What is on this page and what Medicine cards test
This page gives you 15 OET Medicine role-play cards, each with your card, the interlocutor card for a study partner or the TalkDrill AI patient, a full model route through the card written by TalkDrill, and an examiner note naming the criterion the card is really testing. Before the cards, six short sections cover how the five minutes run, a consultation structure that fits inside them, how to explain a diagnosis without jargon, how to break bad news and share a decision, where doctors lose marks, and what the GMC and ECFMG actually ask for. The cards cover breaking bad news, a new diagnosis, a patient leaving against advice, an antibiotic request, consent, a statin and its side effects, a parent asking for admission, delirium, a demand for a scan, low mood, a post-operative infection, alcohol, anticoagulation, MRSA isolation and a COPD review.
Medicine cards are marked on the same nine criteria as every other profession, but the weight falls differently. Nursing cards tend to test adherence, education and reassurance. Medicine cards tend to test Information giving (a diagnosis, a result, a risk, a procedure) and shared decisions (a test the patient wants and you do not recommend, a treatment the patient fears, a discharge the patient demands). The OET criteria overview describes Information giving as finding out what the patient already knows, pausing to check understanding, encouraging reactions and checking back; almost every Medicine card on this page lives or dies on that one criterion. The criteria and scoring page has all nine with the 0 to 6 and 0 to 3 scales and a self-score sheet.
- Speaking takes approximately 20 minutes: a warm-up of about two to three minutes, then two profession-specific role plays of about five minutes each. The handbook lists two tasks, the role plays; the warm-up is not one of them.
- You get three minutes with each card before you speak. You may write on the card and look at it during the role play; you hand it back at the end.
- The role plays are recorded and two official OET assessors mark the audio. The interlocutor does not mark you.
- A role play normally ends naturally at about five minutes; if not, the interlocutor signals the close. There is no penalty for not completing every task.
- Grade B candidates have achieved predominantly 5 out of 6 on the linguistic criteria and 2 out of 3 on the clinical communication criteria.
Use a card the way the test uses it: three minutes with a pen, five minutes speaking to a partner who holds only the interlocutor card or to the TalkDrill AI role-play with a hard stop, then the model and the note. The model is one good route, not a script; the assessors mark a recording of a conversation, and a conversation follows the patient's answers. The everyday consultation English underneath every card, from opening a consultation to safety-netting, is in English for doctors: patient communication.
How the role play runs: three minutes to read, five to speak
The two role plays, about ten of the twenty minutes, are the two tasks the criteria are applied to, per the OET Test Handbook 2026. The sequence is fixed and the cards, timing and marking are identical in every delivery mode. What changes is the room: on OET on Paper, Speaking is face-to-face with the interlocutor in a private room at the centre (OET on Paper page); on OET on Computer it is usually taken at home through an online platform on a different day from the other sub-tests, and at a venue in some countries (OET on Computer page; the OET Ready speaking page names Zoom); on OET@Home it runs on the OET Speaking platform with a live interlocutor (OET@Home page).
| Step | About how long | What happens | What you do |
|---|---|---|---|
| ID check and warm-up | About 2 to 3 minutes (handbook) | Identity check, recording starts, a few easy questions about your work. Not one of the two assessed tasks. | Full sentences to warm the voice. Settle, do not perform. |
| Card 1: preparation | 3 minutes | You get the candidate card. The interlocutor holds the matching patient card. | Read twice. Circle the feeling. Decide the ideas, concerns and expectations you must find. Write plain words for every term. Plan your first sentence. |
| Card 1: role play | About 5 minutes | You lead. The interlocutor plays the patient as their card instructs, including push-back, silence or anger. | Open, gather, explain in chunks, decide together, close with a plan and a safety net. |
| Card 2: preparation | 3 minutes | A second card, usually a different kind of task (a result after a persuasion, a relative after a patient). | Same routine. Leave the first role play behind. |
| Card 2: role play | About 5 minutes | Second recorded role play. | Same shape. If the interlocutor signals time, finish the sentence and give a one-line close. |
The arithmetic of five minutes is the first thing to internalise. A typical Medicine card has four tasks; after a fifteen-second opening and a forty-five-second close, that leaves about a minute per task. The OET post on the three preparation minutes tells you to decide which task needs the time and which can be done in two sentences. On a bad-news card the time goes to the news and the reaction; on a scan-refusal card it goes to the explanation of why not; on a leaving-against-advice card it goes to the barrier and the risk. Decide before you speak, and write the plan as numbers on the card.
You are expected to take the lead. The interlocutor will not fill a silence for you, and a quiet or evasive patient is a deliberate test of structure. If the patient goes silent after bad news, that silence is yours to hold, not to fill; if the patient goes silent because they are bored, that is a sign to ask a question. The format and modes page covers the practical side of each delivery mode.
A consultation structure that fits five minutes
Doctors arrive at OET with a consultation model already in their heads, and that is an advantage as long as you compress it to five minutes and say the structure out loud. Assessors mark Providing structure on whether the conversation has a logical order and whether topic changes are signalled, per the OET criteria overview. A good structure that the patient cannot hear scores lower than a plain one that is announced. Here is the five-step shape every card on this page follows, with the time each step usually earns.
| Step | Time | Purpose | Criteria it feeds | Say |
|---|---|---|---|---|
| 1. Open | 0:15 | Name, role, reason, permission. | Relationship building | "Mr Brennan, your blood tests are back and one of them needs a proper conversation, so I am glad you came in." |
| 2. Gather: ideas, concerns, expectations | 1:00 | What the patient thinks is going on, what worries them most, what they hoped you would do today. | Information gathering; Understanding the patient's perspective | "What do you think is going on?" "What worries you most about it?" "What were you hoping I would do today?" |
| 3. Explain in chunks | 2:00 | The diagnosis, result, risk or reasoning, two or three sentences at a time, plain words, a check after each chunk. | Information giving; Appropriateness; Fluency | "Can I explain what the test shows?" "How does that sound so far?" "Shall I go on?" |
| 4. Decide together | 1:00 | Options with honest trade-offs; the patient's preference; the practical barriers solved. | Understanding the patient's perspective; Information giving | "There are two reasonable options." "Which would you prefer?" "What would make that easier?" |
| 5. Close with a safety net | 0:45 | Summarise the plan, check back, name the warning signs and the next contact, invite a last question. | Providing structure; Information giving | "So, to go over it..." "Can you tell me what you would do if...?" "What is the one question you still have?" |
Step 2 is the one doctors skip under pressure, and it is the step that costs most. Ideas, concerns and expectations are not a formality; they tell you which explanation to give. In card M02, the patient's mother lost a leg to diabetes, and a candidate who explains the condition before learning that gives a textbook answer to a man who is quietly terrified and hiding it with jokes. In card M09, the patient believes a disc has "slipped", and no amount of scan logic lands until that belief is named and corrected. Ask first, in plain words, and listen for the answer that changes your plan.
Worked opening and gather (card M09, the MRI request), written by TalkDrill
The first forty seconds
"Mr Kowalski, four weeks of back pain and time off work is a lot to deal with. Before we talk about scans, can I ask what you think is going on in your back, what worries you most, and what you were hoping I would do today?"
