An MD Acumen school · PLAB 2 OSCE / CPSA course · free practice resources

Practice case P2-19 · Face-to-face · simulated relative

“Do we have to tell her?” — a son with lasting power of attorney

An 84-year-old care-home resident with established dementia has come back from hospital with a new diagnosis of widespread cancer. Her son, who holds a lasting power of attorney for her, has asked to see a doctor about what she should be told.

Reviewed and kept current

Station family: Ethics and law — a conversation with a relative · 8-minute station · 1 min 30 s reading · Last editorial review: 20 September 2026.

Candidate instructions

Read this as you would outside the room

You have 1 minute 30 seconds to read, then 8 minutes. Candidates: everything below this section is folded away — leave it closed until you have finished the station.

	Information
Your role	Foundation Year 2 doctor in a general practice. Your supervising GP, Dr Khan, has asked you to meet Mr Fletcher and is available afterwards.
You are meeting	Mr Stephen Fletcher, 58 — the son of your patient. The patient is not present.
Patient	Mrs Dorothy Fletcher, 84, resident at Beechwood House care home for 18 months. Alzheimer’s disease diagnosed five years ago, now advanced.
Hospital letter (discharged three days ago)	Admitted with abdominal pain and vomiting. CT of the abdomen and pelvis: widespread peritoneal cancer with ascites, and multiple liver metastases; primary site uncertain. Decision of the hospital team with her son: no biopsy and no cancer treatment — best supportive care; prognosis likely to be weeks to a few months. Pain controlled on discharge; referred to the community palliative care team. Capacity: assessed on the ward as lacking capacity for decisions about investigating and treating the cancer — she could not retain the information for more than a few minutes. She was told the diagnosis once on the ward, with her son present.
Records	A lasting power of attorney (2022) naming Mr Fletcher is scanned into her notes. Dr Khan visited yesterday and recorded that Mrs Fletcher could not recall having been in hospital.

Your task

•

Find out what Mr Fletcher is asking, and what he knows.

•

Discuss with him whether his mother should be told about her diagnosis.

•

Agree what happens next.

Folded away

For the actor and the examiner

1 · Actor script — role player only

Candidates: do not open until you have consulted.

Persona and manner

Stephen Fletcher, 58, secondary-school caretaker. Married to Linda. You visit your mother Dorothy at Beechwood House every day after work. Your sister Karen lives in Toronto.
Tired, close to tears at moments, and torn — you are not demanding anything. You want someone to help you work out the right thing to do. You have not slept properly since the hospital rang.

Opening line — say this verbatim

“Thanks for seeing me, doctor. It’s about Mum. The home keep asking me what they should say to her — and I don’t know. Do we have to tell her she’s got cancer?”

Volunteer freely if given the space

The hospital consultant told you the scan result by phone, and then told Mum on the ward with you there. She cried for the best part of an hour — “I’ve never seen her like that” — and by the time her tea came she had forgotten all of it and asked when she was going home.
Since she came back she is comfortable most of the time. She asks the carers “why does my tummy hurt?” and “when am I going home?” several times a day.
You understand what the scan showed and that no treatment is planned. You agreed with that — “she couldn’t cope with hospitals and needles”.

