· 15 min read
MMI Role-Play Stations: Scenarios, Examples, and How to Break Bad News
How MMI acting stations work, a four-step way through any role-play, 24 practice scenarios, a full breaking bad news example using SPIKES, a weak and a strong apology, and actor briefs to practice with a friend.
You read the prompt on the door: you looked after your roommate's fish, you forgot to feed it, and it died. She has just come home. You open the door and there she is, an actor who has been told exactly how upset to be and what she will reveal if you ask the right questions.
Role-play stations, also called acting stations, feel like the least predictable part of an MMI. They are also where good applicants lose the most points. In Confetto practice, role-play was the lowest-scoring of the 17 question types we track, and nearly half of role-play answers missed a core point (see the 2026 interview report). The reason is rarely a lack of empathy. It is usually that applicants spend the station being kind and never get to the task.
This guide shows how acting stations run, a four-step structure that keeps you on task, how to break bad news with the SPIKES method, a weak and a strong apology side by side, 24 scenarios to practice, and actor briefs you can hand to a friend.
How a role-play station works
- The prompt. You get about 1 to 2 minutes outside the door to read a short scenario: who you are, who you are about to meet and what you need to do.
- The actor. A trained actor or standardized patient plays the other person. They work from a brief that tells them how to feel, how to react to what you say, and what extra information to reveal only if you ask or earn their trust.
- The examiner. Usually sits to the side, says nothing and scores you. At some schools the actor also rates how you made them feel.
- The time. Typically 5 to 8 minutes. There is no prize for finishing the conversation, but there is a cost to never reaching the point.
What examiners look for is consistent across schools: whether you listen, show empathy in a way the other person can feel, communicate clearly, stay calm, are honest, and still get the job done. No medical knowledge is needed, even when the prompt makes you a doctor.
ROLE: four steps through any role-play
Scripts fail in acting stations because the actor will not follow yours. What you need is a route you can adapt as the conversation turns. We call it ROLE.
A good rule for timing: the core task should happen in the first half of the station. Everything after it is listening, supporting and planning. Applicants who save the hard part for the end often get cut off by the bell before they say it.
Breaking bad news with SPIKES
Breaking bad news is the most common role-play. Doctors learn a six-step method for it called SPIKES, first published by oncologists Walter Baile and Robert Buckman in 2000. You do not need to name it in the interview, but its steps fit almost any bad news station, clinical or not:
- Setting: privacy, sit down, the right people present.
- Perception: find out what they already know or suspect.
- Invitation: a warning shot, and a sense of how much they want to hear.
- Knowledge: the news, in plain words and small pieces. Then pause.
- Emotions: respond to the reaction before anything else.
- Strategy and summary: what happens next, and who will do what.
Here it is in a station that tests the same skills without any medicine.
Prompt: You are a counselor at a summer day camp. A parent has arrived to pick up her 10-year-old son, Jordan. This afternoon he fell on the climbing wall and hurt his arm. The camp nurse thinks it is broken, and another counselor has taken him to an urgent care clinic. You are the one who has to tell his mother.
Why it works: the reassurance that he is safe comes before the details, because that is the first thing any parent fears. The news is short and plain. The applicant does not defend the camp, guess at what happened, or promise anything they cannot deliver, and the conversation ends with a concrete next step: getting her to her son.
In a clinical version ("You are a doctor telling a patient that his scan shows a tumor"), the steps are the same. Ask what he understands about the scan, give the warning shot, use the word plainly, pause, and do not fill the silence with medical detail he did not ask for.
A weak and a strong apology
Admitting a mistake is the second most common acting station, and the one where applicants most often talk themselves into trouble. Here is the same prompt answered twice.
A simple pattern for any apology station: own it, check on them, fix it, prevent it. In that order.
24 MMI role-play scenarios
These are written in the style of real acting station prompts and grouped by type. Under each group is what the actor is usually holding back. Go in expecting it and you will listen for it.
Breaking bad news
- Your roommate asked you to feed her fish while she was away for two weeks. You forgot for several days and the fish died. She has just walked in.
