90+ scenarios with over 10 hours of interview material

Welcome to the world’s leading psychiatry online training product used by over 1000 subscribers. Here you can browse through descriptions of 90 + scenarios under 10 different domains. All scenarios are based on past MRCPsych CASC / RANZCP OSCE exam stations and clinical practice. The skills learnt will allow you to be flexible no matter what station is asked.

Click on a specific scenario headline to view the tasks covered and scroll over the video for additional material.

1. Mood Disorders

  • Perinatal history taking
  • Risk assessment
  • Medication and pregnancy
  • Medication and breastfeeding

Take a competent perinatal history and perform a risk-benefit analysis regarding the management of postnatal depression. Explain the role of medications and psychological strategies in not only breastfeeding but also when planning the next pregnancy. The slides outline the latest evidence.

  • History taking in Bipolar disorder
  • Risk-benefit analysis
  • Medications and pregnancy
  • Medications and post partum period

Take a competent history of bipolar disorder in the outpatient department and develop a collaborative discussion model to help the patient make an informed decision. Provide psychoeducation about management in pregnancy and postpartum.

  • Detailed assessment of depression
  • Risk assessment
  • Precipitating, predisposing and maintaining factors in depression
  • Management of depression
  • Differentiating between bipolar and unipolar depression

Complete a competent assessment of an extremely common and potentially serious condition, and equip yourself with knowledge of the relevant bio-psycho-socio-cultural predisposing, precipitating and perpetuating factors to devise a formulation. Manage a case of depression confidently.

  • Sexual side effects of antidepressants
  • Sensitive history taking
  • Establishing temporal relationships
  • Management of sexual dysfunction with antidepressants

Obtain a history of sexual dysfunction with antidepressants; a common but rarely volunteered side effect leading to non-compliance, establish the complex relationship between depression, antidepressant and sexual dysfunction, and manage the case confidently based on evidence based strategies.

  • Electro convulsive therapy
  • Obtaining informed consent
  • Electrode placements
  • Evidence based recommendations for ECT

Explain ECT in detail to a depressed patient or family member, displaying competent knowledge of the treatment, its benefits, side effects and indications. Obtain informed consent from the patient. The slides outline the evidence based recommendations for ECT.

  • Explanation of lithium augmentation in depression
  • Explanation of side effects
  • Risk benefit analysis

Psychoeducate the patient regarding lithium augmentation in depression explaining the risks , benefits and side effects associated with the treatment helping the patient make an informed decision.

  • Assessing suitability for interpersonal psychotherapy
  • Knowledge of the components of IPT
  • Explanation of IPT to patient

Assess the patient’s suitability for IPT and provide psychoeducation about the treatment and its components.

  • Understanding symptoms and stages of grief
  • Understanding symptoms and signs of abnormal grief
  • Differentiating between grief and major depressive disorder

Perform a diagnostic assessment on a patient who has recently lost a family member in a car accident.

  • Psychoeducation about grief
  • Stages of grief
  • Explaining the difference between grief and depression

Provide psychoeducation about grief outlining the key stages of grief.

  • Aetiology of adolescent depression
  • Difference between adolescent and adult depression
  • Treatment strategies
  • Antidepressants and suicidal ideation

Provide psychoeducation to a general practitioner about adolescent depression. Explain the difference between adolescent and adult depression. Explain the treatment options and address the controversy between antidepressants and suicidal ideation in adolescents.

  • Assess the patient’s current mental state
  • Identify side effects
  • Explain the most evidence-based indications for medicinal cannabis that are likely to meet legislative requirements.
  • Negotiate a treatment plan

Take a history from a patient who has bipolar disorder and wants to stop medications due to side effects and wants to consider medicinal cannabis.