One sentence that acknowledges the situation, then ideas, concerns and expectations in one breath. The patient's answer ("something has slipped, moving will make it worse, I am worried about my job, I want a scan") gives you the whole second half of the role play: the belief to correct, the fear to name and the expectation to handle.
Explaining a diagnosis without jargon
Appropriateness of language is marked on whether you use words a non-medical person can understand, per the OET criteria overview, and Information giving is marked on chunking and checking. Doctors lose more on these two than on grammar, because the card is written in clinical language and it is natural to speak the words you have just read. The fix is mechanical: in the preparation minutes, write a plain version beside every term on the card, and in the role play say the plain version first. Add the term afterwards only if the patient will meet it elsewhere ("the nurses will call it a hypo").
| On the card | Say to the patient | Then, if useful |
|---|---|---|
| Type 2 diabetes, raised HbA1c | "The sugar level in your blood has been too high for some months." | "That is what type 2 diabetes means." |
| Troponin to be repeated | "The blood test that shows whether the heart muscle has been damaged can be normal in the first hours and rise later, so we repeat it." | No term needed. |
| Mechanical low back pain, no red flags | "The pain is coming from the muscles and joints of the lower back, and your examination shows nothing dangerous: strength, feeling and reflexes are all normal." | "We call that mechanical back pain." |
| Atrial fibrillation, anticoagulation | "Your heart is beating irregularly, which lets blood pool and form a clot; the tablet thins the blood so a clot is much less likely to cause a stroke." | "The rhythm is called atrial fibrillation." |
| Viral pharyngitis, antibiotics not indicated | "This is a virus, and antibiotics only kill bacteria, so they would not shorten it but could give you side effects." | No term needed. |
| Delirium | "The infection has upset the way her brain is working, so she is confused. This is common in older people and usually improves as the infection clears." | "The medical word is delirium." |
| MRSA colonisation, isolation | "A germ that lives on the skin of some people without harming them has been found on you. It is harder to treat with usual antibiotics, so we keep it away from other patients' wounds." | "It is called MRSA." |
| Prophylactic, post-operatively | "To prevent problems after the operation." | No term needed. |
Two more habits that protect the Appropriateness mark. Give any figure as something the patient can picture ("about one person in every ten") rather than as a percentage, and give instructions as suggestions with a reason ("I would suggest walking today, because backs heal by moving") rather than as orders. The Hindi and Arabic speakers page covers the sentence-level habits that make explanations harder to follow for those first languages, and the Malayalam page covers word stress in long drug and condition names, which is the Intelligibility risk in every explanation.
Breaking bad news and sharing decisions
These are the two Medicine tasks candidates fear most, and they share one rule: say the hard thing plainly, once, and then stop talking. Both are marked mainly on Information giving and on Understanding the patient's perspective, with Fluency scored on whether your pauses are deliberate rather than searching.
Bad news: warning shot, plain word, silence, honesty, next contact
Card M01 (the biopsy that confirms bowel cancer) carries the full sequence. Find out what the patient expects ("probably piles"). Give a warning shot: "I have the results, and I am afraid the news is not what we hoped." Pause. Say the word: "The biopsy shows that the bleeding was caused by a cancer in the bowel." Then do not fill the silence; the silence is the patient's. When they speak, answer what they actually asked. "How long have I got?" gets honesty about uncertainty, not a dodge and not a promise: what is known today, what the scan next week will tell, and that you will say clearly what it shows. Close with a named contact and a check: "Can you tell me what you will tell your wife, so we are sure it is clear?" The losses are predictable: softening the news into vagueness ("some abnormal cells"), filling the silence with a speech ("I did not hear anything after the word cancer", says the interlocutor card), and promising outcomes.
Shared decisions: the option, the trade-off, the preference, the barrier
Cards M03 (leaving with chest pain), M06 (the statin), M09 (the scan) and M13 (anticoagulation) are shared-decision cards, and the structure is the same each time. Make the decision shared out loud at the start: "I will not stop you against your will. Before you decide, can I understand what is pulling you away? Then I will tell you honestly where we are, and we can decide together." State the risk once, specifically and without threat: what the test is for, what could be missed, and that you are saying it so the decision is informed. Solve the practical barrier, because it is usually the real one: the meeting that can be a phone call, the child who can be collected by someone else. Offer a reversible option where there is one: a three-month trial of the statin with a blood test, stop if it does not suit. Then hand the decision back and respect it, with a safety net: "If the pain comes back, even mildly, call an ambulance; do not drive yourself."
Worked shared decision (card M06, the statin), written by TalkDrill
"There is no emergency here. You could try it for three months and we check how you feel and a blood test; if it does not suit you, we stop. Or you could take time to think. Which would you prefer?"
Two real options, a reversible trial, and the choice given to the patient. The examiner note on M06 says marks go for dismissing the reading, overstating the benefit, or not offering a reversible trial.
Where doctors lose marks
First, the honest context. The OET 2025 demographic data PDF shows Speaking is the sub-test our readers are most likely to pass: 85.0 per cent of Malayalam first-language candidates, 89.1 per cent of Hindi speakers, 85.4 per cent of Tagalog/Filipino first-language candidates and 91.1 per cent of Arabic speakers reached Grade B or above in Speaking in 2025. The same PDF's profession table shows Medicine candidates as a whole at 92.8 per cent in Speaking, against 77.6 per cent in Listening and 78.9 per cent in Reading. The blockers for the first-language groups above are Listening and Reading; for Malayalam speakers the B rate was 27.8 per cent in Listening and 24.0 per cent in Reading. A doctor with good consultation habits should expect to secure B in Speaking with focused practice, and should give the larger share of study hours to the Listening and Reading sub-tests. For the GMC and ECFMG, where all four sub-tests must come from one sitting, that balance matters even more.
When doctors do miss B in Speaking, it is rarely for English. The losses below are the ones the official criteria descriptors penalise most directly, each with the criterion it hits.
| The loss | What it sounds like | Criterion it hits | The fix |
|---|---|---|---|
| The lecture | Ninety seconds of correct pathophysiology with no pause and no question. | Information giving; Providing structure | Two or three sentences, then a check. Ask what the patient already knows before you start. |
| Skipping ideas, concerns, expectations | Explaining the scan logic to a man who thinks a disc has slipped. | Information gathering; Understanding the patient's perspective | Three questions in the first minute, every card. |
| Jargon straight off the card | "We will repeat the troponin and keep you under observation." | Appropriateness of language | Plain words written in the preparation minutes; the term second, if at all. |
| Commanding | "You must stay." "You have to take it." | Appropriateness; Relationship building | "I would strongly suggest", "my advice is", then the reason, then the choice. |
| Vague bad news | "Some abnormal cells", "something we need to keep an eye on". | Information giving | Warning shot, the plain word once, silence. |
| Filling the silence | The patient goes quiet and the doctor talks for a minute. | Fluency (pausing well is part of it); Understanding the patient's perspective | Count to five. Then: "What is going through your mind?" |
| Promising outcomes | "Do not worry, it will be fine." "You will definitely be home tomorrow." | Information giving | What is known, what is not, when you will know more. |
| Catastrophising to win | "If you leave you could die tonight." | Appropriateness; Relationship building | Specific risk, stated once, with the reason you are saying it. |
| No safety net, no close | The interlocutor ends the role play during task three. | Providing structure; Information giving | Start the close at four minutes: plan, check back, warning signs, next contact. |
| Stress and endings | "anTIbiotics", "DIabetes", a swallowed "-ed" on "settled". | Intelligibility | Mark stress on every long word on the card; slow down on drug names and numbers. |
GMC and ECFMG targets: one sitting
Doctors on the PLAB and GMC route and doctors on the ECFMG Pathways route both take OET Medicine, and both regulators apply a one-sitting rule, which changes how you should prepare. The table is per the GMC page on using your OET certificate and the ECFMG Pathways OET page, both read in full on 20 October 2026, and matches our regulator requirements page, which re-checks both weekly. Both sites refuse plain automated fetches, so if you re-check them yourself, open them in a normal browser. Read the regulator's page yourself before you book.