Only if asked

The power of attorney: Mum made it in 2022, the year after she was diagnosed, while she could still decide that for herself — with the family solicitor. It is the health and welfare one (there is a separate one for her money). It came back stamped by the Office of the Public Guardian; you are the only attorney; she ticked the option that lets you decide about life-sustaining treatment; there are no special instructions. You have never had to use it for anything big before this week.
She never wrote her wishes down — no living will or advance decision.
What she would have wanted — give the next line only if the doctor asks what she was like, what she would have wanted, or whether she ever said anything about it (or at the minute-4 cue, or when invited to add anything).
When Dad — Ron — was dying of bowel cancer twelve years ago she did not want the details; she asked the doctors to “talk to Stephen”. She said to you more than once: “If I ever get it, don’t tell me. I’d rather not know — just keep me comfortable.”
What she asks now: about her tummy, and about going home — by which she means the house she grew up in. She has never asked “is it cancer?” or “am I dying?”. She settles quickly with a cup of tea and someone sitting with her. She knows you most days but cannot tell you what she had for lunch. Mornings are a little brighter, but nothing new stays with her for more than a few minutes.
Karen: you spoke last night. She thinks “Mum has a right to know — she was always straight with us.” You ended up arguing. Karen is not an attorney. She is flying over in ten days.
The home: the manager, Mrs Osei, wants to know what staff should say. One carer told Mum “it’s just a bit of wind”; another changed the subject. You did not like either.
Resuscitation and hospital: nobody has talked to you about that. You would not want her “dragged back into hospital”; you would want her to stay at Beechwood, where she knows the faces.
You: not sleeping, eating badly, back at work tomorrow. Linda is supportive. You have not seen your own GP.

Impact on daily life — the family and the home (only if asked)

You lie awake rehearsing what to say to her. You have started to dread the visits you used to enjoy.
You and Karen have not argued like this since Dad died.
The carers are giving different answers, and Mum picks up on the awkwardness — she was unsettled and tearful the evening before last after one of them looked upset.

Ideas, concerns and expectations

Idea: that telling her again would be cruel, because she will grieve as if for the first time and then lose it again — but you are not sure you are allowed to decide that.
Concerns: that keeping it from her is lying to your own mother; that you could get into trouble as her attorney; that Karen will never forgive you.
Expectation: that the doctor will tell you what the rules are, and help you decide — not just say “it’s up to you”.

Cues to deliver, timed

Minute 2: “She cried for an hour in that hospital, and then it was gone. Gone. I can’t put her through that every day.”
Minute 4, if her own past wishes have not been asked about: “She was never one for knowing, my mum — not even with Dad.”

If the doctor summarises and asks whether you want to add anything

If her own wishes have not come out: “There is one thing. When Dad was ill she said to me, more than once, ‘If I ever get it, don’t tell me — just keep me comfortable.’ Does that count for anything?”
If they have: “But what do I actually say when she asks why her tummy hurts? I’m not going to lie to her — but I can’t tell her that either.”

How to respond to the doctor

If the doctor says flatly that she has a right to know and must be told: distressed — “So you’d make her go through that again? Every day?”
If the doctor says “you’re the attorney, it’s your decision” and leaves it there: lost — “I came here because I don’t know what to do.”
If the doctor simply agrees — “fine, we won’t tell her” — without asking anything about her: uneasy — “Is that it? Are we allowed to just decide that?”
If the doctor asks what she would have wanted, weighs it up with you, and arrives at not bringing it up with her again — but never lying to her if she asks: visibly relieved — “That’s what she’d have wanted. I just needed to know it was all right.”
If offered words to use when she asks about her tummy — honest, simple, comforting — you try them out loud and nod.
Once a decision is forming: “And Karen? She’ll say I’ve gone behind Mum’s back.” If the doctor offers to speak to Karen with you, or to involve her when she arrives: grateful.
If asked how you are: you well up — “Nobody’s asked me that.”

Do not

Volunteer what your mother said when your father was dying unless the doctor asks about her wishes, her character or what she would have wanted — or until the minute-4 cue or the invitation to add anything.
Demand that the diagnosis be kept from her. You are asking for help, not giving an instruction.