- You are a camp counselor. A parent arrives to pick up their 10-year-old, who fell on the climbing wall this afternoon and is at urgent care with another counselor.
- You coordinate volunteers at a community center. You have to tell a volunteer of eight years that the after-school program she runs is being cut.
- You are a resident. A patient's daughter has taken another day off work for her father's surgery, and you have to tell her it has been postponed again.
What the actor may be holding back: A reason the news hits harder than you expect: the fish was a gift from someone who just moved away, the daughter may lose her job if she misses more work.
Admitting a mistake
- You work at a pharmacy counter. A customer comes back furious: last week she was given the wrong strength of her blood pressure pills.
- You borrowed a friend's laptop and spilled coffee on it. Her thesis is due tomorrow.
- As a research assistant, you accidentally deleted a week of a labmate's data.
What the actor may be holding back: What they need beyond an apology: to know whether they are at risk, and that it will not happen again.
Someone angry or upset
- You volunteer at the front desk of an emergency department. A man whose mother has waited four hours starts shouting at you.
- A teammate is upset that you were chosen to lead the group project instead of her.
- A neighbor knocks on your door at midnight to complain that your party woke her baby.
What the actor may be holding back: The fear or hurt underneath the anger: a mother who seems to be getting worse, a teammate who feels overlooked again.
Persuading someone to change
- Your father keeps driving after his doctor told him to stop because of his eyesight.
- A friend plans to stop taking her antidepressant because she feels better.
- A coworker keeps posting stories about patients on social media, saying they are anonymous.
What the actor may be holding back: Why they are resisting: driving is how your father sees his friends, your friend hates the side effects.
Confronting a colleague or friend
- You suspect your lab partner made up results in a report you both signed.
- A fellow volunteer keeps arriving late, and you have been covering for her for weeks.
- A classmate makes a joke about a patient's accent within earshot of the patient's family.
What the actor may be holding back: Something going on in their life that explains the behavior, without excusing it.
Explaining something clearly
- Explain to an elderly neighbor how to start a video call with her grandchildren.
- Explain to a worried parent why her child's cold does not need antibiotics.
- Describe to someone how to tie a shoelace without using your hands.
What the actor may be holding back: A misunderstanding you only find by checking what they took in: the parent heard "nothing can be done."
Supporting someone in distress
- A friend tells you she did not get into any medical school for the second time and is thinking of giving up.
- A classmate says he has not slept properly in weeks and "can't keep going like this."
- A patient on the ward where you volunteer says she is scared about her surgery tomorrow and has no one to call.
What the actor may be holding back: Sometimes a safety concern. If someone hints they might hurt themselves, ask them directly and help them get support.
Saying no
- A friend asks for some of your prescription pain medication for his back.
- A patient's relative asks you, a volunteer, to tell her what is in her mother's chart.
What the actor may be holding back: The real need behind the request, which you can often help with in another way.
When the actor cries, shouts or goes quiet
Actors are briefed to react, and their reactions are part of the test. These are the ones that throw applicants most often.
| The actor | What to do | What to avoid |
|---|---|---|
| Cries or goes silent | Stop talking. "Take your time." Offer a tissue if there is one, and wait. | Filling the silence, or jumping to solutions. |
| Gets angry or raises their voice | Stay calm, lower your voice, acknowledge it: "You have every right to be upset." Then the facts. | Defending yourself, or matching their tone. |
| Asks "Is it my fault?" | Answer honestly and kindly, with what you actually know. | False reassurance, or guessing. |
| Asks for something you can't give | Say no clearly, explain why, and offer what you can do instead. | A vague "I'll see what I can do." |
| Changes the subject | Follow it for a moment. It is often the hidden issue. | Dragging them back to your plan. |
| Refuses to talk | Acknowledge it, ask one gentle open question, and offer to come back. | Pushing harder or lecturing. |
Seven traps in acting stations
- Never getting to the task. Minutes of small talk and sympathy, and the news is still unsaid when the bell rings.
- Excuses before ownership. "We were really busy" turns any apology into a defense.