  • Assess for causes of treatment resistance in depression
  • Convey the findings to the patient

Assess for the causes of treatment-resistant depression and convey the findings to the patient

2. Anxiety, Obsessive Compulsive Spectrum and Trauma Related Disorders

  • History taking in anxiety disorder
  • Diagnosing anxiety disorders
  • Psychoeducation about anxiety to patient
  • Explanation of treatment strategies to patient

Take a history in a patient presenting with anxiety and diagnose the appropriate anxiety disorder. Provide the patient with the explanation of anxiety and management strategies, including a detailed explanation of psychological strategies to manage anxiety. The slides contain a section on anxiety disorders and their evidence based management.

  • History taking in PTSD
  • Ruling out co-morbidities
  • Evidence based management of PTSD

Take a competent history of post-traumatic stress disorder and manage the case based on evidence based principles. Provide psychoeducation to the patient including explanations of trauma focused psychological therapies.

  • History taking in OCD
  • Ruling out co-morbidities
  • Explanation of exposure and response prevention
  • Evidence based management of OCD

Obtain a competent history in OCD and provide psychoeducation to the patient including explanation of exposure and response prevention. The slides outline the evidence based guidelines for the management of OCD.

  • History Taking in Panic disorder and Agoraphobia
  • Psychoeducation of panic disorder
  • Explanation of cognitive behavioural therapy

Take a history of anxiety symptoms. Establish a diagnosis of the type of anxiety disorder and provide focused psychoeducation. Explain cognitive behavioural therapy to the patie

  • History taking in a case of hypochondriasis

Obtain a competent history in a client presenting with somatic complaints with a view to establishing a diagnosis.

  • Explanation of Hypochondriasis
  • Explanation of management
  • Explanation of CBT

Psychoeducate a family member on hypochondriasis and its treatment with a focus on cognitive behavioural therapy.

  • Diagnostic assessment in BDD

Obtaining a competent history in a patient who is concerned about her appearance. Special thanks to Prof David Castle, expert on BDD, for his input.

  • Psychoeducation to parent on BDD
  • Explanation of aetiology of BDD
  • Explanation of treatment
  • Explanation of key principles in psychological treatment

Provide psychoeducation about Body Dysmorphic Disorder (BDD) to a concerned parent. Outline the treatment options explaining the key principles in psychological treatment for BDD.

  • History taking of PTSD in a refugee patient
  • History taking in a culturally sensitive manner
  • Psychoeducation in a culturally sensitive manner

Take a competent history of post-traumatic stress disorder in a refugee patient and provide psychoeducation to the patient about your most likely diagnosis.

  • Take a focused history examining mood, behaviour and cognitions
  • Explain principles and core components of CBT
  • Apply CBT techniques to the patients specific cognitions and behaviours

Take a focused history from the patient examining mood symptoms, behaviour and cognitions and explain to the patient the application of Cognitive Behavioural Therapy for anxiety specific to her needs.

3. Psychotic Disorders

  • History taking in temporal lobe epilepsy
  • Relationship between psychiatric disorders and epilepsy
  • Medications and epilepsy

Take a competent history from a patient with a particular focus on the presentation of temporal lobe epilepsy and its relationship with psychiatric disorders.

  • Addressing myths
  • Explanation of bio-psycho-social treatment options

Sensitively address the important concerns in schizophrenia to a family member and explain competently the important aspects regarding the treatment based on bio-psycho-social principles.

  • Indications for Clozapine
  • Benefits of Clozapine
  • Side effects of Clozapine
  • Monitoring in Clozapine
  • Management of non-response to Clozapine

Provide psychoeducation about Clozapine treatment (monitoring, benefits and side effects) to a patient or family member. Initiate Clozapine treatment in clinical practice confidently.

  • Assessment of acute psychosis
  • Risk assessment
  • Management

Perform a competent assessment of psychosis and risk in a time limited setting.

  • Assessment of delusional jealousy
  • Risk assessment
  • Management in delusional jealousy

Complete a competent assessment of a patient presenting with thoughts of infidelity, making a diagnosis of delusional jealousy. Perform a competent risk assessment and recognise the importance of this potentially serious condition. Present and manage the seriousness of this case to your colleague or examiner.

