Discussing sensitive topics like terminal illness requires a delicate balance of professional clarity and deep empathy. This post provides a comprehensive guide to a high-stakes OET medicine speaking end-of-life care scenario, featuring a Grade B model answer designed to help you master the nuances of clinical communication.

Role-Play Card

Setting: Palliative Care Ward
Profession: Medicine
Patient: You are speaking with the daughter of Mr. Garcia, a 78-year-old patient with terminal metastatic lung cancer. He was admitted two days ago for symptom management.
Task:
– Establish a rapport with the daughter and acknowledge the difficulty of the situation.
– Explain the current focus of care (palliative vs. curative).
– Discuss what to expect in the coming days/weeks (symptom control, comfort).
– Address her concerns regarding nutrition and hydration.
– Involve her in the decision-making process regarding a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order.

Sample Role-Play Dialogue

Candidate: Good morning, Ms. Garcia. Thank you for taking the time to sit down with me today. I’m Dr. Miller, one of the physicians looking after your father. Before we begin, how are you holding up? I know it’s been a very challenging few days since your father was admitted.

Interlocutor (Daughter of Mr. Garcia): Honestly, Doctor, I’m exhausted. It’s just so hard to see him like this. He was always so active, and now he’s barely awake. I just want to know what the plan is. Are we still trying to fight the cancer?

Candidate: I can certainly understand how distressing this transition is for you. To answer your question directly, we have reached a stage where the cancer is very advanced and has spread to several organs. Because of this, our focus has shifted from trying to cure the disease—which, unfortunately, is no longer possible—to what we call palliative care. Have you heard that term before, or would you like me to explain what that means for your father?

Interlocutor: I’ve heard it, but I always thought it just meant giving up. Is that what we’re doing?

Candidate: That is a very common concern, but I want to reassure you that palliative care is far from giving up. It is actually a very active form of care. Our primary goal now is to ensure your father is as comfortable, pain-free, and dignified as possible. We are focusing on managing his symptoms, like his shortness of breath and pain, rather than putting him through aggressive treatments that his body may no longer be able to tolerate. Does that make sense?

Interlocutor: I suppose so. But he’s hardly eating anything. Shouldn’t we be putting him on a drip or a feeding tube? I’m worried he’s starving.

Candidate: It’s completely natural to feel that way; providing food is how we show love. However, in the advanced stages of cancer, the body’s metabolism slows down significantly. Forcing fluids or nutrition through a tube or a drip can sometimes cause more harm than good, such as fluid building up in the lungs, which would make his breathing much harder. We will continue to offer him small sips of water or his favorite foods for comfort, but we won’t force him to eat. How do you feel about that approach?

Interlocutor: It’s hard to hear, but I don’t want him to struggle for breath. I just want him to be peaceful.

Candidate: That is exactly our priority as well. Moving forward, we expect him to spend more time sleeping, and his breathing might become shallower. We will be using medications to ensure he doesn’t feel any distress. Now, there is one more difficult but important thing we need to discuss, which is a “Do Not Attempt Resuscitation” order. Based on your father’s current condition, if his heart were to stop, performing CPR would not be successful and would likely cause him significant trauma. We would like to focus on a natural, peaceful end when the time comes. What are your thoughts on this?

Interlocutor: My father always said he didn’t want to be kept alive by machines if there was no hope. So, I think he would agree with you. It’s just so much to take in.

Candidate: You are doing a wonderful job advocating for him, Ms. Garcia. It’s a lot to process, so please don’t feel you have to remember everything right now. I’ll provide some written information, and I’m available whenever you have more questions. Would you like to spend some quiet time with him now, or is there anything else I can clarify for you first?

Interlocutor: No, I think I’ll just go sit with him. Thank you, Doctor.

Why This Scores Grade B

Achieving a Grade B in the OET Speaking sub-test requires demonstrating proficiency across nine specific criteria. From 31 July 2025, when the Speaking sub-test moves to the new OET Speaking Platform, these criteria remain the gold standard for assessment. For a deeper dive into overall requirements, see our OET Score Guide.