| Regulator | OET version | Minimum | Sittings | Status |
|---|---|---|---|---|
| GMC (UK) | Medicine | Grade B in all four sub-tests | One sitting; the most recent sitting counts | Per the GMC page on using your OET certificate; read 20 October 2026 |
| ECFMG Pathways (USA) | Medicine | 350 in Listening, Reading and Speaking; 300 in Writing | One test administration | Per the ECFMG Pathways OET page; read 20 October 2026 |
| NMC (UK nurses, for comparison) | Nursing | B in Listening, Reading and Speaking; C+ in Writing | Two sittings can be combined within the NMC's rules | NMC OET page, verified 19 October 2026 |
Three consequences for a doctor. First, a Speaking B on its own is worth nothing to the GMC or ECFMG unless Listening, Reading and Writing clear the line on the same day, so a strong speaker who is weak in Reading should put the hours there; the 2025 figures above show Reading is the weaker sub-test for Medicine candidates as a group and by a wide margin for the first-language groups most of our readers belong to. Second, a doctor keeping both routes open should prepare to the GMC line, because its Writing minimum (B) is higher than ECFMG's (C+). Third, because one sitting must do everything, book a date that gives all four sub-tests time, not a date that suits Speaking. The dates page lists the OET on Paper Saturdays from the OET booking page (7 and 21 November, 5 and 19 December 2026, booking closing 24 days before) and the computer and @Home pattern of around ten dates a month with a seven-day cut-off. Grade B is 350 to 440 on the 0 to 500 scale, per the OET Test Handbook 2026; the results and grades page explains the scale and how to let a regulator verify your result.
The 15 Medicine cards in full
Each card below is written by TalkDrill in the shape of the OET candidate card (setting, patient, tasks) with the matching interlocutor card. Give the interlocutor card to a partner, or let the AI play it, and do not read it yourself until you have spoken. The model route is deliberately not a full transcript; it shows the opening, the hardest moment handled with the exact words, and the close. The examiner note names the criterion the card is really testing. M01 to M06 are the core information-giving and shared-decision set (bad news, a new diagnosis, leaving against advice, an antibiotic request, consent, a statin); M07 to M15 add a parent, delirium, a scan request, low mood, a post-operative infection, alcohol, anticoagulation, MRSA and a chronic disease review.
Card M01: Breaking bad news: biopsy confirms bowel cancer
Setting: Hospital outpatient clinic. You are the doctor.
Patient: A 63-year-old who had a colonoscopy and biopsy ten days ago for rectal bleeding. The results confirm a cancer of the bowel. Staging scans have been arranged. The patient has come alone and believes the bleeding was "probably piles".
Task:
- Find out what the patient understands and is expecting from today.
- Break the news clearly and compassionately, at the patient's pace.
- Respond to the patient's reaction and questions, being honest about what is and is not yet known.
- Explain the next steps (scans, the specialist team meeting, a named contact) and arrange support.
Interlocutor card (patient or relative): You are 63. You expected to be told it was haemorrhoids and to be sent home. When you hear the word cancer, go quiet for a while, then ask "how long have I got?" and "is it my fault, I never went to the doctor". You live with your wife, who wanted to come but you told her not to bother. If the doctor gives you time and is honest about what is unknown, you ask about the next steps and whether your wife can come to the next appointment. If the doctor gives a long speech, say "I did not hear anything after the word cancer".
Model route through the card (TalkDrill worked example)
Opening: "Mr Dawson, thank you for coming in. Before we talk about the results, can I ask what you have been thinking since the camera test, and what you were expecting to hear today?" Then a warning shot: "I have the results, and I am afraid the news is not what we hoped." Pause. Let him prepare.
The hardest moment is the word itself and the silence after it. Say it plainly, once, then stop: "The biopsy shows that the bleeding was caused by a cancer in the bowel." Do not fill the silence. When he speaks, answer what he actually asks. "How long have I got?" deserves honesty about uncertainty, not a dodge: "I cannot answer that yet, and I will not guess. What we know today is that there is a cancer in the bowel. What we do not yet know is whether it has spread, and that is what the scan next week will tell us. Many bowel cancers found this way can be treated with surgery. When we have the scan, I will tell you clearly what it shows and what the options are." On "is it my fault": "No. Bleeding from the back passage is usually piles, and most people assume that. You came, and that is what matters now."
Close: "This is a lot to take in alone. I would like your wife to come to the next appointment, if you agree. Here is the name and number of the specialist nurse who will be your contact; you can ring her tomorrow with the questions you will think of tonight. Before you go, can you tell me what you will tell your wife, so we are sure it is clear?"
Examiner note: Tests Information giving under emotional load, Relationship building and Fluency used well (pauses are part of fluency here). Marks are lost by softening the news into vagueness ("some abnormal cells"), by filling the silence, or by promising outcomes. Assessors want a warning shot, the plain word, a pause, honest uncertainty and a named next contact.
Card M02: Explaining a new diagnosis of type 2 diabetes
Setting: General practice. You are the GP.
Patient: A 47-year-old delivery driver whose routine blood tests show type 2 diabetes. He has no symptoms and came in expecting to be told everything was normal.
Task:
- Find out what the patient knows about diabetes and any family history.
- Explain the diagnosis in plain language and what it means for his health long term.
- Discuss the first steps: food, activity, weight, and that medication may be needed.
- Agree a plan and the follow-up, including education and eye and foot checks.
Interlocutor card (patient or relative): You are 47, a delivery driver who eats on the road. Your mother had diabetes and lost a leg, so the word terrifies you, though you hide it with jokes. You ask "do I have to inject?" and "can I still drive?" early. You eat two takeaways a day and your only exercise is carrying parcels. If the doctor explains calmly and gives you two or three realistic changes rather than a lecture, you engage. If the doctor lists complications first, you go quiet and say "so I am going to end up like my mum".
Model route through the card (TalkDrill worked example)
Opening: "Mr Brennan, your blood tests are back and one of them needs a proper conversation, so I am glad you came in. Before I explain, can I ask what you know about diabetes? Some people have family experience of it." The family history shapes the whole consultation; find it before you say the word.
