112 clinically reviewed rehearsal stations across Mock Circuits 1–12 and advanced standalone cases. These original training aids are informed by the Section 2 format; they are not official examination material.
This pilot uses fictional scenarios and learning scaffolds. Verify current local guidance and do not use it as a substitute for senior advice or patient-specific care.
Read the task, speak your answer aloud, then compare it with the model and follow-up prompts. Record one improvement before repeating.
A fictional 52-year-old teacher reports progressive left-sided hearing reduction, non-pulsatile tinnitus and intermittent imbalance over nine months. There is no acute neurological deficit. The examiner asks you to structure your assessment and explain your initial plan.
Open station ↓A fictional 61-year-old person who smokes presents with a painless lateral neck lump that has persisted for six weeks. They have noticed intermittent throat discomfort but no acute airway symptoms. The examiner asks for your first consultation and onward pathway.
Open station ↓A fictional 6-year-old has habitual snoring, witnessed pauses in breathing and daytime behavioural difficulty. Their parent is exhausted and asks whether surgery is definitely required. There are no current signs of acute respiratory compromise.
Open station ↓A fictional 17-year-old attends after a sports injury. They have nasal obstruction and pain. On inspection there is bilateral boggy septal swelling. The examiner asks you to prioritise the assessment, communication and escalation.
Open station ↓A fictional 73-year-old on an anticoagulant has had several self-limiting nosebleeds this week. They are worried and have stopped one dose without advice. There is no active heavy bleeding in the station.
Open station ↓A fictional 52-year-old teacher reports progressive left-sided hearing reduction, non-pulsatile tinnitus and intermittent imbalance over nine months. There is no acute neurological deficit. The examiner asks you to structure your assessment and explain your initial plan.
Give a prioritised, safe approach. State what you would clarify, examine, investigate and communicate, including when you would escalate.
Localise conductive, cochlear or retrocochlear disease; commit to proportionate MRI/audiovestibular assessment and name the consequence of each result.
I would treat this as a progressive unilateral audiovestibular presentation. My first job is to establish whether there are red flags that alter the urgency, then construct a defensible differential and investigation plan rather than prematurely naming a diagnosis.
Activates urgent sudden-SNHL or neurological assessment.
Supports MRI internal auditory meati according to degree and associated features.
Raises retrocochlear concern and changes rehabilitation expectations.
Changes procedural risk tolerance.
MRI shows a 17 mm vestibular schwannoma with serviceable hearing. Compare surveillance, radiotherapy and microsurgery for this individual.
An abrupt change, focal neurological symptoms, severe new imbalance, recurrent falls, severe headache or symptoms suggesting an acute central process would require immediate reassessment and senior input.
I would give a one-line problem representation, the red-flag status, audiological findings when available, what I have requested, the time-critical uncertainty and exactly who will review the result.
Saying ‘it is probably nothing’ before the assessment is complete. A better approach is to acknowledge uncertainty and explain the reason for a proportionate investigation.
It links audiometry and imaging to a management choice, rather than merely requesting both.
A clear anatomical differential, quantified hearing, justified imaging and an owned hearing/vestibular rehabilitation plan.
Which phrase helps you acknowledge concern while staying honest about uncertainty? Rewrite it in your own words.
Format source: JCIE Intercollegiate Specialty Examination in Otolaryngology: guide to scope and format · UK and Ireland · JCIE · checked 2026-09-05.
Clinical content source: NICE NG98: hearing loss in adults · England · NICE · Current guidance checked September 2026 · checked 2026-09-13.
Station review status: Clinically reviewed and approved 13 September 2026. No accreditation, endorsement or formal CPD approval is claimed.
Change history: 13 September 2026: Added consultant decision pivots, MRI threshold, operative/rehabilitation ownership and calibrated safety anchors. Clinically reviewed and approved for publication.
Related curriculum area: Otology and neuro-otology · unilateral/asymmetrical hearing loss.
A fictional 61-year-old person who smokes presents with a painless lateral neck lump that has persisted for six weeks. They have noticed intermittent throat discomfort but no acute airway symptoms. The examiner asks for your first consultation and onward pathway.
Demonstrate a safe head-and-neck assessment, communicate risk clearly, and explain how you would organise timely senior and multidisciplinary input.
