MRCS Part B

Communication Stations — How to Prepare

4 stations. 80 marks. Double-manned by a surgeon and a lay examiner. This is where knowledge-strong candidates lose the exam.

Practise history taking now →
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The most underestimated section. Communication stations account for nearly a quarter of total marks. Most candidates who fail the Skills component do so here — not because the stations are hard, but because they prepare in the wrong way.

What the Stations Test

Giving & Receiving Information · 2 stations
—Breaking bad news — new malignancy, unexpected complication
—Consenting a patient for surgery
—Explaining a diagnosis or management plan
—Cancelling a patient's surgery
—Handing over to a colleague
History Taking · 2 stations
—Focused surgical history from an actor-patient
—Presenting differential diagnosis to the examiner
—Discussing your management plan

How Marking Works

🩹
Surgeon Examiner
Marks clinical content — correct complications, red flags, sensible differential
+
👤
Lay Examiner
Marks communication — listening, plain language, exploring concerns

You can score well with the surgeon and badly with the lay examiner. Many candidates do. Reading consent checklists and calling it preparation does not work.

What Examiners Want to See

ICE
Ideas, Concerns, Expectations
Ask early and genuinely. “What do you think might be going on?” separates a real consultation from a clinical transaction. The lay examiner is watching for this.
STRUCTURE
Chunk and check
Deliver information in manageable pieces, then check understanding before moving on. Do not monologue.
LANGUAGE
Plain English only
“An operation to remove your gallbladder” not “a laparoscopic cholecystectomy.” If you use a medical term, explain it immediately.
EMOTION
Acknowledge before continuing
When a patient reacts — fear, anger, silence — pause and acknowledge it. “I can see this is a lot to take in” is what the lay examiner is scoring.
SAFETY NET
Always close with a plan
Tell the patient what to do if things change or if they have more questions. Every station, every time.

Scenarios to Practise

→Breaking news of bowel, breast or lung cancer
→Consenting for laparoscopic cholecystectomy
→Explaining an anastomotic leak to a relative
→Cancelling an elective case on the morning
→History of rectal bleeding with red flags
→History of a breast lump — young patient
→Neck swelling — possible lymphoma
→Deteriorating post-op patient — handover
The only revision that works

You have to practise out loud with another person. Reading scripts is not preparation. Find a colleague and run through scenarios with them acting as the patient.

Ask them to be difficult: anxious, upset, angry, in denial. These are the scenarios where the lay examiner's marks are won or lost.

History stations live now
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✓ History taking stations✓ Clinical scenario format✓ Model answers included