2 · Examiner mark sheet — generic scheme plus the key facts for this case

Domain marks — with the key facts that earn a 4 at this station

Domain (GMC wording) · key facts for this case	1	2	3	4	Score
1 · Data gathering, technical and assessment skills What he is asking and what he knows; what happened when she was told — an hour of distress, then no memory of it Legal ground checked: which LPA (health and welfare), registered, sole attorney, its scope; nothing written by her; the recorded capacity assessment was about treatment — not this decision Her wishes, feelings, beliefs and values — “if I ever get it, don’t tell me”; how she coped with her husband’s illness; what she asks now, and what settles her Who else should be consulted — Karen, the care-home staff; red flags: uncontrolled symptoms, attorney acting against her interests, dispute; his ideas, concerns and the impact on him	☐	☐	☐	☐	/4
2 · Clinical management skills Summary and check, then the formulation: she cannot retain this, so — once that is recorded for this decision — it is a best-interests decision under the Mental Capacity Act: her attorney and her doctors together Weighed openly: honesty against repeated fresh grief she cannot retain, nothing she has to decide, and her own stated wish — outcome: not raised with her again; nobody lies to her; reviewed if she starts to ask If she asks: truthful, simple, comforting words; one approach shared with family and staff; she is seen herself; recorded and confirmed with Dr Khan; palliative care and advance care planning Safety-net: pain, vomiting or distress not settling, or she starts asking directly about dying → the home rings the practice or the palliative care line that day · Follow-up: visit to her within the week — symptoms and advance care plan; decision reviewed then and when Karen arrives	☐	☐	☐	☐	/4
3 · Interpersonal skills Acknowledges how hard this is before any law Neither dictates nor abdicates — reaches the decision with* him* Names and eases the guilt: deciding this carefully is not “lying to your mother” Checks he is at ease with the decision and can say it in his own words; leaves the door open to revisit it	☐	☐	☐	☐	/4
Station total					/12

Examiner's overall judgement (standard-setting only — it does not decide your result): ☐ Unsatisfactory ☐ Borderline ☐ Satisfactory ☐ Good

Marks are 1 to 4 in each domain; the generic descriptor for each mark is on the mark scheme page, and the structure of the eight minutes is on the 8-minute station page. The full standard for this case is in section 3 and the GMC feedback statements, with examples from this case, are in section 4.

3 · Expanded station-specific marking standard — what earns 4, 3, 2 and 1 here

The top row is the full picture of what a competent F2 could do at this station, including the working diagnosis with its justified differentials, the safety-net and the follow-up; lower rows describe how performance falls away. It is a debriefing aid, not a checklist to recite: nobody says every line in eight minutes, and a 4 is a judgement that the essentials — the italic key facts on the mark sheet — were done well, in plain language and at the patient’s pace. Acumen training standard — the GMC does not publish station mark sheets.