The hardest moment is the mother. He needs the diagnosis and the hope in the same breath: "The blood test shows type 2 diabetes. I can see what that word means to you because of your mum, so let me say the most important thing first. What happened to your mother is what diabetes does when it is not found or not controlled for many years. Yours has been found early, before any symptoms, and that is the best time to find it. Controlled well, most people with type 2 diabetes keep their eyes, their feet and their driving licence." Then the plain explanation: "Type 2 diabetes means the body is not handling sugar in the blood properly, so the level stays high. Over years, high sugar damages small blood vessels. Bringing it down protects them." Then his questions: "No injections at this stage; many people start with food and activity changes and a tablet if needed. You can keep driving; we will talk about what to tell the licensing authority if your treatment changes."
Close: "Three things to start: swap one takeaway a day for something you make, walk for twenty minutes on your break, and come back in two weeks for a longer appointment with the nurse, who will teach you the rest. Eye and foot checks get booked today. What is the one question you still have?"
Examiner note: Tests Information giving and Understanding the patient perspective. Marks go when the candidate lists complications before discovering the family history, or uses "HbA1c" and "insulin resistance" without translation. Assessors look for the diagnosis given plainly, hope grounded in facts, and two or three concrete first steps.
Card M03: Chest pain, patient wants to go home against advice
Setting: Emergency department. You are the doctor.
Patient: A 54-year-old who came in with chest pain this morning. The pain has settled. The first heart tracing was unclear and the blood test for heart damage must be repeated in a few hours. The patient wants to leave now because of a business meeting and a child to collect from school.
Task:
- Find out why the patient wants to leave and what is driving the decision.
- Explain clearly why staying for the repeat test matters and what could be missed.
- Explore solutions for the practical problems.
- If the patient still wants to leave, explain the risks honestly and what to do if the pain returns, and respect the decision.
Interlocutor card (patient or relative): You are 54, self-employed, and a missed meeting means a lost contract. Your child finishes school at three and your partner is away. The pain has gone and you feel foolish for coming. Your brother had "a scare" that turned out to be indigestion. If the doctor explains what the repeat test is for and helps with the practical problems (a phone call, a relative to collect the child), you agree to stay. If the doctor says "you cannot leave" or threatens you with dying, you insist on going.
Model route through the card (TalkDrill worked example)
Opening: "Mr Adeyemi, I hear you want to go, and I will not stop you against your will. Before you decide, can I understand what is pulling you away? Then I will tell you honestly where we are with your tests, and we can decide together." Making the decision shared, out loud, defuses the stand-off.
The hardest moment is explaining risk without threatening. Be specific about what the test is for: "Your pain has settled, which is good, but settled pain does not tell us what caused it. The first heart tracing was not clear, and the blood test that shows whether the heart muscle has been damaged can be normal in the first hours and rise later. That is why we repeat it. If we miss a small heart attack today, the next one may not settle. I am not saying this to frighten you; I am telling you what the test is for, so that your decision is an informed one." Then move to the practical, because that is the real barrier: "Let us deal with the meeting and your child. Can the meeting be a phone call from here? Is there anyone who can collect your child, and can I ring them to explain that you are being kept for a test?" If he still chooses to leave: "That is your decision and I respect it. I will write down that we discussed the risks. If the pain comes back, even mildly, call an ambulance; do not drive yourself."
Close: "So you will stay until the second blood test at four, we have arranged your child, and if that test is normal you go home tonight with a follow-up. Is there anything else I can sort out to make the wait easier?"
Examiner note: Tests shared decision making: Understanding the patient perspective and Information giving about risk. Marks are lost by commanding ("you must stay"), by catastrophising, or by never addressing the school pick-up. Assessors want the barriers found and solved, the risk stated plainly, and the patient left with the decision.
Card M04: Request for antibiotics for a viral sore throat
Setting: General practice. You are the GP.
Patient: A 31-year-old teacher with three days of sore throat, runny nose and cough. Examination shows a viral upper respiratory infection. The patient asks for antibiotics because "they always work" and there is a school inspection next week.
Task:
- Find out the patient's expectations and reasons for wanting antibiotics.
- Explain the diagnosis and why antibiotics will not help, including the harms.
- Explain how to manage the symptoms and how long recovery usually takes.
- Agree a safety net: what should prompt a return visit.
Interlocutor card (patient or relative): You are 31, a teacher, and your head teacher expects you in for the inspection. Last year you were given antibiotics for a sore throat and felt better in two days, so in your mind they work. You think the doctor is refusing to save money. If the doctor explains clearly why the antibiotics "worked" last year and gives you a real plan to get through the week, you accept. If the doctor just says "it is viral", push back: "That is what they always say".
Model route through the card (TalkDrill worked example)
Opening: "Ms Okafor, you have had a rough few days and you have an inspection coming up, so I understand why you want something that works fast. Can I ask what you are hoping for from today, and why antibiotics in particular?" The expectation is on the card; get it in the patient's words anyway.
The hardest moment is "they worked last year". Do not argue with the experience; explain it: "I believe you felt better two days after starting them last year. The thing is, a sore throat like this usually turns the corner around day four or five on its own, and antibiotics are often started on day three, so they get the credit for what your body was already doing. Today your throat, ears and chest show a viral infection. Antibiotics do nothing to viruses, and they come with real costs: diarrhoea, thrush, allergic reactions, and the next time you truly need them they may work less well." Then be useful: "What will actually help this week: regular paracetamol or ibuprofen for the throat, plenty of fluids, salt-water gargles, honey and lemon, and rest in the evenings. You will probably be noticeably better by the weekend. I am happy to give you a note for the head if you need to rest a day before the inspection."
Close: "Here is the safety net. If you develop a high fever that does not settle, difficulty swallowing fluids or breathing, or you are getting worse after a week rather than better, come straight back and we will re-examine you. Is that a plan you can work with?"
Examiner note: Tests Information giving and Appropriateness of language with a patient whose expectation is wrong. The usual loss: repeating "it is viral" without explaining the previous experience, and leaving the patient with nothing useful. Assessors look for the expectation explored, the harms stated, a symptom plan and a clear safety net.
Card M05: Consent for a colonoscopy, patient anxious about the procedure
Setting: Gastroenterology clinic. You are the doctor.
Patient: A 59-year-old referred with a change in bowel habit. A colonoscopy has been recommended. The patient is frightened of the procedure, embarrassed, and has heard "it is agony".
Task:
- Find out what the patient knows and fears about the procedure.
- Explain why it is recommended, what it involves, the preparation, the sedation options and the main risks and alternatives.
- Check understanding and answer questions.
- Confirm whether the patient agrees to proceed and what happens next.
Interlocutor card (patient or relative): You are 59 and private. A friend described colonoscopy as the worst pain of her life, and you are embarrassed about the whole area. You also do not understand why a scan would not do. You do not want to know every statistic; you want to know if it will hurt, if you will be awake and whether something could go wrong. If the doctor answers those three honestly, you agree. If the doctor reads out a list of risks like a form, you say "I will think about it" and do not book.
Model route through the card (TalkDrill worked example)
Opening: "Mrs Lindqvist, the test I want to talk about is a colonoscopy. Before I explain it, can I ask what you already know about it and what you have heard? I would rather deal with your worries than guess at them." She names the friend; now you know the three questions she is really asking.