- Talking at the actor. A monologue, however kind, means you are not listening, and you will miss what they are holding back.
- False promises. "It will definitely be fine" and "I'll make sure you get a refund" are things you cannot know or deliver.
- Jargon. Even in a clinical role, say "the cancer has spread" rather than "metastatic disease."
- Performing for the examiner. Talking to the person in the corner, or narrating your technique ("I'm going to show empathy now"), breaks the scene.
- Lying to make it easier. If you forgot to feed the fish, say so. Honesty is part of the score in almost every acting station.
UK, US, Canada and virtual MMIs
UK. Role-play is a standard part of most UK MMIs, and breaking bad news is one of the most common prompts. Expect at least one, often more.
US and Canada. Acting stations are less common, but many MMI circuits include one or two, often with a standardized patient. Other schools test the same skills in a discussion station ("How would you tell a friend that..."), where you describe what you would say. The structure is the same: say the actual words.
Virtual MMIs. The actor appears on video. Look at the camera when you speak, use their name, and remember that silence feels longer on video than in a room, so let it run anyway.
Ethics inside a role-play. Many acting stations hide a dilemma: the friend who wants your prescription pills, the colleague who wants you to cover for them. Handle the person with ROLE and the dilemma with the method in our MMI ethics questions guide.
Check which format your school uses in our school interview guides.
Practice with a friend: actor briefs
You cannot practice role-play by reading. You need someone to play the other person, and they need a brief, or they will be too easy on you. Give a friend one of these, keep it hidden from yourself, read the matching scenario, and run it for 6 minutes. Then ask them how the conversation made them feel.
Brief 1: the roommate's fish (scenario 1)
You are Priya. The fish was a gift from your younger brother, who left for basic training last week. Be quiet and hurt at first. If the applicant makes excuses, get upset. If they apologize sincerely and ask about the fish, tell them about your brother. Calm down if they offer something thoughtful rather than just money.
Brief 2: the father who won't stop driving (scenario 11)
You are 78 and proud. Driving is how you get to church and see your friends; without it you would be stuck at home. Get defensive if the applicant lectures you about safety. Open up if they ask what driving means to you. Agree to try another way of getting around if they offer real alternatives.
Brief 3: the classmate who can't keep going (scenario 21)
You are Alex, exhausted and behind on everything. Downplay it at first ("I'm just tired"). Only if the applicant asks you directly whether you have thought about hurting yourself, admit you have had passing thoughts but no plan. You are relieved when someone tells you it is OK to get help and offers to go with you.
After each run, check yourself against ROLE: did you read your role, open well, find the hidden issue, and end with a plan? Then swap roles. Playing the actor teaches you a lot about what good listening feels like.
For other station types with model answers, see our complete list of MMI questions and answers.
Frequently asked questions
Who scores an MMI role-play station?
Usually an examiner who watches from the side of the room and scores how you handled the conversation. At some schools the actor also gives a rating or feedback on how you made them feel. Treat both as your audience, but talk to the actor, not the examiner.
Do I need medical knowledge for a role-play station?
No. Even when the prompt makes you a doctor or a pharmacist, the station tests communication, not clinical knowledge. If the actor asks a medical question you cannot answer, say so honestly and explain who could answer it.
What should I do if the actor starts crying?
Stop talking and give them a moment. Acknowledge it simply ("I can see this is really hard"), offer a tissue if there is one, and wait. Do not rush to fill the silence or move on to solutions until they are ready.
Can I touch the actor, for example a hand on the shoulder?
It is safer not to. Many schools tell actors not to expect physical contact, and some examiners mark it down. Show comfort with your voice, your posture and your words instead.
Do US and Canadian medical schools use role-play stations?
Some do. Role-play is a standard part of most UK MMIs, and many North American MMIs include one or two acting stations in a circuit, often with a standardized patient. Check your school's interview format, and practice at least a few in case you get one.
What if the station ends before I finish?
That is normal and costs less than you think. Examiners score how you handled the conversation, not whether you reached the end of a script. Make sure the core task (the news, the apology, the no) happens in the first half, so the bell cannot cut it off.