SCA practice case · Video consultation
“My niece is being taken ‘home’ this summer — I’m frightened they’ll cut her”
Video consultation
Adult patient
Someone else speaking
Hard
Ethnicity, culture & diversityChildren & young peopleProfessional & ethical dilemmas
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
Halima Yusuf · 34 years · female
Setting
Video consultation — a relative discloses a child at risk of FGM abroad.
Past history
- Nil significant recorded
Medication
- None
Allergies
None recorded
Recent notes
No recent attendances.
Reason for contact
Booked video call: "Personal — would like to speak to a doctor."
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)
A disclosure that a girl is at risk of female genital mutilation — here a 7-year-old to be taken abroad in the summer when cutting traditionally occurs — is a child-protection emergency: a girl at risk of FGM is a child at risk of serious harm, FGM is a form of child abuse and illegal in the UK, and this overrides the usual confidentiality and family-loyalty considerations, with time critical if travel is imminent. The mandatory duty is to act, not deliberate: take the disclosure with the utmost seriousness, gather proportionate information (the child’s name and age, parents, when and where they are travelling, the specific risk, and whether other girls in the family are at risk), and make a prompt safeguarding referral to children’s social care (and the police via 999 if travel is imminent or there is immediate danger) — you do not manage this alone, merely advise the relative, or delay to investigate yourself — involving the practice safeguarding lead. Know the legal framework (FGM Act 2003, as amended): FGM and taking or arranging to take a UK girl abroad for it are illegal; FGM Protection Orders can be obtained to prevent travel (including surrendering passports) and protect a specific child — by the girl or the local authority without the court’s leave, or by anyone else (including the police or a relative) with it; and the statutory mandatory-reporting duty for regulated professionals applies specifically to KNOWN/identified FGM in a girl under 18 (report to police), while a child merely at risk goes through the safeguarding-referral route. Be culturally sensitive and compassionate — especially as the aunt is herself a survivor acting protectively against her own family — but never collude, holding absolute clarity that FGM is child abuse regardless of cultural framing and that tradition is no justification. Support the aunt (acknowledge her courage and divided loyalty, reassure her she is doing right, signpost FGM specialist and survivor support, and record her own disclosed FGM in her notes and the mandatory FGM Enhanced Dataset — explained to her, no consent needed, and not a police report for an adult), consider the wider family, and document carefully. The hidden agenda is her torment between protecting the child and loyalty to/fear of family, plus her own trauma; respond decisively to the child-protection duty while holding her with compassion and not leaving the burden on her.
The guidance behind it
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