Mark	Domain 1 · Data gathering, technical and assessment skills	Domain 2 · Clinical management skills	Domain 3 · Interpersonal skills
4	Opens by finding out what he is asking and why now; establishes what he already knows about the diagnosis and the plan, and that he agreed with best supportive care What happened when she was told in hospital, and how she has been since — what she asks, how often, what settles her; whether she has ever asked directly about cancer or dying Capacity: does not assume it from the diagnosis of dementia, and notices that the recorded assessment was about treatment decisions — not this one; establishes that nothing new stays with her for more than minutes, even at her best time of day; says that her capacity for this decision will be assessed and recorded, with Dr Khan, before the best-interests decision is final Authority: checks what the record leaves open — that the LPA is the health and welfare one (not only property and financial affairs), that it is registered, that he is the sole attorney, its scope (life-sustaining treatment; any instructions or restrictions), and that she never made an advance decision or wrote her wishes down Her past and present wishes, feelings, beliefs and values: what she was like, how she dealt with her husband’s illness, anything she said or wrote about what she would want Others to consult: Karen’s view and the reasons for it; what the care staff are saying now; anyone else close to her Red flags: symptoms not controlled; any sign the attorney is acting in his own interests rather than hers; a family dispute that cannot be settled; safeguarding concerns in the home — none here His ideas and concerns — that not telling is lying, that he could be in trouble as attorney, Karen — and the impact on him: sleep, work, dreading the visits	Summarises what he has heard and checks whether Mr Fletcher wants to add anything Working diagnosis — here, a formulation of the decision: Mrs Fletcher cannot retain information about her illness, so — once that has been assessed and recorded for this decision — the question is not “does the family want her told?” but “what is in her best interests?”, decided under the Mental Capacity Act by her attorney and her doctors together. Alternatives considered and set aside: that she must simply be told because every patient has a right to know (the duty to give information is strongest when someone needs it to decide, and she cannot make this decision — but she is still owed honesty and must be involved as far as she is able, so the question is how we are truthful with her, not whether); that the family may simply choose (relatives cannot, but a best-interests process can); that he can simply instruct us (he is the decision-maker for welfare matters within the LPA, but he must apply the Act’s checklist and consult, the clinicians must be satisfied that it is in her interests, and nobody can be required to lie to her) Works through the checklist aloud with him: her past wishes (“don’t tell me — keep me comfortable” — weighty, though not legally binding), her present feelings, her values; the views of those close to her; all the options — tell her again, tell her whenever she asks anything, not raise it but answer honestly, or actively deny it; and the benefits and harms of each Agreed outcome: the diagnosis is not raised with her again, because she cannot retain it, each telling is a fresh bereavement, nothing she has to decide depends on it, and it is what she said she wanted — but nobody lies to her. It is a decision not to raise it, not a decision to withhold it if she asks — and it is reviewed: if she starts to ask, the approach changes Offers words for her questions — truthful, simple, pitched to what she asks: “Your tummy is poorly, Mum. The medicine is for the pain, and we’re all looking after you.” Respond to the feeling; stay with her. If she asks directly whether it is cancer or whether she is dying, answer gently and honestly, and tell the practice She is seen herself: says who will visit her — at her best time of day — to take the lead from what she asks, so that the decision is not made entirely through her son. One shared approach: with his agreement, the decision and the wording go to the care-home manager and the palliative care team, so staff stop improvising (“just a bit of wind” stops today) Records the decision and the reasons — capacity, who was consulted, her wishes, options weighed — and confirms it with Dr Khan; offers to talk to Karen with him. Credit if offered, not required: what happens if the family cannot agree (a second opinion, a meeting with everyone involved) Looks ahead: symptom control and palliative care input; tells him that a separate conversation is needed, with him as attorney, about where she is cared for, hospital admission and resuscitation. Credit if offered, not required: the ReSPECT form by name; support for him as a carer Safety-net: if her pain, sickness or distress is not settling, the home rings the practice — or the palliative care advice line out of hours — the same day; if she begins to ask directly and repeatedly whether she is dying, or seems to want to know more, tell us so that the decision can be looked at again; if, after Karen has been spoken to, the family still cannot agree, come back to us — there are ways to resolve it (a second opinion, a meeting with everyone involved) before anyone is left to carry it alone. Follow-up: a visit to Mrs Fletcher at Beechwood House within the week, at her best time of day, by Dr Khan or the F2 — to see her, take the lead from what she asks, review her symptoms, and assess and record her capacity for this decision; an advance care planning conversation with Mr Fletcher as attorney (ReSPECT form: preferred place of care, hospital admission, resuscitation); the best-interests decision recorded in her notes and shared, with his agreement, with the care-home manager and the palliative care team; a conversation with Karen offered when she arrives; the decision reviewed at each visit; Mr Fletcher encouraged to see his own GP, and given carer-support details.	Begins with him, not the law — acknowledges the week he has had Holds the silence when he is close to tears; does not rush to fix Explains the law in one or two plain sentences, as a support rather than a threat — “the law asks us to decide what is best for her, and to use what she told you” Shares the decision: does not dictate and does not hand it back to him alone Names the guilt and answers it: choosing, carefully and for her sake, not to keep re-breaking bad news is not deceit Asks how he is coping; checks that he is at ease with the decision and can put it in his own words; leaves the door open to revisit it
3	Her wishes and the hospital episode explored and the legal ground checked; one of Karen’s view, what the staff are currently saying, or the impact on him missing.	Sound best-interests reasoning and the right outcome, including honesty if she asks; one of seeing her, a shared approach for the home, documentation and the supervising GP, Karen, or forward planning missing. A different outcome reached by the same process — for example one more supported conversation at her best time of day with Karen present, then no more — is acceptable provided nobody lies to her and the decision is reviewed.	Kind and clear; slightly legalistic in places, or the son’s own wellbeing touched on only briefly.
2	Hears the story sympathetically but never asks what she would have wanted; capacity or the LPA taken as read; others’ views not sought.	Reaches “we won’t tell her” by sympathy rather than by process — her wishes not used, options not weighed; or no guidance on what to say when she asks; follow-up vague.	Sympathetic but hides behind process or jargon; the son’s guilt not addressed; little checking of understanding.
1	Treats it as a simple request to withhold information; asks little; moves straight to a rule. Or unsafe: no exploration — refuses to discuss his mother’s care with him, or agrees to whatever he says within the first minute because he is “the attorney” or “next of kin”.	Applies a rule without reasoning — “patients must always be told” or “it’s the attorney’s decision” — and leaves him with it; no plan for the home. Or unsafe: agrees that staff and family should deny the diagnosis or invent an explanation if she asks; promises that it will never be mentioned whatever she asks; insists on re-telling her regardless of distress; or refuses to involve the attorney at all.	Lectures on patients’ rights or on the attorney’s duties; he leaves more anxious than he arrived. Or unsafe: accuses him of wanting to deceive his mother, or is dismissive of the question.

