MRCS Part B Revision · Communication skills
Breaking Bad News 1 — MRCS Part B Communication skills
By Dr Richard Miller, MBChB FRCS · Reviewed
Breaking Bad News 1 is a communication station. Four of the seventeen examined stations in the MRCS Part B OSCE are communication, the second largest content area in the exam. The communication stations put a patient, a relative or a colleague in front of you and mark how you gather and give information, not only what you know.
The model answer for the Breaking Bad News 1 station
Communication stations are marked on what you do, not only on what you say. The walkthrough for this station covers what the scenario is really testing, what the actor has been briefed to do, and the ordered moves that earn the marks.
Because it includes the actor’s own briefing, it is part of the question bank rather than a public page.
Read the full walkthrough in the question bankImages from this station
What are you asked at the Breaking Bad News 1 station?
The station runs to 15 questions over nine minutes. A prompt the station repeats — against each marker on a specimen, for instance — is listed once here; the model answers are in the question bank.
- Introduce yourself to the patient
- The gentleman has been told by his GP that he might have a fracture. How would you proceed?
- The patient explains that his wife has just had a miscarriage and that he is self-employed so he is worried that he will be off work with a fracture and not able to support his wife. Explain to the gentleman what the radiographs show
- The patient cannot believe the news and is upset. He sits silently looking at the floor. What would you do next?
- The patient looks up and asks: “Is it definitely cancer?” How will you respond?
- The patient again appears upset and is quiet. How would you approach this?
- The patient states that his father died of lung cancer and is worried about death and leaving his wife. How will you respond?
- The patient understands but wants more specific information regarding what happens next. What will you tell him?
- You contact the specialist unit and speak with the consultant. Their PACS system is offline. Summarise the patient history to the consultant
- The consultant would like you to describe the radiographs as the PACS system is offline
- The consultant is appalled that the GP missed this lesion and wants to know what is being done to flag this up. How would you respond?
- The consultant is happy with the referral and explains that they will see the patient within two weeks in their outpatient clinic. He should use crutches for comfort. Close the phone consultation
And 2 more at this station.
How is the communication skills station marked in MRCS Part B?
Four of the seventeen stations are communication, and they are not marked alike. The two history-taking stations carry 4 marks for knowledge, 8 for clinical and technical skill, 4 for communication and 4 for professionalism. Talking with relatives and carers carries 12 of its 20 marks for communication. Communicating with colleagues splits 8 for communication and 8 for professionalism. Two of these stations are preceded by a preparation station.
FAQ
What does the Breaking Bad News 1 station ask?
It opens with "Introduce yourself to the patient" and runs to 15 questions over nine minutes. Four of the seventeen stations are communication, and they are not marked alike. The two history-taking stations carry 4 marks for knowledge, 8 for clinical and technical skill, 4 for communication and 4 for professionalism. Talking with relatives and carers carries 12 of its 20 marks for communication. Communicating with colleagues splits 8 for communication and 8 for professionalism. Two of these stations are preceded by a preparation station.
How many communication stations are there?
Four of the seventeen examined stations: two history taking, one giving information to a patient or relative, and one giving information to another health professional. That makes communication the second largest content area in the exam.
Which communication station carries the most communication marks?
Talking with relatives and carers, where 12 of the 20 marks are for communication itself. It is also one of the two stations with a preparation bay before it, and it is examined by a surgeon alongside a lay examiner.
What is the station where I speak to a colleague?
Communicating with colleagues is a handover or referral station, often by telephone. It splits its marks 8 for communication and 8 for professionalism, with 4 for knowledge, so how you structure the call matters more than the clinical detail.
When do I present my findings in a history station?
You are signalled after six minutes of the nine. The history has to be finished inside six minutes so that the presentation is not cut off, which is the most common way marks are lost here.
How many stations are in the MRCS Part B OSCE?
Seventeen examined stations of nine minutes each, with a minute to read the task before each one. Two preparation stations and at least one rest station bring the circuit to about twenty, and the exam takes about three and a half hours.
What is the pass mark for MRCS Part B?
There is no published pass mark. The cut score is set separately for Applied Knowledge and Applied Skills, for each circuit, by borderline regression. Published pass rates across the 2024/25 diets ranged from 51% to 66%.
Can I fail a station and still pass?
Yes. There is no rule about how many stations you may fail: the cut score applies to your total mark in each component, so a weak station costs the marks you lost on it and strong stations elsewhere can make them back. Applied Knowledge and Applied Skills are passed separately and must both be passed at the same sitting, so a strong anatomy performance cannot rescue a weak communication one.
Dr Richard Miller, MBChB FRCS
Station summaries are reviewed against the current intercollegiate MRCS syllabus and the published marking blueprint. Guidance changes between diets: check the royal colleges' own pages before relying on a date, a fee or a threshold.
Practise this station
The question bank carries the model answer to every question above, with the rest of the communication skills stations.
More communication skills stations