SCA practice case · Video consultation
Mental health: SCA practice case
A tired teenager and a college letter
Video consultation
Young person
Typical
Children & young peopleMental health & addictionHealth 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
Zara Hussain · 17-year-old young woman
Setting
Video consultation booked by a 17-year-old who feels exhausted and is missing college.
Past history
- No significant past medical history
- Asthma as a child, no inhalers for 5 years
Medication
- No regular medication
Allergies
No known drug allergies
Recent notes
No consultations for 2 years. Household: mother Nadia (46, secondary progressive MS, wheelchair user, needs help with transfers; MS nurse review overdue) and brother Adam (11). Father not living with the family. No carer’s or young carer’s assessment recorded for anyone in the household.
Reason for contact
Booked a video appointment herself: “Tired all the time. College says I need a doctor’s note.”
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)
Fatigue in a teenager is often social, not biochemical. This 17-year-old is a hidden young carer doing night-time personal care, and her low attendance, energy drinks and passive suicidal thoughts follow from that. The skills are to ask about home and sleep, name the caring role without judgement, assess mood and suicide risk directly, respect her confidentiality and autonomy at 17, and reduce the caring load by improving her mother’s care and getting her support, while answering her fear that services will split the family.
The guidance behind it
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