4 · GMC feedback statements — where underperformance was identified — with case-specific examples

A feedback statement marks where underperformance was identified in the consultation. With PLAB 2 results the GMC may attach any combination of the ten statements to a station — none, one or several. The right-hand column shows what each one looks like at this station. Record the statements that applied in the practice log.

GMC feedback statement	Underperformance it signals (generic)	Case-specific examples
1 · Consultation	Disorganised or unstructured consultation	Moves between the law, the cancer and the care home with no thread; no summary before the decision; the decision itself never clearly stated.
2 · Issues	Key issues or priorities not recognised	Treats it as a breaking-bad-news or a “relative asks you to withhold” station and applies the capacitous-patient rule; does not recognise that this is a best-interests decision for a person who lacks capacity.
3 · Time	Poor time management	Spends five minutes on the hospital admission and the scan; her wishes, the decision and what to say when she asks are squeezed into the last minute or never reached.
4 · Findings	Abnormal findings or results, or their implications, not identified	Does not use what is in front of them — a recorded capacity assessment, a scanned LPA, “told once on the ward” — or does not grasp the meaning of “could not retain the information”; does not notice that the recorded assessment was about treatment, not about this decision.
5 · Examination	Physical examination or use of instruments not competent	Not an examination station — the equivalent failure is not checking what the record leaves open: which kind of LPA it is and whether it is registered, whether she ever wrote her wishes down, and whether her understanding is better at some times than others.
6 · Diagnosis	Working diagnosis or differential diagnoses not correct	No formulation: cannot say who the decision-maker is or on what basis the decision is made; “lacks capacity because she has dementia”; confuses a health and welfare LPA with next-of-kin status.
7 · Management	Management plan not reflecting current best practice	“It’s up to you”, or “she has to be told”, or “fine, we won’t tell her” — with no weighing of options, no wording for her questions, no plan for the care staff, nobody going to see her, nothing recorded, nothing said about what the home should do if her pain or distress worsens, no review.
8 · Rapport	Rapport and sensitivity to the patient’s feelings and concerns not shown	Goes straight to the law while he is in tears; no acknowledgement of his distress or his guilt; never asks how he is.
9 · Listening	Verbal and non-verbal cues not used; poor active listening	Misses “she was never one for knowing, my mum” — the opening to her past wishes; never invites him to add anything, so her own words — “if I ever get it, don’t tell me” — are never heard.
10 · Language	Language or explanations not understandable; understanding not checked	“Under section 4 of the MCA, as donee of the LPA you are the decision-maker, subject to the best-interests checklist” — with no translation.

