SCA practice case · Video consultation
“The health visitor says he’s dropped centiles — am I starving my baby?”
Video consultation
Child patient
Someone else speaking
Typical
Children & young peopleMental 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
Noah · 5 months · male
Setting
Video consultation — mother of a 5-month-old crossing down centiles.
Past history
- Nil recorded
Medication
- None
Allergies
None recorded
Recent notes
⚠ Health visitor: weight crossed down two centile spaces (UK-WHO chart). Breastfed. GP review requested.
Reason for contact
Video consultation with mother re weight concern.
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)
Faltering growth (a sustained fall across centile spaces / slower-than-expected weight gain) needs a STRUCTURED, NON-BLAMING assessment — careful feeding and medical/developmental history, examination, and accurate plotting (correct chart, prematurity, mid-parental size, regression to the mean, measurement error) — and most is NON-ORGANIC and feeding-related, not a sign the mother is "starving" her baby. Assess feeding closely (breastfeeding attachment/positioning, frequency, posseting, stools; observe a feed; involve lactation support), EXCLUDE organic red flags (significant vomiting, diarrhoea/malabsorption, recurrent infections, dysmorphism, developmental concerns) and consider safeguarding only where indicated, and manage with practical support and MONITORING (regular weights with the health visitor; paediatric/dietetic referral if red flags or no improvement). The examinable hidden agenda is the MOTHER: exhaustion, guilt, a sense of failing and possible postnatal depression with crumbling breastfeeding confidence — relieve the blame explicitly (it is usually not her fault; seeking help is good mothering), assess and support her mental health, and frame everything as partnership not judgement.
The guidance behind it
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