  • Phenomenological assessment of stalking
  • Risk assessment in stalking
  • Interviewing techniques in an agitated patient

Performing a competent mental state examination to clarify phenomenology and completing a risk assessment adopting a non-interrogatory style. Knowledge of stalking specific risk factors for recidivism.

  • Assessment of psychopathology in late onset schizophrenia.
  • Understanding of the differences between late onset and early onset schizophrenia

Perform a brief mental state examination focussing on elucidating the psychopathology in late onset schizophrenia.

  • Explanation of key features of paraphrenia to a family member

Provide Psychoeducation to a family member about late onset schizophrenia.

  • Forensic risk assessment
  • HCR-20

Perform a competent and structured risk assessment for violence, using an evidence based tool; the HCR-20. Present a structured risk assessment to the examiners or if needed, in a forensic report, using the HCR-20.

  • Elicit a history of a transient psychotic episode following a cluster of seizures.
  • Emphasise the significance of the period of lucidity between the patient’s seizure and psychotic features

Explore the link between psychosis and epilepsy in a patient with post-ictal psychosis and present a brief formulation.

4. Drug and Alcohol Disorders

  • History taking in drug and alcohol misuse
  • Risk assessment
  • Perinatal history
  • Psychoeducation
  • Risk-benefit analysis

Take a detailed opiate use history with a focus on perinatal history and risk assessment. Educate the patient (risk-benefit analysis) and collaboratively develop an evidence based management plan. The slides outline harm reduction, pharmacological and psychological management.

  • History taking in alcohol use
  • Differentiating between dependence and misuse
  • Perform motivational interviewing
  • Evidence based management strategies

Take a competent history of alcohol use to differentiate between misuse and dependence. Perform a motivational interview which is an effective tool in affecting change as part of management. This will prove beneficial in the exams and your clinical practice, as alcohol dependence / misuse is commonly encountered. The slides outline evidence based bio-psycho-social management strategies.

  • Assessment of Internet Addiction Disorder (IAD)
  • Asseessment of the physical complications of Internet addiction disorder (IAD)
  • Psychoeducation of internet addiction disorder to a concerned parent




Take a history from a mother who is concerned about her 16 year old son who has been spending excessive time on the computer. Provide a brief explanation to the mother about the most likely diagnosis.

  • Assess mental state
  • Assess medical history
  • Assess dependence
  • Assess motivation to quit
  • Discuss the advantages and consequences of stopping smoking
  • Provide advice on options available

To take relevant history and give appropriate advice to a patient with schizophrenia who is requesting help to quit smoking.

5. Mental State Examination Components

  • Memory tests
  • Parietal lobe examination
  • Frontal lobe examination

Perform a competitive cognitive examination which covers the basic MMSE and the important additional parietal lobe and frontal lobe tests to inform clinical practice. The tests are based on well known textbooks and interpretations explained.

  • Psychosis assessment
  • Mood assessment
  • Anxiety assessment
  • OCD assessment
  • Risk assessment
  • Assessment of insight and judgement

Perform a competent mental state examination in limited time. This will benefit you for the exam and be extremely relevant in your clinical practice.

  • Mental state examination in schizophrenia
  • Parkinsonian side effects
  • Akathisia
  • Dystonia
  • Tardive dyskinesia
  • Management

Perform a mental state examination and EPSE based on the gold standard Abnormal Involuntary Movement Scale. Present your findings to the examiner succinctly and describe the management of tardive dyskinesia. The slides outline the management of EPSE.

  • Perform relevant parietal lobe testing
  • Perform relevant frontal lobe testing
  • Correctly interpret the PET scan findings of parietotemporal hypometabolism
  • Present a relevant management plan for the likely diagnosis

Perform a relevant cognitive examination on Mr Daniel Rogers a 62 year old male presenting with memory difficulties. Present a management plan incorporating the findings of the PET scan.

