SCA practice case · Video consultation
Mental health: SCA practice case
A request for a letter about adjustments at work
Video consultation
Young person
Typical
Health disadvantage & vulnerabilitiesMental health & addiction
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Callum Fraser · 26-year-old man
Setting
Video consultation booked online by the patient, who asked for “a letter for work”.
Past history
- Autism spectrum condition (diagnosed age 19, adult autism service)
- Asthma in childhood, resolved
Medication
- No regular medication
Allergies
No known drug allergies
Recent notes
Reasonable adjustment flag: prefers clear, literal language; written summary after appointments; extra time to answer; may prefer to type in the chat. No consultations in the last two years. Weight 68 kg at last check (two years ago).
Reason for contact
Video consultation booked online: “I need a letter for work about reasonable adjustments.”
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
Autistic adults have high rates of depression and anxiety, and both can be missed when symptoms are attributed to autism or to a stressful environment. This case tests adapting communication (literal, structured, written follow-up), understanding the Equality Act 2010 duty to make reasonable adjustments (an employer cannot insist on a GP letter, but a factual letter or fit note can help), and noticing cues that point to depression and passive suicidal ideation. Occupational health and Access to Work are often more useful than a GP letter.
The guidance behind it
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