A MFDS Part 2 station on MedMock, start to finish
This is an illustrative MFDS Part 2 station written by MedMock to show what the station is like: the brief, everything the patient says, the candidate’s answers and the feedback were all written by us, not recorded from a real session. The feedback is laid out the way MedMock marks this exam. It is here to show the format and the standard, not as a model answer to learn by heart.
The brief
Candidate instructions (7-minute OSCE station after 2 minutes of reading time): You have just completed root canal instrumentation of the lower right first molar (LR6) for Mrs Helen Vance, aged 46. On your post-instrumentation periapical radiograph you identify that a 3 mm tip of a rotary nickel-titanium file has separated in the apical third of the mesiobuccal canal. There is no periapical radiolucency and the canal was irrigated with sodium hypochlorite beforehand. Speak with Mrs Vance to explain what has happened, fulfil your GDC Duty of Candour, and agree the management plan.
OSCE — Breaking Bad News, Ethics & Candour: the full transcript
Mrs Vance, thank you for sitting up. Now that I have taken the check X-ray of your lower right molar, I need to explain something unexpected that happened during the root canal cleaning today.
Something unexpected? Is something wrong with my tooth?
First, I want to say I am very sorry that this has happened. While I was shaping the narrow front root canal of your tooth, a small three-millimetre tip of the fine flexible metal file separated and remained at the very tip of the canal. I want to be completely open and honest with you about what that means and how we can look after the tooth from here.
A piece of metal broke off inside my tooth? Is it dangerous—will it travel into my jaw or cause a bad infection?
That is a completely understandable worry. The fragment is made of medical-grade sterile nickel-titanium and is wedged inside the root canal itself, so it cannot travel through your body. Because the tooth had no infection around the root tip on the X-ray and we had already disinfected the canal with our antiseptic wash before the tip separated, the outlook for the tooth remains good. What the fragment does is block the very last three millimetres of that one canal.
So what are my options now? Do I have to have the tooth taken out?
No, you certainly do not need the tooth extracted at this stage. We have three realistic options. First, I can refer you to a specialist endodontist—a root canal specialist who uses an operating microscope—to assess whether they can either bypass or gently remove the fragment and complete the root filling. Second, we can clean and seal the canal right up to the fragment and monitor the tooth closely with clinical checks and X-rays at six and twelve months. Third, if symptoms ever developed in future, apical microsurgery or extraction would be fallback options. Referral to an endodontic specialist gives you the best chance of bypassing the fragment safely, and we will arrange that for you and document everything clearly in writing.
Thank you. That is the end of the station.
Example feedback
90 / 100
Disclosed the separated instrument immediately, apologised sincerely and explained the clinical findings honestly.
Addressed the patient's fear about the metal fragment in lay terms and explained how canal disinfection and apical status affect prognosis.
Presented specialist endodontic referral, obturation/monitoring and contingency options clearly so the patient could make an informed choice.
What went well
- Opened transparently and offered a clear, sincere apology in line with the GDC Duty of Candour without defensiveness.
- Reassured the patient accurately in plain language that the sterile nickel-titanium fragment is confined within the canal and explained the favourable prognostic factors (vital/non-periapical status and prior sodium hypochlorite disinfection).
- Set out balanced Montgomery-compliant options including specialist endodontic referral, obturation to the fragment with radiographic follow-up, and clear written documentation.
What to improve
- Confirm interim dressing and coronal seal arrangements today so the patient knows how the tooth is protected while awaiting the specialist endodontic appointment.
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