Location: You are an foundation year doctor in sexual health
Patient: 25 year old man has come into clinic and has indicated on his booking form he has discharge from his penis
Note to actor: Try to restrain yourself from volunteering too much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
You are a 26 year old man. You start the consultation by admitting to the doctor that you feel embarrassed as you have never been to a sexual health clinic before.
You have noticed some painful discharge from your penis over the past 3 days. It is a thick white / green colour. It has been collecting in your underwear. You find it very painful to pass urine and you feel like you need to go to the toilet more often.
If asked you have had some painful dedication and your stools have been a bit looser and whiter in colour.
Only give information if prompted – you last had sex 1 week ago with a male partner, this was a casual and was a one off. You had oral sex, anal both receptive and penetrative. This is the first and only time you have had unprotected anal intercourse. You are unsure if your partner has symptoms.
Parter before this was 2 weeks ago, it was a casual partner and you only had oral sex both giving and receiving.
You have had sex with 10 people in the past 3 months.
You have never had an STI screen or HIV test before. You have had not been vaccinated against hepatitis A or B.
You drink more than 10 double gin and tonics in a single evening more than 4 times a week. You occasionally take party drugs if you are offered by others.
If the candidate appears to have finished early remind them how long is left at the station and enquire if there is anything else they would like to ask, or whether they have finished. If they have finished, please remain silent and allow the candidate that time for reflection.