The hardest moment is giving enough information for real consent without burying her. Answer the three questions in order: "Will it hurt? It can be uncomfortable, with cramping as the air goes in, and we offer sedation and pain relief, which most people say makes it manageable; some remember very little. Will you be awake? Lightly sedated, able to respond, usually relaxed. Can something go wrong? The serious risk is a tear in the bowel wall, which is rare but would need an operation, and some bleeding if we remove a polyp. I tell you this so that you decide knowing it, not to frighten you." Then why not a scan: "A scan can show a shadow, but only the camera lets us see the lining clearly and take a sample at the same time, and a change in bowel habit at your age is exactly the symptom we should not leave unexplained." Preparation explained plainly: the clear-fluid day, the laxative, the time away from work.
Close: "You do not have to decide in this minute, but I would recommend it, and I would recommend doing it soon. Can you tell me, in your own words, what the test involves and the main risk? Good. Shall I book it, and would you like a copy of what we discussed to take home?"
Examiner note: Tests Information giving for consent: benefits, risks and alternatives, in language the patient can use. Marks are lost by reading the risks as a list without pausing, by hiding the serious risk, or by never checking understanding. Assessors want the patient fears driving the order of information and a teach-back before agreement.
Card M06: Starting a statin, patient has read about side effects
Setting: General practice. You are the GP.
Patient: A 56-year-old with raised cholesterol and a family history of early heart disease. A statin has been recommended. The patient has read online about muscle pain, memory problems and "doctors being paid to prescribe them", and is reluctant.
Task:
- Find out what the patient has read and which concerns matter most.
- Explain the reason for the recommendation in terms of the patient's own risk.
- Give a balanced account of the benefits and the side effects, and what would happen if a side effect occurred.
- Reach a shared decision and agree follow-up.
Interlocutor card (patient or relative): You are 56. Your father had a heart attack at 60, which frightens you, but you are proud of being "not a pill person". A relative stopped statins because of aching legs. You half believe the conspiracy posts but mostly you want to be taken seriously. If the doctor gives you a balanced picture and says you can stop if side effects occur, you agree to a trial. If the doctor dismisses what you read as nonsense, you refuse.
Model route through the card (TalkDrill worked example)
Opening: "Mr Castellano, I would like to talk about a statin, but I can see you have already done some reading, and I would rather start with that. What have you read, and which part concerns you most?" Treating the reading as a starting point rather than a problem earns the next ten minutes.
The hardest moment is balancing honesty about side effects with the reason to take it. Do both, and tie it to him: "Your father's heart attack at sixty and your cholesterol together put you in a group where a statin makes a real difference to the chance of a heart attack or stroke over the next ten years. That is the reason, not a target on a screen. Now the side effects, honestly: some people get muscle aches, and your relative may well have. If that happens, you tell me, we stop or switch, and the aches go. Memory problems have been looked for carefully in large studies and the evidence does not support that worry. On doctors being paid, I can only tell you that I am not, and that the recommendation comes from the same guidance that applies to me and my family." Then share the decision: "There is no emergency here. You could try it for three months and we check how you feel and a blood test; if it does not suit you, we stop. Or you could take time to think. Which would you prefer?"
Close: "So a three-month trial, one tablet at night, ring me if you get any aches, and a blood test and review in twelve weeks. Can you tell me what you would do if you got muscle pain? Good. Any last question?"
Examiner note: Tests shared decision making and balanced Information giving. Marks are lost by dismissing the reading, by overstating benefit, or by not offering a reversible trial. Assessors look for the concern ranked by the patient, the risk made personal, side effects stated honestly with a plan, and a real choice.
Card M07: Parent wants admission for a child with gastroenteritis
Setting: Paediatric assessment unit. You are the doctor.
Parent: The father of a three-year-old girl with two days of vomiting and diarrhoea. You have assessed her: she is mildly dehydrated but drinking, alert and safe to go home with oral rehydration. The father wants her admitted "to be safe".
Task:
- Acknowledge the father's worry and find out what is behind the request for admission.
- Explain your assessment and why home care is safe for her now.
- Explain exactly how to rehydrate at home and what to expect over the next days.
- Give clear warning signs for return and check the father is confident.
Interlocutor card (patient or relative): You are the father. Your wife is a nurse working nights and she told you to "make them keep her". Your daughter has never been this ill, she is floppy compared with usual, and you are scared you will miss something at home alone. You feel the hospital wants the bed. If the doctor explains what was checked and gives you a clear plan with numbers you can act on, you agree to go home. If the doctor says "she is fine", you say "she is not fine, look at her".
Model route through the card (TalkDrill worked example)
Opening: "Mr Haddad, I can see Lina has had a miserable two days and that you are worried. Before I explain what I found, can I ask what is making you feel she needs to stay in? Sometimes there is something specific behind it." He mentions his wife and being alone at night; now you know what to solve.
The hardest moment is "she is not fine, look at her". Agree with what he sees, then show your reasoning: "You are right, she is not herself, and a three-year-old who is flat like this is frightening to look at. Let me tell you exactly what I checked. Her heart rate and breathing are normal, her mouth is moist, she is passing urine, and when I pinched the skin on her tummy it sprang back. She also kept down the fluid we gave her here. Those are the signs that tell us the dehydration is mild and that her body is coping. Children with a tummy bug look dreadful and then bounce back within a few days. Admission would not change what we do; it would be the same fluids, in a ward full of other infections." Then the plan, concrete: "Small sips of the rehydration solution every five to ten minutes, a syringeful at a time, even if she vomits some back. Keep going through the night. A dry nappy for more than eight hours, no tears when she cries, drowsiness you cannot wake her from, or blood in the diarrhoea: come straight back, day or night."
Close: "You can also phone the unit tonight if you are unsure, and your wife is welcome to call us. Can you tell me how you will give the fluids and what would bring you back? Good. You know her best; trust that."
Examiner note: Tests Information giving with a third party and Relationship building. The usual loss: "she is fine" without showing the evidence, or warning signs given as a vague list. Assessors want the worry behind the request found, the assessment explained in observable terms, a precise home plan and a checked safety net.
Card M08: Delirium in an elderly patient, daughter asking for answers
Setting: Medical ward. You are the doctor.
Relative: The daughter of an 85-year-old woman admitted with pneumonia two days ago. Since this morning the patient has been confused, agitated and accusing staff of stealing. The daughter is upset and wants to know whether her mother "has gone mad" and whether she will be sedated.
Task:
- Acknowledge the daughter's distress and find out her mother's usual mental state.
- Explain delirium, its likely cause in this case and the expected course.
- Explain the management approach, including why sedation is used sparingly and what the ward does instead.
- Discuss how the daughter can help and agree how she will be updated.
Interlocutor card (patient or relative): You are the daughter and your mother's main carer. Your mother was forgetful but managed at home with help; she has never been like this. You are frightened she will be "drugged" because you saw that happen to a neighbour. You feel guilty that you brought her in. You keep asking "is this permanent?". If the doctor is calm, defines the word and gives you a role, you settle. If the doctor talks about "antipsychotics" and "sepsis", you say "please talk to me in English".