6. Family Interviews

  • History taking in Child and Adolescent Psychiatry
  • Principles of management in Child and Adolescent Psychiatry
  • Evidence based management of ADHD

Take a competent history from a parent about ADHD and learn the general principles of history taking in any child and adolescent case. Evidence based guidelines are outlined for the management of ADHD.

  • Expression of bad news to family member
  • Knowledge of Huntington’s dementia / disease
  • Management of progressively deteriorating conditions

Deliver sensitive news to a family member and provide information on a progressively deteriorating and fatal condition. Collaboratively devise pharmacological and psychosocial strategies to support both the patient and the carer.

  • History taking in dementia from a carer
  • Presentations in fronto-temporal dementia
  • Management of dementia

Take a competent history from a carer with a particular focus on the presentation of fronto-temporal dementia which often presents with psychiatric symptoms. Develop a collaborative management plan based on bio-psycho-social principles. The slides outline the management of dementia, including Alzheimer’s dementia.

  • Dealing with an angry family member
  • Clinical governance
  • Risk management in organisations
  • Complaint management pathways
  • Neuroleptic Malignant Syndrome (NMS)
  • Management of NMS

Deal with an angry family member sensitively and explain the critical incident in detail, showing good knowledge of Neuroleptic Malignant Syndrome. Display good knowledge of clinical governance and complaint management systems in hospital settings.

  • Psychoeducation to a family member about Alzheimer’s dementia
  • Knowledge of Lewy body type dementia
  • Treatment of Alzheimer’s dementia
  • Bio-psycho-socio-cultural approach to management
  • Carer burden

Provide psychoeducation to a family member about Alzheimer’s dementia including the management and psychosocial aspects.

  • Parenting and Learning disability
  • Psychsocial aspects in management
  • Parenting skills and its importance

Provide psychoeducation to combat the myths present in family members regarding intellectual disability and parenting. Explain the supports available.

7. Medico-Legal Assessments in Psychiatry

  • Interviewing a colleague
  • Recognising impairment in doctors
  • Priniciples of management of an impaired doctor

This scenario is a commonly asked question in job interviews. Interview a colleague with impairment and manage the case based on medico-legal principles.

  • Forensic risk assessment
  • HCR-20

Perform a competent and structured risk assessment for violence, using an evidence based tool; the HCR-20. Present a structured risk assessment to the examiners or if needed, in a forensic report, using the HCR-20.

  • Mental state examination in outpatient
  • Assessment of finances
  • Assessment of capacity to manage financial affairs
  • Safeguards if the individual lacks capacity

Perform a relevant mental state examination and assess one’s capacity to manage financial affairs. The slides contain assessment of testamentary capacity and information on Enduring Power of Attorney (EPA).

  • Assessment of criminal responsibility
  • Assessment of fitness to plead
  • M’Naghten’s (McNaughten’s) rules

Complete a basic forensic assessment for criminal responsibility and fitness to plead; the two commonest requests obtained in forensic report writing. The medico-legal principles are broadly similar across US, UK, Canada and Australia however; one should refer to local legislation for details.

  • Components of capacity
  • Capacity assessment
  • Management of impaired capacity
  • Medico-legal principles

Assess capacity in a Consultation-Liaison setting and provide your opinion to your medical colleagues and patients. Manage individuals with impaired capacity as well as those who retain capacity, and assist them with decision making.

  • Risk Assessment in sexual offenders
  • Risk factors associated with recidivism

Perform a competent risk assessment in a sex offender with a particular focus on risk of recidivism.

