Location: You are a junior doctor in general practice
Patient: 50 year old male patient has come to see you with a mole on his back
– Take a focused history from the patient
– After 6 minutes you will be asked a series of questions by the examiner
– Answer any questions that the patient may have
Note to actor: Try to restrain yourself from volunteering too much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
You are a 50 year old man who has come to see his GP. You are really only here because your wife has nagged you into coming. You have been told you have a mole on your back which is getting larger.
You have a lot of moles all over your body including your back, you have seen your GP a couple of years ago and were told it was nothing to worry about but if there was any change to return.
If asked, when you are exposed to the sun more often than not you will burn and not tan. You work as a gardener and because it is warm you will often not wear a shirt in summer. You do not wear any sun protection (sun tan lotions / hats). You personally like the look of tanned skin.
You used lived in South Africa as a child for 10 years, you often remember burning and having blisters as a child. But that’s just what happened back then.
You have not been previously diagnosed with any skin cancers.
Past Medical History (PMH)
– Usually fit and well
– No regular medications
– No known drug allergies
Family History (FH)
Your father died of cancer, you do not know what type but it was in his ‘bones’
If the candidate appears to have finished early remind them how long is left at the station and enquire if there is anything else they would like to ask, or whether they have finished. If they have finished, please remain silent and allow the candidate that time for reflection.