A 14 year old patient requests birth control pills from you and asks that you not tell her parents. What would you do?

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 95 applicants who finished this question on Confetto, we took their first scored answer and counted the part that scored lowest.

• Structure: a clear order and a clear point41 of 95
• Content: covering what the question needs28 of 95

Confetto data as of November 8, 2026. A part is shown only when 20 or more applicants share it. Answers where two parts tied are not counted toward either. We never show anyone's answers or details.

What this question tests

• Ethics
• Patient care

How to structure your answer

1. Ask questions (25 seconds). Begin by saying you would ask the patient privately why she wants contraception and why she does not want her parents told. The answer explores sexual activity, relationship safety, other health concerns, and her understanding of contraception and STI prevention before deciding what to do.
2. Who is affected (20 seconds). The patient comes first, particularly her health, safety, privacy, and trust in healthcare. Her parents or another trusted adult may provide support, while the clinician must meet legal and ethical responsibilities when providing care to a minor.
3. The conflict (20 seconds). The conflict is between respecting the patient's confidentiality and supporting parental involvement in a minor's healthcare. The answer seeks to protect her access to care and trust while exploring whether involving a trusted adult could support her safety and well-being.
4. Options (40 seconds). The answer considers confidential contraceptive care, which preserves access and trust but may leave her without parental support, and encouraging voluntary involvement of parents or another trusted adult, which may feel frightening to her. It favors exploring those fears rather than making parental involvement a condition of care.
5. Choose (30 seconds). The answer chooses to prescribe birth control if the patient maintains her request, demonstrates sufficient understanding and maturity, and applicable law permits confidential care. Its main reason is to protect her health and maintain trust while providing counseling and continuing to encourage voluntary parental involvement.
6. What next (20 seconds). The answer commits to thorough documentation and checking the legal and ethical requirements for treating minors. It also emphasizes regular medical follow-up, counseling about side effects and STI protection, and keeping communication open about involving parents or another trusted adult.

Example answer from Confetto

Example answer from Confetto. Not a real applicant's answer.

I recognize this is a complex situation that requires carefully balancing patient confidentiality with the wellbeing of a minor. My immediate concern is ensuring this young patient feels safe and comfortable discussing her healthcare needs while also addressing any underlying issues that may have prompted this request.

I would first have an open, non-judgmental conversation with the patient to understand her situation better. I believe it's crucial to ask about her reasons for seeking birth control, whether she's sexually active, if she feels safe in her relationships, and if she has any other health concerns. I would also assess her understanding of sexual health, contraception options, and the importance of protection against STIs.

Regarding confidentiality, I know that in many jurisdictions, minors can legally consent to contraceptive care without parental involvement. However, I would encourage her to consider involving her parents or another trusted adult in her healthcare decisions. I would explore her reasons for wanting to keep this from her parents and address any fears or concerns she might have about parent communication.

My approach would be to provide comprehensive counseling about sexual health, safety, and the various contraceptive options available. I believe it's important to ensure she understands all aspects of her choice, including potential side effects and the importance of regular medical follow-up. If she remains firm in her decision and I determine she has the maturity to make this choice, I would prescribe birth control while continuing to encourage open dialogue with her parents.

Throughout this process, I would document everything thoroughly and ensure I'm following all legal and ethical guidelines for treating minors. My primary goal would be to provide appropriate medical care while protecting her health and safety, maintaining her trust in the healthcare system, and promoting responsible decision-making.

Use it for its structure. Interviewers can tell a memorized script, so tell your own story.

Keep going

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• A patient refuses a life-saving vaccination for their child based on personal beliefs. How do you balance the parents' autonomy with the child's well-being and public health concerns?
• You are the physician caring for Mrs. Miller, who has been declared brain dead and would be an excellent organ donor. When you ask her husband and son for consent, they strongly object. What would you do?
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