8. Miscellaneous Assessments in Psychiatry

  • Diagnostic interviewing in eating disorder
  • Obtaining information for a bio-psychosocial formulation
  • Physical examination in eating disorder
  • Management of anorexia nervosa and bulimia nervosa

Complete a competent diagnostic interview, outline the predisposing, precipitating and perpetuating risk factors for a case formulation, and perform a brief physical examination in a patient with eating disorder. The slides outline the evidence based management of anorexia nervosa and bulimia nervosa.

  • History taking in insomnia
  • Psychoeducation
  • Management of insomnia

Obtain a complete history of insomnia, diagnose the type of insomnia and exclude psychiatric disorders. Provide psychoeducation regarding treatment strategies. The slides outline the types of insomnia and evidence based strategies in the management of insomnia.

  • Risk assessment in a self-harm / suicide attempt
  • Diagnostic interview to assess personality disorder (borderline type)
  • Crisis intervention

Take a relevant history of a self harm / suicide attempt to establish the severity of the attempt and exclude any major mental illness. Ask the relevant questions to assess Borderline Personality Traits and devise a relevant crisis management plan with the patient. The slides cover evidence based psychological and pharmacological strategies for the management of Borderline Personality Disorder.

  • History taking from a carer
  • Performing a functional analysis
  • Causes of behavioural difficulties
  • Awareness of interview techniques

Obtain a competent history from a carer and develop a collaborative management plan based on the principles of functional analysis. Recognise the common causes of behavioural difficulties.

  • History taking of behavioural disturbance in a Consultation-Liaison setting
  • Management of delirium
  • Knowledge of Alcohol withdrawal and its management
  • Non-pharmacological management of delirium

Take a history from a nursing colleague in a Consultation-Liaison setting about behavioural disturbance on the surgical ward. Explain the diagnosis and management.

  • History taking in Bulimia Nervosa
  • Formulation in Bulimia Nervosa

Take a competent history of bulimia nervosa in order to reach a Bio-psychosocial formulation. In the linked station you will have to have to explain the choice of psychological therapy to the student nurse.

Explanation of the cognitive model of Bulimia
Explanation of CBT-Bulimia Nervosa


Provide a competent explanation about CBT-BN incorporating the cognitive formulation, psycho education, cognitive and behavioral strategies.

  • History taking in Adult ADHD
  • Ruling out important co-morbidities

Perform a competent assessment to assess the possibility of Adult ADHD in a time restricted setting.

  • Assessment of parenting capacity
  • Understanding the key areas in assessment of attachment and bonding
  • Risk assessment
  • Relapse prevention

Perform a competent assessment of parenting capacity in a female with mental illness.

  • Principles in history taking in intellectual disability
  • Understanding of different forms of communication in intellectual disability
  • Preparation for an interview
  • Key principles in the diagnostic interview
  • Aetiology of behavioural disturbance
  • Understanding diagnostic overshadowing
  • Principles in management of behavioural disturbance

Explain the key principles of assessment and management in intellectual disability.

  • Collateral history gathering from a carer in intellectual disability
  • Aetiology behind behavioural disturbance in intellectual disability
  • Basic management plan

Perform a competent assessment of behavioural disturbance in intellectual disability by interviewing a carer.

  • Symptoms of school refusal
  • Causes of school refusal
  • Assessment of school refusal
  • Treatment of school refusal
  • Role of teachers and parents in school refusal

Interview a child support worker who is reporting school refusal in a student. Explain the assessment, aetiology and management.

  • Taking a relevant personal history
  • Identifying key psychological elements of formulation
  •  Assessing psychological mindedness

Perform a competent assessment to assess the suitability for psychotherapy focusing on the key elements of psychological mindedness.

  • Difference between Childhood and Adult ADHD
  • Principles in assessment of ADHD
  • Co-morbidities in ADHD
  • Behavioural and psychological treatment strategies
  • Medications for Adult ADHD

Provide psychoeducation to your patient on Adult ADHD explaining the diagnosis and treatment.

