SCA practice case · Video consultation
“It got my dad, it’ll get me”
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
Errol Bennett · 49 years · male
Setting
Video consultation — new type 2 diabetes; first conversation.
Past history
- Nil significant
- Current smoker — 10/day
Medication
- No regular medication
Allergies
NKDA
Recent notes
⚠ HbA1c 71 then 69 mmol/mol (tiredness screen). TC 5.9. eGFR and ACR normal. BMI 32. BP 142/88. No QRISK3, retinal screening or foot check on file.
Reason for contact
Video consultation to discuss blood results. Occupation: self-employed delivery driver.
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 new-T2DM consultation is not a data download — the HbA1c is the easy part. The examinable core here is the hidden agenda: fatalism built on a father lost to untreated complications, plus an unvoiced terror about the driving licence and livelihood. A prescription handed into that despair changes nothing. The skill is to treat the fatalism first — his father’s untreated course in another era is not Errol’s fixed fate; complications come from years of uncontrolled glucose/BP/lipids/smoking, all modifiable — and to answer the DVLA question proactively and accurately — having asked what he drives: on a car/van licence (Group 1), diet, metformin or an SGLT2 inhibitor means no notification and no licence loss; a Group 2 lorry licence would need notification on tablets. Then negotiate a plan built around his actual day, lead with smoking cessation as highest-yield CVD action, offer remission as a real goal given early onset (NHS Type 2 Diabetes Path to Remission Programme), start treatment per NICE NG28 (updated February 2026: metformin then an SGLT2 inhibitor), and leave him with one concrete step and genuine agency.
The guidance behind it
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