SCA practice case · Video consultation
“I want to talk about my pill — and this time without my mum”
Video consultation
Adult patient
Typical
Ethnicity, culture & diversityGender, reproductive & sexual healthHealth disadvantage & vulnerabilities
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
Leah Thompson · 27 years · female
Setting
Video — Deaf BSL user with a registered BSL interpreter joining the same video call.
Past history
- Profoundly Deaf since birth — BSL first language (alert flag: BSL interpreter required)
- Appendicectomy 2025
- Previous appointments booked by mother
Medication
- Levonorgestrel 150 micrograms / ethinylestradiol 30 micrograms — 21/7 regimen (since 2022)
Allergies
No known drug allergies
Recent notes
Community pharmacy pill check 2 months ago: BP 118/72, BMI 23, non-smoker. Email received from patient last week requesting an appointment “about my pill and headaches — with a BSL interpreter, not my mum”. Interpreter booked: Aisha (NRCPD registered), joining by video.
Reason for contact
Video consultation with BSL interpreter: “pill and headaches”.
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)
Accessible communication is part of clinical safety. With a BSL interpreter on video: check consent and privacy, speak to the patient (not the interpreter), take turns, allow for the lag, and check understanding by teach-back. Adapt red-flag questions — for a signer, “difficulty speaking” becomes “difficulty signing” and hand weakness matters. Migraine with aura is UKMEC 4 for combined hormonal contraception: stop it and offer a same-day progestogen-only method or LARC. Under the Accessible Information Standard the practice must identify, record, flag, share, meet and review communication needs — interpreters booked automatically, text or email contact, longer appointments — and never rely on family members to interpret.
The guidance behind it
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