Treat a persistent adult lateral neck mass as malignancy until adequately excluded, while avoiding open-biopsy contamination.
I would approach this as a persistent adult neck mass requiring prompt structured assessment. I would establish immediate airway and systemic safety first, then communicate why urgent investigation is appropriate without implying a diagnosis has been made.
Immediate stabilisation precedes diagnostics.
Does not equal benign branchial cyst; HPV-related metastasis must be considered.
Directs HPV/EBV testing and primary search.
Requires structured panendoscopy/imaging strategy, not indefinite observation.
Ultrasound calls the mass a cyst and FNA is paucicellular. State the next diagnostic step and what you will not do.
I would answer honestly: ‘It is one possibility among several, and we do not yet have enough information to say. The reason for the urgent pathway is to find the cause promptly.’
Time course, mass site and examination, red flags, swallowing/airway/nutritional status, risk factors, comorbidity, relevant imaging or bloods, communication needs and the action already taken.
Either delaying the pathway with repeated empirical treatment, or frightening the patient by presenting suspicion as confirmation.
Reassuring an adult with a cystic neck mass or excising it before the oncological pathway is defined.
Timely cancer-pathway diagnosis using image-guided tissue, complete mucosal/skin examination and no unplanned open biopsy.
How would you separate ‘possible serious diagnosis’ from ‘confirmed diagnosis’ in one sentence?
Format source: JCIE Intercollegiate Specialty Examination in Otolaryngology: guide to scope and format · UK and Ireland · JCIE · checked 2026-09-05.
Clinical content source: NICE NG36: upper aerodigestive tract cancer · England · NICE · Current guidance checked September 2026 · checked 2026-09-13.
Station review status: Clinically reviewed and approved 13 September 2026. No accreditation, endorsement or formal CPD approval is claimed.
Change history: 13 September 2026: Added unknown-primary pathway, airway thresholds and surgical ownership. Clinically reviewed and approved for publication.
Related curriculum area: Head and neck surgery · neck lump and suspected malignancy.
A fictional 6-year-old has habitual snoring, witnessed pauses in breathing and daytime behavioural difficulty. Their parent is exhausted and asks whether surgery is definitely required. There are no current signs of acute respiratory compromise.
Structure a paediatric assessment and shared decision-making conversation, including uncertainty, comorbidity and safety-netting.
Decide who needs objective testing, adenotonsillectomy, enhanced postoperative monitoring and a residual-disease pathway.
I would run a child-centred, family-centred assessment. I would first determine severity and current safety, then assess comorbidity and impact before discussing management as an individualised decision rather than promising surgery.
Obesity, trisomy 21, neuromuscular or craniofacial disease raises residual and perioperative risk.
Changes urgency and monitoring.
Prompts dynamic/multilevel assessment rather than automatic adenotonsillectomy.
Require reassessment, not reassurance.
The child has trisomy 21, obesity and small tonsils. Explain why routine day-case adenotonsillectomy is not an adequate plan.
Use short age-appropriate questions, offer choice where genuine choices exist, and ask the parent to add context rather than speaking over the child.
It can alter assessment, peri-operative risk, the need for multidisciplinary input and the certainty with which a single intervention can be recommended.
Treating a parent’s request for surgery as an indication, or failing to assess the wider sleep, developmental and medical impact.
It anticipates residual disease and perioperative risk rather than presenting surgery as a cure.
Severity and phenotype defined, treatment individualised, anaesthetic monitoring explicit and residual OSA actively sought.
Write one teach-back question that checks understanding without sounding like a test.
Format source: JCIE Intercollegiate Specialty Examination in Otolaryngology: guide to scope and format · UK and Ireland · JCIE · checked 2026-09-05.
Clinical content source: NICE NG202: obstructive sleep apnoea and hypopnoea syndrome · England · NICE · Current guidance checked September 2026 · checked 2026-09-13.
Station review status: Clinically reviewed and approved 13 September 2026. No accreditation, endorsement or formal CPD approval is claimed.
Change history: 13 September 2026: Added severity stratification, perioperative risk and residual-OSA planning. Clinically reviewed and approved for publication.
Related curriculum area: Paediatric ENT · sleep-disordered breathing.
A fictional 17-year-old attends after a sports injury. They have nasal obstruction and pain. On inspection there is bilateral boggy septal swelling. The examiner asks you to prioritise the assessment, communication and escalation.