Model route through the card (TalkDrill worked example)
Opening: "Mrs Sullivan, I am Dr Ahmed, I am looking after your mother. Hearing her accuse the nurses must be distressing, and I would like to explain what we think is happening. First, could you tell me what she was like at home last week? That really helps us." The baseline matters for the diagnosis and shows respect for the mother as a person.
The hardest moment is the two fears: permanent madness and being drugged. Take them separately: "What your mother has is delirium. It is sudden confusion caused by illness, here the pneumonia, and it is common in older people when they are unwell and in a strange place. It is not madness and it is not usually permanent. As the infection is treated, most people clear over days, sometimes a week or two, though with her previous forgetfulness recovery can be a little slower. On sedation: we avoid sedating medicines where we can, because they can make delirium worse. What we do instead is treat the infection, keep her hydrated, get her glasses and hearing aid on, keep the lights right for day and night, and have familiar people around. Only if she is a danger to herself would we consider a small dose of medicine, and we would tell you first."
Close: "You can help more than any of us: come at the times she is most unsettled, bring photographs, talk about ordinary things, and gently remind her where she is. You did the right thing bringing her in. I will update you after the round each day; here is the ward number. What else would you like to ask?"
Examiner note: Tests Information giving and Appropriateness of language with an anxious carer. Marks are lost by jargon, false certainty on timing, or skipping the sedation fear the card hands you. Assessors look for delirium defined plainly, the course given honestly, the non-drug approach explained and a role for the relative.
Card M09: Low back pain, patient demanding an MRI scan
Setting: General practice. You are the GP.
Patient: A 38-year-old warehouse worker with four weeks of low back pain after lifting. Examination shows simple mechanical back pain with no warning signs. The patient wants an MRI "to find out what is wrong" and has stopped work and most activity.
Task:
- Find out the patient's ideas, concerns and expectations about the pain and the scan.
- Explain your assessment and why a scan is not recommended now.
- Explain the plan: staying active, pain relief, physiotherapy, gradual return to work.
- Agree the warning signs that would change the plan and arrange review.
Interlocutor card (patient or relative): You are 38. You believe something has "slipped" and that moving will make it worse, so you have been resting in bed. A colleague had a scan and then an operation and is fine now. You are worried about losing your job and about being told it is "all in your head". If the doctor explains what the examination showed and why movement helps, and offers a real plan with a return visit, you accept it. If the doctor refuses the scan without explaining, say "so you are just going to fob me off with painkillers".
Model route through the card (TalkDrill worked example)
Opening: "Mr Kowalski, four weeks of back pain and time off work is a lot to deal with. Before we talk about scans, can I ask what you think is going on in your back, what worries you most, and what you were hoping I would do today?" Ideas, concerns, expectations, in that order, in plain words.
The hardest moment is refusing the scan without sounding dismissive. Explain the examination, then the scan logic: "Here is what I found. Your strength, reflexes and feeling in the legs are all normal, you have no bladder or bowel problems, and the pain is in the muscles and joints of the lower back, which is what we see after a lifting strain. That pattern is called mechanical back pain, and it is the most common kind. A scan now would not change what we do, and there is a problem with scans: most people your age have changes on an MRI that are normal wear and have nothing to do with pain. Seeing them tends to make people more worried and less active, which slows recovery." Then the belief that is doing the damage: "The most important thing I can tell you is that nothing has slipped and that resting in bed is making this worse, not better. Backs heal by moving. Gentle walking today, build up each day, regular pain relief so that you can move, and I will refer you to physiotherapy."
Close: "The signs that would change this plan are numbness around the back passage, trouble passing urine, or weakness in a leg; those need same-day help. Otherwise, I will see you in three weeks, and we will plan the return to lighter duties with your employer. What do you make of that?"
Examiner note: Tests Information gathering (ideas, concerns, expectations) and Information giving about why a test is not done. Marks are lost by refusing the scan before exploring the belief that something has slipped. Assessors want the examination findings explained, the scan reasoning given, the harmful belief corrected and a definite plan with review.
Card M10: Low mood after bereavement, reluctant to talk
Setting: General practice. You are the GP.
Patient: A 66-year-old man who has come about "poor sleep". His wife died five months ago. The nurse noted that he has lost weight and seems withdrawn. He has not mentioned his mood.
Task:
- Explore the sleep problem and gently widen the conversation to mood, appetite, energy and daily life.
- Ask directly and sensitively about thoughts of self-harm.
- Explain what grief and depression can look like and that help is available.
- Agree a next step the patient is comfortable with and arrange follow-up.
Interlocutor card (patient or relative): You are 66. You came for sleeping tablets and you do not want to "make a fuss". You wake at four every morning, you have stopped cooking, you have not seen friends since the funeral, and sometimes you think you would not mind not waking up, though you have no plan to harm yourself. You think men of your generation should cope. If the doctor is patient and asks directly without fuss, you answer honestly and accept a follow-up and perhaps talking to someone. If the doctor seems rushed or reaches for a prescription, you say "just the tablets, doctor".
Model route through the card (TalkDrill worked example)
Opening: "Mr Fletcher, you mentioned sleep. Tell me what the nights are like." Then listen for the pattern and widen slowly: "Waking at four every day is exhausting. I am sorry about your wife; five months is no time at all. How have the days been since she died?" Open questions, short ones, and silence that you do not rush to fill.
The hardest moment is asking about self-harm directly without alarming him. Normalise, then ask plainly: "When people are grieving and sleeping badly and have stopped eating, it is common to have very dark thoughts. Some people tell me they would not mind not waking up. Have you had thoughts like that?" If yes: "Thank you for telling me. Have you had any thoughts of doing something to end your life, or made any plans?" Hear the answer calmly. Then name what you are seeing: "Grief is not an illness, and much of what you describe is grief. But the early waking, the weight loss, the withdrawal from friends and the dark thoughts together suggest the grief has tipped into depression, which is common after a loss like yours and which does respond to help. It is not weakness and it is not making a fuss."
Close: "I am not going to push tablets at you today. I would like to see you again next week, and I would like you to consider talking to the bereavement counsellor, who sees people exactly where you are. If the dark thoughts get stronger before then, here is the number to ring any time. Would you be willing to come back on Tuesday?"
Examiner note: Tests Information gathering with a reluctant patient and Relationship building. Marks are lost by jumping from "poor sleep" to depression scales, by avoiding the self-harm question, or by prescribing to end the conversation. Assessors listen for open questions, silence used well, a direct risk question and a step the patient agrees to.
Card M11: Readmitted with a wound infection after surgery
Setting: Surgical admissions unit. You are the doctor.
Patient: A 50-year-old discharged five days ago after a gall bladder operation, now readmitted with a red, discharging wound and a fever. The patient is angry, believes the surgery was "botched" and wants to complain.
Task:
- Acknowledge the patient's anger and find out what happened since discharge.
- Explain what a wound infection is, why it can happen after good surgery, and how it will be treated.
- Explain the patient's right to complain and how to do so, without becoming defensive.
- Agree the plan for the next 24 hours.
Interlocutor card (patient or relative): You are 50. You were told the operation went well and you would be back at work in a week. Now you are back in hospital, feverish and frightened, and you feel lied to. Underneath the anger you are scared the infection will spread. You want someone to say sorry. If the doctor listens, explains without excuses and tells you how to complain, you calm down and ask about treatment. If the doctor says "these things happen" or blames the way you cared for the wound, you escalate.
