Colleague Consultation · Intermediate · Communication

Colleague Wellbeing and Occupational Health Concern

Practise this PLAB 2 colleague consultation station on Colleague Wellbeing. 8-minute voice AI simulation with feedback on all 3 marking domains.

Clinical scenario

You are an FY2 doctor working in a medical team. You have become concerned about a colleague's wellbeing. You have noticed signs that suggest he may have a problem with alcohol including smelling of alcohol at work, appearing hungover, mood changes, reduced performance, and occasional unsafe practice. You must approach this conversation professionally, express your concern clearly without judgment, explore whether he is willing to seek support, and discuss appropriate pathways including occupational health and medical support.

Background notes: PMH: Nil significant

What this station tests

  • Expressing concern not accusation: 'I am worried about you' not 'you have a problem'
  • GMC duty: if patient safety is at risk from a colleague's health or behaviour, you must act
  • Offering non-punitive support: occupational health, Practitioner Health Programme, BMA wellbeing
  • Escalation pathway: direct conversation first, escalate to consultant if safety concern unresolved
  • Documenting the conversation: professional record of the concern and the action taken

How to use your 8 minutes

  • 0-1 min — Introduction: Introduce yourself and your role. State the purpose of the consultation clearly.
  • 1-3 min — Present Case: Use SBAR structure. Situation, Background, Assessment, Recommendation. Be concise and relevant.
  • 3-5 min — Discussion: Discuss differential diagnosis and management. Listen to colleague's perspective. Share concerns professionally.
  • 5-7 min — Agree Plan: Agree on management plan. Clarify roles and responsibilities. Discuss escalation criteria.
  • 7-8 min — Closing: Summarise agreed actions. Confirm documentation. Arrange follow-up communication.

Consultation approach

The opening

Approaching a colleague about their wellbeing requires care, compassion, and knowledge of the professional obligations. Ernest is 35, a senior registrar, recently separated, showing signs of burnout: late arrivals, short-tempered, smelling of alcohol on one occasion. Open with a private conversation: 'Ernest, I have been worried about you. Can we talk?'

Core approach

Express concern, not accusation. 'I have noticed you have been arriving late and seem stressed. I wanted to check in because I care about you as a colleague.' Do not start with the alcohol observation: build trust first. He may deny, deflect, or open up. If he opens up: listen. If he deflects: 'I am here when you are ready to talk.'

If patient safety is at risk (alcohol at work): this changes the conversation from optional to mandatory. GMC guidance: if a colleague's health or behaviour puts patients at risk, you have a duty to act. This does not mean reporting behind his back immediately: it means addressing it directly and escalating if he does not engage.

Offer support. Occupational health. GP for confidential support. BMA wellbeing service. Practitioner Health Programme (confidential service for doctors). These are non-punitive resources.

Closing and safety netting

If he engages: encourage him to see occupational health or his GP. Offer practical support (covering shifts while he gets help). If patient safety is at risk and he does not engage: you must escalate to your consultant or clinical director. 'Ernest, I do not want to go above your head, but if I am worried about patient safety, I have a duty to act. Let me help you before it gets to that point.'

Document the conversation. Follow-up: check in within days. 'I am on your side. I want to help you through this.'

How examiners mark this station

Examiners will assess both Domain 1 (Data Gathering) and Domain 2 (Clinical Management) as primary: clarity and structure of your case presentation, appropriateness of your clinical reasoning, and whether you agree a clear plan. Domain 3 (Interpersonal Skills) assesses professional communication and collaborative approach.

Domain 1 (Supporting)

Scores well: Signs identified. Patient safety risk assessed. Context understood (separation, stress).

Costs marks: Not recognising the signs.

Domain 2 (Primary focus)

Scores well: Direct conversation first. Support resources offered. Escalation pathway known. Documentation. GMC duty understood.

Costs marks: Ignoring. Reporting without speaking first. No support offered.

Domain 3 (Primary focus)

Scores well: Compassionate approach. Expressing concern not accusation. Offering help. Being on his side. Private conversation.

Costs marks: Accusatory. Public conversation. Not offering support. Threatening.

Common examiner feedback (and how to fix it)

Did not communicate clinical information effectively

Fix: Use SBAR (Situation, Background, Assessment, Recommendation) every time. State clearly what you need from the colleague at the outset.

Did not identify the patient's problems and/or did not develop a management plan adequately

Fix: Before ending, confirm: What is the plan? Who is doing what? When will you communicate next? Document the agreed plan.

Common mistakes in this station

  1. Ignoring the signs: if patient safety is at risk, you have a professional duty to act
  2. Reporting immediately without speaking to the colleague first: direct conversation should come first unless immediate danger
  3. Being accusatory: 'I think you have a drinking problem' shuts down the conversation

Resitting PLAB 2?

If colleague consultation stations have been challenging, practise the SBAR format until it is automatic. The most common issue is failing to clearly state why you are consulting the colleague and what you need from them. Be direct about your clinical question.

Example opening

Hello, this is Dr [Name], I'm the FY2 on [ward]. Thank you for taking my call. I'd like to discuss a patient I'm looking after and get your advice on management.

Frequently asked questions

How should I approach this colleague wellbeing colleague consultation?

Approaching a colleague about their wellbeing requires care, compassion, and knowledge of the professional obligations. Ernest is 35, a senior registrar, recently separated, showing signs of burnout: late arrivals, short-tempered, smelling of alcohol on one occasion.

What does a strong performance look like to the examiner in this station?

Strong performances show: Signs identified. Patient safety risk assessed. Context understood (separation, stress). Weak performances: Not recognising the signs.

What is the biggest pitfall in this colleague wellbeing station?

Ignoring the signs: if patient safety is at risk, you have a professional duty to act.

How should I prepare for colleague wellbeing if I have never seen it in practice?

This station rewards process over personal experience. The skill being assessed: GMC duty: if patient safety is at risk from a colleague's health or behaviour, you must act. Use the domain breakdown on this page to target your preparation, then practise the station aloud so your structure survives exam pressure.

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