Telling a patient their surgery has been cancelled
PLAB 2 & PRES 3 · orthopaedics / communication · medium · 8 minutes
Candidate brief
You are an FY2 doctor on an orthopaedic ward. Mrs Sandra Bell, 58, was admitted this morning for an elective left total hip replacement. She has been nil by mouth since midnight, is changed into a theatre gown, and her consent form is signed. Her operation has now been cancelled: two emergency cases overnight and this morning — a fractured neck of femur and an emergency laparotomy — have taken the theatre time and the last post-operative bed. The consultant has asked you to inform her. Please tell Mrs Bell that her operation is cancelled, explain why, and discuss what happens next.
What examiners look for
Say it early, say it plainly, apologise first. A cancellation delivered after two minutes of warm-up is cruelty with good manners. The sentence she needs is short: the operation is not happening today, and you are sorry. Her anger is information, not obstruction. Eight months of pain, an unpaid day, a daughter on a motorway — when she lists them, she is telling you the real size of what was cancelled. Repeat her losses back to her; feeling accurately heard is most of what de-escalates this station. Explain the triage, don't hide behind it. "Emergencies" as a magic word sounds like an excuse; one honest sentence about a fractured hip and an emergency abdominal case lets her picture why — while never breaching those patients' confidentiality with detail. The forbidden move is the false promise. A made-up date buys thirty seconds of calm and a formal complaint later. Give the real rebooking arrangement and a named contact instead; honest uncertainty with a mechanism beats comforting fiction. Never let her leave believing it was her fault. Patients cancelled on the day quietly conclude they were too heavy, too old or too complicated. Say explicitly that the decision was about theatre and bed capacity, not about her. Food is a clinical intervention here. She has fasted for over eleven hours on your instruction; "you can eat and drink now, and I'll make sure something comes" is both humane and a scored action — alongside discharge, the work note, and interim pain relief. A complaint offered calmly is a trust signal. Giving her the PALS route yourself, and confirming it cannot harm her rebooking, shows the apology was real. Defensiveness at this point converts disappointment into a formal complaint.
Guideline references
- https://www.gmc-uk.org/-/media/documents/openness-and-honesty-when-things-go-wrong--the-professional-duty-of-candour-61540594.pdf
- https://www.nhs.uk/conditions/having-surgery/
Practise this station
Role-play it with an AI patient and get feedback against the full marking scheme. Create a free account — 3 stations per month free.