Model route through the card (TalkDrill worked example)
Opening: "Mr Novak, I am Dr Pereira. You have had a horrible week: an operation, home, and now back here with a fever. I would be angry too. Before I examine you properly, tell me what has happened since you went home, from the beginning." Letting him tell it, uninterrupted, is the treatment for the anger.
The hardest moment is the accusation of botched surgery and the demand for an apology. Apologise for the experience without inventing fault, and explain honestly: "I am sorry that this has happened to you and that you are back here. From what I can see, you have an infection in the wound. That is a known complication after any operation, even when the surgery itself is done well, because the skin is opened and bacteria that live on all of us can get in. I have looked at your operation notes and the surgery went as planned. That does not make this any less unpleasant for you, and I am not going to tell you it is nothing. It needs treating now, properly." Then the complaint: "You have every right to raise a complaint, and I will give you the details of the patient liaison service before you leave this unit; raising it will not affect your care in any way." Then the plan: "We will take a swab, start antibiotics through a drip tonight, clean and dress the wound, and check your blood. If there is a collection of pus, you may need it drained. We will know more by tomorrow morning."
Close: "So tonight: antibiotics, dressings, bloods, and I will see you on the morning round with the results. Here is the complaints information. Is there anything you want to ask me now that you have the full picture?"
Examiner note: Tests Relationship building under hostility and honest Information giving. Marks are lost by defending the surgeon, blaming the patient, or apologising so vaguely that it sounds like an admission of error. Assessors want the story heard, a sincere apology for the experience, a plain explanation of the complication, the complaint route given and a concrete plan.
Card M12: Raised liver tests, discussing alcohol
Setting: General practice. You are the GP.
Patient: A 44-year-old accountant whose routine blood tests show raised liver enzymes. On questioning he drinks most evenings and more at weekends, well above low-risk levels. He has come to "get the results".
Task:
- Explain the blood results and what they may mean.
- Take an alcohol history without judgement and find out how the patient sees his drinking.
- Explain the link between alcohol and the liver, and the benefit of cutting down now.
- Agree a realistic plan to reduce, with support and follow-up.
Interlocutor card (patient or relative): You are 44, under pressure at work, and wine in the evening is how you switch off. You do not think of yourself as a drinker; "everyone in the office drinks more than me". You are startled by the liver result and privately frightened, but you will minimise the amount at first. If the doctor is factual and non-judgemental and suggests a specific, achievable change, you agree to try. If the doctor uses the word "alcoholic" or lectures you, you become defensive and say the tests must be wrong.
Model route through the card (TalkDrill worked example)
Opening: "Mr Hughes, thanks for coming in. Your blood tests were mostly normal, but the liver tests are higher than they should be, and I would like to work out why with you. There are several possible causes. One of the common ones is alcohol, so can I ask about that, as I do with everyone? Tell me about a typical week." Framing it as routine removes the sting.
The hardest moment is the minimising. Do not confront it; quantify it with him: "So a bottle of wine on a weeknight and more at the weekend. Shall we add that up together? That comes to roughly double the level we consider lower risk. I am not using the word alcoholic and I am not judging you; plenty of people in demanding jobs drink like this. What matters is that your liver is telling us it is under strain, and the good news about the liver is that it recovers remarkably well when the strain is reduced, especially at this stage." Then the mechanism in plain words: "Alcohol is processed by the liver, and more than it can handle causes inflammation, which is what these raised numbers show. Carry on and that can become scarring, which does not reverse. Cut down now and the numbers usually improve within weeks." Then a plan he chooses: "Which feels possible: two or three alcohol-free days a week, a smaller glass, or stopping at one? And what would you do instead to switch off?"
Close: "So three alcohol-free nights a week, a walk after work on those nights, and we repeat the blood test in eight weeks so you can see the result yourself. If cutting down turns out to be harder than you expect, tell me; there is help for that and no shame in it. How does that sound?"
Examiner note: Tests Information gathering without judgement and Information giving that motivates. Marks are lost by labelling, lecturing, or accepting the first minimised answer. Assessors look for the quantity established respectfully, the liver explained in plain terms with the recovery message, and a specific, patient-chosen change with a measurable follow-up.
Card M13: Starting anticoagulation for atrial fibrillation, fear of bleeding
Setting: Cardiology clinic. You are the doctor.
Patient: A 72-year-old woman with newly diagnosed atrial fibrillation. Her stroke risk means a blood-thinning tablet is recommended. She is reluctant because a friend "bled to death on warfarin" and she gardens and bruises easily.
Task:
- Find out the patient's understanding of atrial fibrillation and her concerns about blood thinners.
- Explain why the tablet is recommended, weighing the stroke risk against the bleeding risk in plain terms.
- Explain the practical points: taking it every day, what to do about cuts and bruises, when to seek help.
- Reach a shared decision and agree follow-up.
Interlocutor card (patient or relative): You are 72, active, and you garden every day. Your friend died after a bleed while on warfarin and you are convinced the tablet is more dangerous than the condition, which you cannot even feel. You do not understand what an irregular heartbeat has to do with a stroke. If the doctor explains the link and compares the two risks honestly, and reassures you about bruises, you agree. If the doctor pushes without explaining, say "I would rather take my chances".
Model route through the card (TalkDrill worked example)
Opening: "Mrs Yilmaz, the heart tracing shows an irregular rhythm called atrial fibrillation. Before I explain what I would recommend, can I ask what you know about it, and I understand you have some strong feelings about blood thinners; I would like to hear them." You cannot weigh risks with her until her risk, the friend, is in the room.
The hardest moment is a patient who cannot feel the disease but can picture the treatment killing her. Build the link first: "When the top chambers of the heart quiver instead of beating, blood can pool and form a small clot. If that clot travels to the brain it causes a stroke, and strokes from this cause tend to be severe. You cannot feel the rhythm, but the risk is real, and for you it is high enough that we recommend protection." Then compare honestly: "The blood thinner roughly cuts that stroke risk by two thirds. It does increase the chance of bleeding, and I will not pretend otherwise, but for most people in your position the stroke prevented outweighs the bleed risked, several times over. I am very sorry about your friend. The newer tablets we use now are simpler than warfarin, need no regular blood tests, and serious bleeding is less common." Then the gardening: "Cuts bleed a little longer; press firmly for ten minutes. Bruises are expected and not dangerous. Black stools, blood in the urine, or a head injury are the things to come in for."
Close: "This is your decision. My recommendation is to start, and we can review how you get on in a month. Can you tell me why I am suggesting it, in your own words? Good. Shall we start it tomorrow morning?"
Examiner note: Tests Information giving about competing risks and shared decision making. Marks are lost by saying "the benefits outweigh the risks" without explaining either, or by dismissing the friend. Assessors want the condition linked to the stroke plainly, both risks stated honestly, the practical fears addressed and a teach-back before the decision.
Card M14: MRSA found on screening, explaining isolation
Setting: Pre-admission clinic before a planned hip replacement. You are the doctor.