5 · Examiner points of fact and guidelines

Points of fact the examiner should have to hand

Mental Capacity Act 2005, the five principles (s1): presume capacity; support the person to decide; an unwise decision is not incapacity; anything done for a person who lacks capacity must be in their best interests; and choose the less restrictive option. Capacity is decision-specific and time-specific — a diagnosis of dementia does not establish it (s2–3: understand, retain, use or weigh, communicate). NICE NG108: the capacity assessment for the decision in question must be recorded before a best-interests decision is made — here the ward’s assessment covered treatment, so her capacity to take in and retain information about her illness is assessed and recorded for this decision too.
Best interests (s4): not based on age, appearance or condition; consider whether capacity may return; permit and encourage the person to take part as far as they can (s4(4)) — which is why someone must see Mrs Fletcher, not only her son; take into account their past and present wishes and feelings — especially anything written — and their beliefs and values (s4(6)); and consult, where practicable, anyone named by the person, carers, those interested in their welfare, and any attorney (s4(7)). An advance decision can only refuse treatment (ss24–26), so her “don’t tell me” is not binding — it is a past wish under s4(6), and a weighty one. It is what is best for her — not what the family, or the doctor, would want for themselves.
Health and welfare LPA (s9–11): valid only once registered with the Office of the Public Guardian; can be used only when the donor lacks capacity for the decision; covers consent to or refusal of treatment, but life-sustaining treatment only if the LPA expressly says so; the attorney must act in the donor’s best interests. Check it — the stamped document, the online “Use a lasting power of attorney” access code (LPAs registered in England and Wales on or after 1 January 2016), or a search of the Office of the Public Guardian’s register. “Next of kin” has no legal authority to decide; a property and financial affairs LPA does not cover health decisions.
Who decides? Where a decision falls within a registered LPA, the attorney is the decision-maker; the clinician’s role is to inform and advise — without pressure — and to be satisfied that the decision is in the person’s best interests. For everything else it is the professional responsible for the act. In practice — as here — it is reached together and recorded. If the clinicians are not satisfied that an attorney’s decision is in the person’s best interests, or the family cannot agree: discuss, seek a second opinion, hold a best-interests meeting, and ultimately apply to the Court of Protection (NICE NG108; MCA Code of Practice, chapters 5, 7 and 15). An attorney cannot require a clinician to deceive a patient: honesty is the doctor’s own professional duty.
The contrast to know: for a patient with capacity, a relative’s request to withhold a diagnosis cannot be followed. GMC, Decision making and consent: you should not withhold information a patient needs to make a decision unless giving it would cause serious harm — which “means more than that the patient might become upset” — and not because someone close to them asks you to (paras 14–15). Here the patient cannot make the decision, cannot retain the information, and said in the past that she would not want to know: a different question, answered by a best-interests process — not by the family’s preference. Patients who lack capacity must still be involved as far as they want and are able (GMC; NICE NG97) — so the outcome is “not raised again”, never “kept from her if she asks”.
Truth-telling in dementia: the Mental Health Foundation’s inquiry (“What is truth?”, 2016) looked at how to respond when a person with dementia experiences a different reality; applied here by analogy, it recommends starting as close to the whole truth as possible and moving away from it only to avoid unnecessary distress — finding the meaning and emotion behind a question, and comforting, come long before any untruth, and an outright lie is a last resort. It also asks that responses are consistent across family and staff, and that what works is written down and shared. Agreeing not to keep re-breaking bad news is compatible with this; instructing staff to deny the diagnosis is not. Doctors must be honest and trustworthy (GMC, Good medical practice).
Confidentiality: information may be shared with an attorney who needs it to make decisions, and — when a patient lacks capacity — with those close to them where that is in the patient’s best interests (GMC, Confidentiality). Karen is not an attorney, but she is someone “interested in her welfare” whose views should be sought; what is shared with her is itself a best-interests judgement.
Looking ahead (NICE NG142; NG97 section 1.10, palliative care in dementia): community palliative care, anticipatory planning and medicines, preferred place of care, avoiding burdensome admission, and a ReSPECT conversation with the attorney. CPR: if it could not work it is not offered — a clinical judgement, explained to the attorney. If it might, the question is her best interests: where the health and welfare LPA expressly covers life-sustaining treatment — as Mrs Fletcher’s does — the attorney may refuse CPR on her behalf and that refusal must be respected; where it does not, the senior clinician responsible decides after consulting the attorney and those close to her, before any DNACPR decision is recorded. Nobody, attorney included, can require CPR that the clinician judges clinically inappropriate. Carers are entitled to an assessment and support.
Jurisdiction: the Mental Capacity Act 2005 applies in England and Wales. Scotland has the Adults with Incapacity (Scotland) Act 2000 (welfare power of attorney), and Northern Ireland the Mental Capacity Act (Northern Ireland) 2016. The principles tested here are the same.

