SCA practice case · Video consultation
“Insulin in poorly-controlled T2DM, Ramadan approaching”
Video consultation
Adult patient
Typical
Ethnicity, culture & diversityLong-term conditions & cancer
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
Imran Shah · 48 years · male
Setting
Video diabetes review — booked by the practice nurse.
Past history
- Type 2 diabetes — 7 years
- BMI 36
- No retinopathy at last screen
- Occupation: taxi driver
Medication
- Metformin 1 g BD
- Gliclazide 80 mg BD
Allergies
NKDA
Recent notes
⚠ Diabetes nurse note last week: HbA1c 84 mmol/mol (target 53). Fastings 11–14 self-reported. DNA'd last two annual reviews. Nurse advised "treatment needs stepping up" — patient "reluctant, Ramadan soon".
Reason for contact
Video diabetes review. Ramadan begins in 5 weeks.
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)
The marking gap on this kind of station is cultural humility paired with clinical correctness. Tasks: SGLT2 + GLP-1 before insulin where possible, DVLA disclosure, Ramadan-adjusted dose. Relating-to-others: honouring the patient's faith without colluding with unsafe practice. Diabetes UK and IDF-DAR Ramadan guidance are the reference points.
The guidance behind it
Similar SCA cases
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