Show a concise, safe trauma approach. Identify what must be assessed immediately and how you would arrange urgent specialist action.
A consultant must diagnose clinically, drain urgently, prevent recollection and plan late structural consequences.
This is not a routine cosmetic-trauma consultation. Bilateral boggy septal swelling after nasal trauma raises a time-sensitive concern, so I would prioritise safe trauma assessment, urgent ENT escalation and clear explanation over independent procedural action.
Urgent drainage; radiology must not delay.
Culture, antimicrobial and admission requirements increase.
Raises saddle deformity and later reconstruction needs.
Mechanism and supervision require appropriate assessment.
Purulence and cartilage loss are found at drainage. Describe sampling, washout, packing/drain, antibiotics and follow-up.
Eye injury, orbital symptoms, broader mid-face trauma, dental/malocclusion issues, CSF leak concerns and head injury all change the assessment and need documentation.
I would not force it. I would provide appropriate analgesia, seek senior help and use a safe, child- or patient-centred approach.
Focusing only on appearance, or describing an invasive procedure without recognising limits of competence and the need to escalate.
Deferring drainage for swelling to settle or relying on fracture radiographs.
Same-day drainage with recollection prevention, infection control and long-term septal-growth/deformity surveillance.
Name the sentence you would use to explain urgency without frightening the patient unnecessarily.
Format source: JCIE Intercollegiate Specialty Examination in Otolaryngology: guide to scope and format · UK and Ireland · JCIE · checked 2026-09-05.
Clinical content source: NHS Greater Glasgow and Clyde: nasal injuries in children · Scotland · NHS clinical guidance · Current guidance checked September 2026 · checked 2026-09-13.
Station review status: Clinically reviewed and approved 13 September 2026. No accreditation, endorsement or formal CPD approval is claimed.
Change history: 13 September 2026: Added operative drainage, antimicrobial, reconstruction and abscess rescue depth. Clinically reviewed and approved for publication.
Related curriculum area: Rhinology and facial plastics · nasal trauma.
A fictional 73-year-old on an anticoagulant has had several self-limiting nosebleeds this week. They are worried and have stopped one dose without advice. There is no active heavy bleeding in the station.
Take a focused history, give safe immediate advice within your role, and agree an escalation and follow-up plan without independently changing prescribed anticoagulation.
Control bleeding while balancing thrombotic indication, reversal and definitive haemostasis rather than simply stopping anticoagulation.
This is both a bleeding assessment and a medicines-safety conversation. I would assess severity first, explore why the anticoagulant is prescribed, avoid independently changing it, and coordinate a plan with the appropriate senior and prescribing teams.
Major-haemorrhage resuscitation and reversal become immediate.
Early airway/operative or endovascular strategy.
Thrombotic risk changes interruption and restart.
Requires endoscopic exclusion of tumour.
Packing fails in a patient with a mechanical mitral valve and falling haemoglobin. State the haemostatic, reversal and restart decision owners.
Not without the appropriate prescriber/protocol and a risk assessment. I would explain that I will urgently seek the correct advice and tell them exactly when and how they will receive it.
By acknowledging both bleeding and thrombosis risks, not minimising either, and ensuring the decision is made by the appropriate team with the relevant clinical context.
Giving a simplistic medicine instruction, failing to quantify the current bleed, or leaving the patient unclear who owns the next decision.
Unilateral cessation of anticoagulation without understanding indication or haemorrhage severity.
Bleeding controlled, anticoagulant indication respected, definitive source treated and restart ownership documented.
What would you say when a patient asks for a yes/no medicine answer that requires multidisciplinary decision-making?
Format source: JCIE Intercollegiate Specialty Examination in Otolaryngology: guide to scope and format · UK and Ireland · JCIE · checked 2026-09-05.
Clinical content source: NICE CKS: epistaxis · England · NICE CKS · Current guidance checked September 2026 · checked 2026-09-13.
Station review status: Clinically reviewed and approved 13 September 2026. No accreditation, endorsement or formal CPD approval is claimed.
Change history: 13 September 2026: Added haemorrhage control, reversal thresholds and definitive vascular escalation. Clinically reviewed and approved for publication.
Related curriculum area: Communication skills · epistaxis and medicines safety.