Patient: A 67-year-old whose routine screening swab has grown MRSA on the skin. The patient is well. Hospital policy requires a decolonisation treatment before surgery and a side room on admission. The patient has heard MRSA is a "killer superbug" and is frightened and ashamed.
Task:
- Find out what the patient has heard about MRSA and how they feel about the result.
- Explain the difference between carrying the bacteria and being infected, and why screening is done before surgery.
- Explain the decolonisation treatment and the side room, and that the operation will go ahead.
- Check understanding and agree the next steps.
Interlocutor card (patient or relative): You are 67. You read about MRSA deaths in hospitals years ago and you now think you are dangerous to your grandchildren and that the operation will be cancelled. You are ashamed, as if it means you are dirty. You will ask "did I catch it from this hospital?" and "can I still hold the baby?". If the doctor explains carrying versus infection clearly and confirms the operation is going ahead, you are relieved. If the doctor uses "colonised" and "decolonisation" without explanation, you say "I do not know what any of that means".
Model route through the card (TalkDrill worked example)
Opening: "Mr Chidi, one of the routine swabs we took before your operation has grown a bacterium called MRSA. I can see that word has landed hard. Before I explain, can you tell me what you have heard about it? There is a lot of frightening history attached to those letters." The question gives you the shame and the fear to answer.
The hardest moment is separating carrying from infection without sounding like you are minimising. "Let me explain what the result means and, just as importantly, what it does not. About one person in every thirty carries this bacterium harmlessly on their skin or in their nose, and you are well, so you are carrying it, not infected by it. It is not a sign of being unclean; it lives on healthy people. We screen everyone before surgery because, if it got into a surgical wound, it is harder to treat than ordinary bacteria. So we deal with it beforehand." Then the plan in plain words: "For five days before the operation you use a special body wash and a nose ointment, which clears most of it from the skin. On admission you will have a side room, which is about protecting other patients' wounds, not punishing you. Your operation is going ahead as planned." Then his questions: "You cannot hold the baby? You can. Normal family contact is fine; wash your hands as you always would. Did you catch it here? We cannot know; it is common in the community too, and it does not matter for what we do next."
Close: "So: the wash and ointment from Monday, the same operation date, a side room when you come in. Can you tell me the difference between carrying it and having an infection, so I know I explained it clearly? Good. Anything else?"
Examiner note: Tests Appropriateness of language and Information giving around infection control. Marks are lost by using "colonised" and "decolonisation" untranslated, by implying fault, or by failing to confirm the operation is going ahead. Assessors look for the carrier versus infection distinction, the policy explained as protection, and the family questions answered.
Card M15: COPD review, refusing pulmonary rehabilitation
Setting: Respiratory outpatient clinic. You are the doctor.
Patient: A 69-year-old retired bus driver with chronic obstructive pulmonary disease, breathless walking to the shops and admitted twice last winter with flare-ups. Pulmonary rehabilitation (a supervised exercise and education programme) has been offered twice and declined. The patient has come for a routine review.
Task:
- Find out how the breathlessness affects daily life and why the patient has declined rehabilitation.
- Explain, in plain words, why exercise helps a damaged lung and what the programme actually involves.
- Review the inhalers, the flu and pneumonia vaccines and the plan for flare-ups.
- Agree one change the patient is willing to make before the next review.
Interlocutor card (patient or relative): You are 69. You believe exercise is dangerous when you cannot breathe, and the word "rehabilitation" makes you think of a gym full of young people. You are embarrassed about being breathless in public and you have stopped going out much. You are lonely since you stopped driving. If the doctor explains the breathlessness cycle and describes the programme as a group of people like you, you agree to one session. If the doctor just re-offers the referral, say "I told them no twice".
Model route through the card (TalkDrill worked example)
Opening: "Mr Baptiste, good to see you. Before we talk about inhalers, tell me what a normal day looks like now, and what the breathing stops you doing." Then, later and gently: "The team have offered the breathing programme twice and I know you said no. I am not going to just offer it a third time. I would like to understand what put you off."
The hardest moment is a belief that feels like common sense: breathless means stop. Replace it with the cycle, in his terms: "What you are describing is a trap that nearly everyone with COPD falls into. Breathlessness makes you do less, doing less makes the muscles weaker, and weaker muscles need more oxygen for the same job, so you get more breathless. Exercise does not repair the lungs, but it breaks that cycle. It is the one treatment that reliably lets people walk further and get admitted less. And the programme is not a gym. It is a room of people your age, most of them bus drivers, builders and nurses with the same lungs, walking and doing chair exercises with a physiotherapist watching, twice a week for a few weeks, with tea afterwards." Then the review, briskly signposted: "Three other things today: your inhaler technique, which I will watch; your flu and pneumonia jabs, which are due; and the rescue pack for flare-ups, so you start treatment at home before you end up in hospital."
Close: "I am not asking for the whole programme. One session, next week, and you tell me afterwards if I was wrong. If you hate it, we think again. Deal? Then I will see you in three months and we compare how far you can walk."
Examiner note: Tests Understanding and incorporating the patient perspective and Providing structure in a multi-task review. Marks are lost by re-offering the referral without exploring the refusal, and by letting the inhaler and vaccine tasks swallow the time. Assessors want the belief about exercise corrected plainly, the programme described as it really is, and a single agreed step.
A practice route for the next six weeks
Fifteen cards, spoken aloud under time, recorded and marked, is a full Speaking preparation for a doctor. Reading them is not practice. This is the Speaking strand of the six-week study plan; the plan also carries the Listening, Reading and Writing work that the one-sitting rule makes essential.
| Week | Cards | Focus | How |
|---|---|---|---|
| 1 | M02, M04 | The five-step shape: open, gather, explain, decide, close. | One card a day, recorded on your phone. Listen back for structure only: were the topic changes announced? |
| 2 | M05, M09, M12, M15 | Information giving: plain words, chunks, checks; refusing a test without dismissing. | AI patient on TalkDrill role-play, five-minute hard stop. Score Information giving and Appropriateness. |
| 3 | M01, M08, M10 | Emotion: bad news, a frightened daughter, a bereaved patient. Pauses as fluency. | Partner reads the interlocutor card and plays it hard. Score Relationship building and the patient's perspective. |
| 4 | M03, M06, M07, M11, M13, M14 | Shared decisions and conflict: risk stated once, barriers solved, the decision handed back. | Two cards back to back with three minutes of preparation each, as in the test. |
| 5 | Any six, paired | Full mocks on alternate days. | Record both role plays; mark all nine criteria; compare with week 1. |
| 6 | The two you found hardest | Taper. | Once each, then stop. Rest the voice the day before. |
Alongside the cards, do the official free sample role plays on OET Ready, which also links the official criteria checklist and the two Ultimate Guides (linguistic and clinical communication) with real candidate samples. The OET speaking criteria overview is the shortest official statement of what the assessors want, and the three preparation minutes post is the source of the preparation routine on this page. The OET Test Handbook 2026 carries the timing and the grade bands. The OET 2025 demographic data PDF is the source of the first-language and profession figures.
If you also supervise or work alongside nurses preparing for the test, the nursing cards use the same structure with the emphasis on adherence, education and reassurance, and the two sets together make thirty cards for a study group. The OET hub has the full format, the dates block and the fee.