You are a family physician. Your patient, Mark, missed an important exam and says his teacher will give him a zero unless he brings a doctor's note. He asks you to write that he was too unwell to write the exam, but you can't find anything wrong with him. Enter the room and talk to Mark.

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 116 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 point53 of 116
• Content: covering what the question needs28 of 116

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
• Communication
• Patient care

How to structure your answer

1. Stay in the scene (15 seconds). The physician introduces themself as Dr. Patel, Mark’s family physician, asks permission to sit, and acknowledges his request for an exam note. They speak directly to Mark throughout, explaining that they want to understand what happened before deciding what they can write.
2. Ask about them (45 seconds). The physician starts with an open question about what happened when Mark missed the exam and how things have been since, inviting his whole story without interruption. Follow-up questions explore resolved symptoms, anxiety, sleep difficulties, or problems at home rather than assuming a normal examination rules out illness.
3. Name the feeling (40 seconds). The physician recognizes the pressure of a possible zero and the urgency created by being told that only a doctor’s note will help. They validate why this matters, express appreciation that Mark came to talk, and invite a quiet moment before continuing.
4. Say it plainly (45 seconds). The physician explains that certifying medical inability requires a reasonable medical basis, while acknowledging that today’s normal findings do not establish how Mark felt then. They offer to document the visit and distinguish Mark’s account from verified findings, without accusing him of dishonesty or promising school acceptance.
5. Agree a next step (30 seconds). The physician asks how an accurate note sounds and offers to review its wording before Mark decides whether to share it. With his permission, they can clarify school requirements or support contact with a counselor about an appeal or makeup exam, while addressing any health concerns.
6. Common pitfalls. Stepping out of the scene to explain ethics to the assessor, or lecturing Mark before hearing his story, would undermine the conversation. Certifying an unsupported illness or promising that the teacher will accept the note would exceed what the physician can honestly establish or control.

Example answer from Confetto

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

Hi, Mark. I’m Dr. Patel, your family physician. Is it okay if I sit down with you? I know you’ve come in about a note for your missed exam, and I want to understand what happened before we decide what I can write.

Can you tell me what was going on when you missed the exam, and what things have been like for you since then? Take your time. I want to hear the whole story, including anything that might feel difficult to bring up. Sometimes what keeps someone from an exam isn’t obvious during a physical examination. Were you having symptoms that have since settled, or dealing with anxiety, trouble sleeping, or something happening at home?

It sounds like the possibility of getting a zero is putting you under a lot of pressure, especially when you’ve been told a doctor’s note is the only way to avoid it. I can understand why getting that note feels urgent. I’m glad you came to talk with me. You don’t have to convince me that this matters to you. Let’s take a moment.

I need to be honest with you: I can’t write that you were medically unable to take the exam unless I have a reasonable medical basis for saying that. Not finding anything wrong today doesn’t prove you felt well on the day, but it also doesn’t let me certify something I can’t establish. I’m not assuming you’re being dishonest. I can document today’s visit and, where appropriate, describe what you report about that day, clearly distinguishing that from what I can verify. I can’t promise your teacher will accept that.

How does that option sound to you? If you’d like, we can review exactly what an accurate note could say before you decide whether to share it. With your permission, I can also help clarify the school’s requirements or support you in contacting a counselor about an appeal or makeup exam. If something is affecting your health, I want us to address that too. What feels like the most useful next step for you?

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

Keep going

• You are a physician in a rural clinic. A 16-year-old patient seeks an abortion but begs you not to inform her parents, with whom she has a difficult relationship. How do you proceed, balancing patient confidentiality and family dynamics?
• You are a specialist at a local hospital. You have just finished your shift and are rushing to your daughter's high school graduation. On your way out, Erica, a patient who knows you well, calls to you from the waiting room: "Doctor! I have bad chest pain. Please stay for a bit. I'll feel much better if you're here." Enter the room and talk to Erica.
• You are a 3rd year medical student doing hospital rotations. A fellow medical student who is doing rounds with you often shows up to these sessions tired, messy, hungover, or even drunk. One day you found him in the lunchroom unaccompanied, so you decided to talk to him. Please enter the lunchroom.
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