Linguistic Criteria

1. Intelligibility

The candidate uses clear pronunciation and varied intonation to convey empathy. For example, the tone softens when saying, “I can certainly understand how distressing this transition is for you.” This prevents the speech from sounding robotic or overly clinical.

2. Fluency

The flow of speech is smooth, with natural pauses that allow the “daughter” to process difficult information. The candidate avoids excessive hesitation or “ums” and “ahs,” maintaining a professional pace even when discussing complex topics like DNACPR.

3. Appropriateness

The language is perfectly suited for a grieving family member. The candidate avoids harsh medical jargon and uses professional yet sensitive phrasing, such as “natural, peaceful end” instead of “death” or “expiration.”

4. Resources of Grammar and Expression

The candidate demonstrates a wide range of grammatical structures, including conditional sentences like “if his heart were to stop, performing CPR would not be successful,” showing a high level of linguistic control. For more on the grammar required for success, check out Mastering Key Verbs in OET Speaking.

Clinical Communication Criteria

1. Relationship Building

The candidate starts by validating the daughter’s feelings: “I know it’s been a very challenging few days.” This establishes a partnership and builds trust from the outset, which is vital for OET Speaking success.

2. Understanding and Incorporating the Patient’s Perspective

Instead of dismissing the daughter’s worry about “starving,” the candidate acknowledges it: “It’s completely natural to feel that way; providing food is how we show love.” This shows the candidate is listening and valuing the family’s emotional viewpoint.

3. Providing Structure

The candidate uses clear signposting to move from one topic to the next, such as “To answer your question directly…” and “Now, there is one more difficult but important thing we need to discuss…” This helps the interlocutor follow the logical progression of the consultation.

4. Information Gathering

The candidate uses open-ended questions to check the daughter’s understanding and feelings, such as “How do you feel about that approach?” and “Have you heard that term before?” This prevents the doctor from doing all the talking.

5. Information Giving

The candidate explains the physiological reasons for lack of appetite in terminal illness using “chunking and checking”—giving a piece of information and then pausing to check understanding. This is a core skill taught in our OET Speaking Role-play Practice course.

Key Vocabulary for This Scenario

Common Mistakes to Avoid

• Being overly blunt: Avoid saying “He is dying” or “There’s nothing we can do” without preamble. Instead, use “warning shots” like “I’m afraid the news isn’t what we hoped for.”
• Ignoring emotional cues: If the interlocutor sounds upset, do not ignore it to finish your task list. Pause and offer empathy.
• Over-explaining medical science: The daughter doesn’t need to know the cellular biology of cancer; she needs to know if her father is in pain. Focus on clinical care, as recommended by the General Medical Council (GMC) guidelines on end-of-life care.
• Rushing the DNACPR discussion: This is a sensitive legal and ethical topic. Never demand a signature; always present it as a clinical recommendation aimed at preventing suffering.
• Monologuing: Ensure the interaction is a two-way street. If you speak for more than 45 seconds without checking in, you are likely losing points in the “Providing Structure” and “Information Giving” criteria.

Practice Tips

1. Record and Review: Use your phone to record your practice sessions. Listen back specifically for your “empathy phrases.” Do they sound sincere or rehearsed?
2. The 3-Minute Prep: During your 3 minutes of preparation, don’t just read the tasks. Write down two open-ended questions and three “signposting” phrases you plan to use.
3. Focus on Reading: Remember that strong communication often stems from a strong vocabulary and comprehension. Review our OET Reading Score Guide to see how reading skills support your overall medical English proficiency.
4. Role-play with a Timer: OET role-plays are strictly 5 minutes. Practice concluding the conversation gracefully within this timeframe so you aren’t cut off mid-sentence by the interlocutor.

Mastering end-of-life care conversations is one of the most difficult yet rewarding parts of the OET Speaking sub-test. By focusing on the clinical communication criteria and maintaining a patient-centered approach, you can demonstrate the high level of professional English required for GMC registration. For personalized feedback on your speaking skills, explore our OET Speaking Role-play Practice sessions today.