Where candidates lose marks at this station

Applying the capacitous-patient rule: “she has a right to know, so she must be told.”
“You’re the attorney — it’s up to you.”
Agreeing in the first minute — no questions about her, and no plan for anyone to see her.
Never asking what she would have wanted.
No answer to “what do I say when she asks?”
Letting the home carry on with “it’s just a bit of wind”.

Guidelines for this station

6 · MLA content map tags for this case

MLA content map	This station
Domain 1 · Areas of clinical practice	Medicine of the older adult · Palliative and end of life care
Domain 3 · Clinical and professional capabilities	Capacity, consent and confidentiality · Legal and ethical responsibilities · Communication with patients, relatives and carers · Palliative and end of life care · Using and recording information safely
Domain 5 · Patient presentations	Mental capacity concerns · End of life care/ symptoms of terminal illness · Memory loss · Death and dying
Domain 6 · Conditions	Dementias (including Alzheimer dementia, Lewy-Body dementia, frontotemporal dementia, vascular dementia) · Metastatic cancer
Station family	Acute care, ethics and safeguarding — Ethics and law — a conversation with a relative

7 · My marks and reflection — practice log form

Record your three domain marks, your station total, the GMC feedback statements that applied (where underperformance was identified), and what you will keep and change. The form is already labelled with this case and its web address; a copy of your entry is emailed to you, so your practice log builds up in your inbox and can be downloaded.

Record my marks and reflection for P2-19

Revision link for this case: acumenprimarycare.com/plab-2-osce/case-19-do-we-have-to-tell-her

← P2-18 All practice cases P2-20 →

Independence & scope. Independent, formative training material from MD Acumen Ltd. Not affiliated with, endorsed by, or delivered on behalf of the General Medical Council. The GMC does not publish its station mark sheets: every mark scheme and descriptor on these pages is an Acumen training tool calibrated to the GMC's published marking domains, feedback statements and the MLA content map. Practice scores are not a prediction of examination performance. Clinical content reflects UK guidance at the date of editorial review — always check the current guideline. All patients are fictional.

Continue through the course

🏠 PLAB 2 course hub 🧭 The exam: structure & syllabus ⏱️ Anatomy of the 8-minute station 📝 Mark scheme & passing 🩺 Practice OSCE cases ✉️ enquiry@mdacumen.com

© 2026 MD Acumen Ltd · Acumen Institute of Primary Care · An MD Acumen school · Registered in England and Wales · 16538952
PLAB 2 OSCE course · Practice cases · IMG roadmap · Observership · Legal & Regulatory · enquiry@mdacumen.com