Core
Free sample
Heaviness at rest, retired supervisor
Adult with chest pain that came on at rest.
ECG available on request
Start consultationPatient simulator
Take a history, reach a diagnosis
Pick a presenting complaint and question the patient in your own words. Ask for observations, request a 12-lead where it is clinically indicated, then submit your ranked differentials and management plan for marking against JRCALC, NICE guidance and BMJ Best Practice.
Up to 50 questions per case Staged observations ECG when indicated
Chest pain
Rest pain, exertional pain and chest wall pain — the sorting job you do every shift.
Intermediate
Sharp pain on breathing, back from a long flight
Adult with sudden sharp chest pain, worse on breathing in.
ECG available on request
Start consultationCore
Sore chest since the gym, university student
Young adult with chest wall pain following exercise and a cough.
ECG available on request
Start consultationBreathlessness
Wheeze, wet chests and silent chests, with oxygen targets that differ by patient.
Core
Worsening over four days, lives alone
Adult who has become progressively short of breath.
ECG available on request
Start consultationIntermediate
Worse lying flat, retired postman
Older adult with breathlessness that has become worse lying down overnight.
ECG available on request
Start consultationIntermediate
Sudden tight chest and wheeze, young adult
Young adult with a rapid onset of severe breathlessness and wheeze.
ECG available on request
Start consultationAbdominal pain
Peritonism, vascular catastrophes and pain of gynaecological origin.
Core
Lying very still, retired driver
Adult with abdominal pain and feeling generally unwell.
ECG available on request
Start consultationAdvanced
Sudden back and abdominal pain while gardening
Older man with sudden severe back and abdominal pain, found slumped in a chair.
ECG available on request
Start consultationIntermediate
Lower abdominal pain and shoulder discomfort in student halls
Young woman with lower abdominal pain and vaginal spotting.
Observations available on request
Start consultationCollapse
Syncope you can safely leave at home, and syncope you absolutely cannot.
Core
Witnessed collapse at home
Adult found on the floor after a collapse.
ECG available on request
Start consultationIntermediate
Recurrent blackouts while out shopping
Older man with recurrent brief collapses and vague dizziness.
ECG available on request
Start consultationCore
Felt faint during a blood test
Young adult who briefly lost consciousness after a medical procedure.
ECG available on request
Start consultationFever and feeling unwell
Sepsis recognition across the ages, including the patient who does not need hospital.
Core
Off legs and shivery for two days
Adult who has become hot, shivery and confused.
ECG available on request
Start consultationAdvanced
Hot, floppy toddler with spots that won't fade
A young child with a fever and a rash, seen by the crew at home.
Observations available on request
Start consultationCore
Sore throat and aches, worried about exams
A young adult in student accommodation feeling generally unwell for two days.
Observations available on request
Start consultationOverdose
Toxicology, risk assessment and mental health, taken together.
Core
Tablets taken overnight, found by a housemate
Adult who has taken more medication than prescribed.
Observations available on request
Start consultationIntermediate
Found slumped in a shop doorway
Adult found unresponsive in a public place by a passer-by.
ECG available on request
Start consultationAdvanced
Collapsed at home with slurred speech and jerking
Adult found drowsy and confused at home after a reported overdose.
ECG available on request
Start consultationHeadache
Thunderclap onset, meningism and the migraine that needs reassurance, not a pre-alert.
Advanced
Sudden severe headache while gardening
Adult with a headache that started abruptly and is the worst they have ever had.
Observations available on request
Start consultationCore
Recurrent headache with visual disturbance, known migraine sufferer
Adult with a headache and visual symptoms similar to previous episodes.
Observations available on request
Start consultationIntermediate
Headache and fever in a university student
Young adult in student accommodation with headache, fever and feeling unwell.
Observations available on request
Start consultationBack pain
Red-flag screening: cord and cauda equina, infection, and simple mechanical pain.
Advanced
Low back pain with numbness and difficulty passing urine
Adult with worsening low back pain and new numbness and urinary symptoms.
Observations available on request
Start consultationCore
Low back pain after moving furniture
Working-age adult with low back pain that started after lifting.
Observations available on request
Start consultationIntermediate
Worsening back pain with fever in a person with a history of injecting drug use
Adult with severe back pain and fever over several days.
Observations available on request
Start consultationPalpitations
Narrow and broad complex tachycardias against the Resuscitation Council UK algorithms.
Intermediate
Sudden fluttering, first time, retired florist
Adult with a new onset of an irregular fast heartbeat and no past cardiac history.
ECG available on request
Start consultationCore
Racing heart at the gym, student
Young adult with a sudden fast regular heartbeat that started during exercise.
ECG available on request
Start consultationAdvanced
Sudden collapse feeling, previous heart attack
Older adult with a previous heart attack now feeling a fast, pounding heartbeat with dizziness.
ECG available on request
Start consultationAltered behaviour
Medical mimics, capacity and safeguarding before any mental health assumption.
Core
Aggressive and confused, known diabetic
Adult reported as aggressive and confused at home, called by a family member.
Observations available on request
Start consultationIntermediate
Frightened and suspicious, university halls
Young adult reported as behaving strangely and refusing help, called by a flatmate.
Observations available on request
Start consultationIntermediate
New confusion, care home resident
Older adult in a care home reported as suddenly more confused than usual.
Observations available on request
Start consultationLimb weakness
Stroke pathways, stroke mimics and progressive neurological weakness.
Core
Sudden weakness on the golf course, retired teacher
Adult found with sudden one-sided weakness while out with friends.
Observations available on request
Start consultationIntermediate
Facial droop woken up with, university student
Young adult who woke with facial droop and is worried it is a stroke.
Observations available on request
Start consultationAdvanced
Legs giving way, warehouse operative recovering from a stomach bug
Adult with progressive leg weakness over several days, recently unwell with diarrhoea.
Observations available on request
Start consultationSimulated patients for education only. Always follow current JRCALC guidance and your local clinical protocols.