Important: Exam dates, fees and policies can change. Verify time-sensitive details on the official Medical Council of Canada website.

Home / Station 13: Contraception counselling

NAC OSCE preparation

Station 13: Contraception counselling

Complete the task in 11 minutes. Reveal the full standardized-patient script, examiner prompts and structured debrief only after your attempt.

Station time

11:00

Ready for an 11-minute attempt.

Candidate instructions

Contraception counselling

11 minutes

Discipline: Obstetrics & Gynecology
Station type: Shared decision-making
Setting: Primary care clinic

Your task

Counsel the patient about contraception and help her choose a method. No examination is required.

Information available at entry

BP 124/78 mm HgBMI 29 kg/m²

Coach prompt: Match contraception to goals, contraindications and preferences without coercion.

In Exam Mode, coaching cues are hidden. Ask a partner to use the standardized-patient script after you start the timer.

Finished your attempt?Reveal the full station only after completing or stopping the timer.

Complete station package

Standardized-patient script and structured debrief

Station 13 of 30

Standardized-patient profile

NameMs. Sofia Alvarez

Age27

Pronounsshe/her

RolePatient

Demeanour: Engaged; concerned about weight gain.

Opening statement: “I don't want pregnancy for five years, but I have migraines and don't know what is safe.”

History and standardized-patient responses

Goals/preferences

Candidate explores	Standardized-patient response
Pregnancy intention	No pregnancy for at least five years; may want children later.
Prior method	Often forgot combined pill and had nausea.
Priorities	Very effective, reversible, low-maintenance and lighter periods.
Concerns	Weight gain, insertion pain and fertility.

Safety

Candidate explores	Standardized-patient response
Migraine	Migraine with visual aura.
VTE/smoking	No smoking or VTE history.
Other contraindications	No hypertension, liver disease or breast cancer.
Medication	Topiramate; interaction/dose requires review.

Sexual health

Candidate explores	Standardized-patient response
STI risk	New partner; condoms inconsistent.
Recent sex	Unprotected sex three days ago.
Coercion	None.

Physical findings

No examination required solely for most contraceptive prescriptions.

Examiner prompts

Methods to avoid/caution?

Estrogen-containing combined contraception is generally contraindicated with migraine with aura; check medication interactions.

Good options?

Long-acting reversible methods such as LNG-IUS or implant may fit after discussing bleeding, insertion, effectiveness and interactions; copper IUD may increase bleeding.

What else today?

Emergency contraception assessment, appropriately timed pregnancy testing, STI screening and condoms.

Differential diagnosis

Not applicable—preventive counselling

Investigations

Pregnancy testing based on timing
STI testing by risk/preference
BP before estrogen-containing methods
No routine pelvic exam solely to prescribe most methods

Management

Offer emergency contraception if indicated
Select reversible method after contraindication/interaction review
Arrange prescription/insertion and backup
Condom/STI prevention
Follow-up for side effects and satisfaction

Communication behaviours

Avoid coercive language
Correct infertility/weight myths honestly
Use teach-back

Critical safety actions

Identify migraine-with-aura risk
Address recent unprotected sex
Check drug interactions

Model closing summary

She wants highly effective, reversible and low-maintenance contraception. Because she has migraine with aura, I would avoid estrogen-containing combined methods. I would compare progestin and nonhormonal long-acting options, including effectiveness, bleeding, insertion and fertility return, while checking topiramate interactions. I would also address emergency contraception, pregnancy follow-up, STI screening and condom use, then support her informed choice.

Common pitfalls

Clinician-centred recommendation
Ignoring STI risk
Promising no side effects
Assuming pelvic exam always required

Reference starting points

Verify current recommendations and local protocols before clinical use.

Continue practising

Choose another complete 11-minute station

1. Chest pain in a 58-year-old 2. Acute dyspnea with wheeze 3. Palpitations followed by syncope 4. Upper gastrointestinal bleeding 5. Sudden focal weakness 6. Fever with hypotension 7. Acute right-lower-quadrant abdominal pain 8. Fever on postoperative day five 9. Severe leg pain after tibial fracture 10. Consent for lumbar puncture 11. First-trimester pain and bleeding 12. Postpartum low mood and unusual beliefs 13. Contraception counselling 14. Fever in an eight-week-old infant 15. Child with severe wheeze and respiratory distress 16. Two-year-old with language delay 17. Adolescent confidentiality and sexual health 18. Depression with suicidal thoughts 19. First-episode psychosis 20. Severely agitated patient 21. Older adult with acute confusion 22. Recurrent falls and dizziness 23. Driving safety in early dementia 24. Breaking a new colorectal cancer diagnosis 25. Disclosure of an insulin medication error 26. Refusal of blood transfusion 27. Cardiovascular examination in heart failure 28. Respiratory examination with pleural effusion 29. Focused neurologic examination for stroke 30. Painful swollen knee