A 15-year-old patient comes to you seeking birth control without her parents' knowledge. She mentions that her boyfriend is 21 years old. You are aware that the age of consent laws in Canada have exceptions for close-in-age relationships, but this age gap may be concerning. How do you proceed with providing care while addressing potential legal and ethical issues?

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 90 applicants who finished this question on Confetto, we took their first scored answer and counted the part that scored lowest.

• Content: covering what the question needs40 of 90
• Structure: a clear order and a clear point31 of 90

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). The answer gathers information from the patient about how the relationship began and whether she feels safe and respected, while explaining confidentiality limits. Its opening instead states the balancing problem, rather than beginning with what the clinician wants to find out.
2. Who is affected (20 seconds). The patient comes first, particularly her reproductive health, safety, confidentiality, and willingness to keep seeking care. The answer also involves the clinician, who has protective responsibilities, and child protective services, while the boyfriend and parents remain relevant but less explicitly discussed.
3. The conflict (20 seconds). The conflict is between preserving confidential reproductive healthcare and protecting a minor from possible exploitation through appropriate reporting. The answer emphasizes that addressing safety concerns must not undermine access to birth control or the trust that brought the patient to seek care.
4. Options (40 seconds). The answer implicitly contrasts providing confidential care alone, which could leave potential exploitation unaddressed, with reporting concerns while continuing treatment, which could strain trust. It also rejects withholding birth control because this could discourage future care and increase reproductive health risks.
5. Choose (30 seconds). The answer chooses to report to child protective services transparently while continuing appropriate birth control care and sexual health counseling. Its main reason is protecting the patient without making healthcare conditional on reporting, although the applicable provincial or territorial reporting requirements should be verified.
6. What next (20 seconds). The answer follows through by explaining the report to the patient, connecting her with support services, and maintaining a supportive, nonjudgmental relationship. It encourages continued access to care, but does not explicitly describe documentation, senior consultation, or a scheduled follow-up.

Example answer from Confetto

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

First and foremost, I recognize this situation requires carefully balancing my duty to provide confidential medical care with my obligation to protect a minor from potential harm. While the patient is seeking birth control, which I believe shows responsibility in terms of reproductive health, the age difference raises serious red flags about potential exploitation.

I would begin by building trust with the patient, acknowledging her maturity in seeking healthcare while gathering more information. I'd explain that everything we discuss is confidential, with certain exceptions that I'm legally required to report. I would ask open-ended questions about her relationship, how they met, and whether she feels safe and respected. The significant age gap concerns me, as a 21-year-old dating a 15-year-old suggests an unhealthy power dynamic that could constitute sexual exploitation.

Based on my understanding of mandatory reporting requirements, I believe this situation warrants reporting to child protective services. However, I would approach this transparently with the patient. I'd explain my concerns about the age difference and why I'm legally and ethically obligated to report it. I would emphasize that this isn't about punishment, but about ensuring her safety and well-being.

Throughout this process, I would continue providing appropriate medical care and counseling about sexual health. I wouldn't withhold birth control, as this could damage trust and potentially lead to riskier behavior. Instead, I would work to connect her with appropriate support services and resources, while maintaining a supportive, non-judgmental atmosphere that encourages her to keep seeking medical care. My primary goal would be protecting her health and safety while preserving the doctor-patient relationship that brought her to seek care in the first place.

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

Keep going

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• 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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