgent advice)
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.
How to approach this card
- Check how she actually took the tablets: timing against meals, when symptoms began, how severe. Her symptoms may link to taking it without food or to the move to twice daily, so details shape your advice.
- Find out why diet alone appeals. Likely reasons include dislike of the symptoms or a wish to avoid medicine, but ask rather than assume. Acknowledge her effort with diet before you disagree.
- Normalise the side effects first, then offer the two strategies on the card with brief practical wording. She will not accept the longer-term argument until she believes the symptoms can be managed.
- Persuade as a partner, not a warning: diet alone may not be enough and other options may exist, so her GP is the right person to decide. The usual error is sounding like blame or scaring her.
- Be explicit about what to do with the tablets until she speaks to her GP, and when to stop temporarily and seek urgent advice. Use your complete reference for those situations, never a partial list.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- Lots of people feel unwell when they start this tablet, so you're not alone.
- Tell me how you took them, day by day, and I'll work out where we can help.
- I'm not asking you to carry on regardless; I'm asking you to talk it through with your GP.
- What would make taking tablets more bearable for you?
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| immediate-release metformin | a standard tablet that releases its medicine soon after you swallow it |
| type 2 diabetes | a long-term condition where the body can't control blood sugar well |
| gastrointestinal side effects | tummy upsets such as feeling sick or loose bowel motions |
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). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Pharmacy role-play cards
- Warfarin patient wanting ibuprofen for back pain Community pharmacy
- New medicines after hospital discharge Community pharmacy
- Demanding antibiotics for a sore throat Community pharmacy
All sets: nurses, doctors, other professions. Your profession's guide: OET Pharmacy.
Questions about this role-play
Can I just tell her to restart the tablets?
Explore what she is willing to do first. Explain how to make them easier to tolerate and be clear the long-term decision belongs with her GP rather than stopping quietly. Do not invent new doses; keep to what the GP prescribed.
What if she refuses all tablets?
Do not argue. Ask what would make treatment acceptable, make sure she knows how to reach her GP soon, and confirm she understands when to stop temporarily and seek urgent advice. Leaving the door open keeps her engaged.
Should I quote blood sugar targets or complication risks?
The card gives no figures, so avoid quoting any. Stay with the message that diet alone may not be enough and other options may exist. Scare tactics risk damaging trust and are not needed to make the point.
Sources
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