  • Take a relevant and focussed history from a non-mental health worker.
  •  Identify the key issues including child protection issues
  • Understand key principles in management, including relevant legislative frameworks.
  • Outline a practical approach to the issues involved for children affected by mental illness in a parent.

Take a history from a community nurse who is raising concerns about a child in the context of maternal mental illness. Present a short and long term management plan.

  • Foster a collaborative approach with Dr Smith
  • Interpret results in the context of delirium
  • Outline a management plan



Manage a consultation request in a General Hospital concerning a patient with delirium, focusing on the communication to the referring doctor, and the knowledge of the principles of management.

  • Demonstrate a thoughtful and empathic attitude during the discussion of the acceptance/refusal of the gift.
  • Reflect on the nature and timing of a gift.
  • Describe the principles surrounding the management of gift-giving from a more general perspective.
  • Specify when it is/is not appropriate to accept a gift.

Addressing the issue of being given a gift by a patient during a psychotherapy session

  • Take a history of a child’s circumscribed anxious behaviour from the teacher
  • Explain your understanding of the problem to the teacher
  • Provide a brief management plan to the teacher

Manage a consultation with a  teacher about a child's anxious behaviour after an incident at school. Present an understanding of the child's problems with a brief management plan.

9. Medical Examinations


Examination of the gastrointestinal system.


Examination of the respiratory system.


Examination of the peripheral vascular system.


Examination of the cardiovascular system.


Examination of the cranial nerves.


Examination of the thyroid gland.


Examination of the neurological system of the upper limb.


Tests in meningitis.


Examination of the optic fundus.


Examination of the neurological system of the lower limb.

10. Lectures

  • Comprehensive assessment in ADHD
  • Rating scales in ADHD
  • Psychological strategies in management
  • Medication initiation and titration

Lecture on the principles in assessment and management of Adult ADHD.

  • Criteria for Insomnia Disorder
  • Causes of Insomnia
  • Restless legs syndrome
  • REM sleep movement disorder
  • Periodic limb movement disorder
  • Assessment of Insomnia disorder
  • Management of Insomnia
  • Sleep hygiene, CBT and pharmacological treatment

Lecture on the assessment and management of Insomnia.

  • Principles in discontinuing benzodiazepines
  • Safe use of benzodiazepines in anxiety disorders
  • Protocol for tapering of benzodiazepines

Lecture on the principles in the management of Benzodiazepine dependence.

  • Role of a psychiatrist in service development
  • Steps in setting up a service
  • Types of resources and their allocation
  • Principles in evaluation of a service

Lecture on the key principles in developing a service. How to think about resources and their optimal allocation in services.

  • Medico-legal obligations
  • Managerial obligations
  • Role of a collaborator
  • Debriefing

Lecture on the approach to a patient suicide.

  • Ethical issues in genetic testing
  • Ethical principles in genetic testing
  • Genetics of Alzheimer’s disease
  • Genetics of Huntington’s disease

Lecture on the key issues in genetic testing in psychiatry. The scenario may be set where you have to provide psychoeducation to a family member of a patient with Alzheimer's disease, Huntington's disease or Schizophrenia. Each condition has a different genetic risk which needs to be taken into account.

  • Boundaries in psychiatry
  • Ethical issues
  • Reporting obligations

Lecture on the professional and legal boundaries that govern the doctor-patient relationship. The scenario can be set as a boundary violation by a doctor.

  • Types of self harm behaviour
  • Causes of self harm in adolescents
  • Strategies for families
  • Do’s and Dont’s
  • Advice to the patient
  • Risk assessment
  • Screening instruments for the identification of at risk individuals
  • Treatment approaches in self harm

Lecture on the principles of managing self harm in adolescents. This question can be set as a psychoeducation session for families or GP's.

  • Key principles in management of Borderline Personality Disorder (BPD)
  • Choosing medication in BPD

Lecture on the management principles in borderline personality disorder.

  • Definition of recovery
  • Andresen 5 stage model of recovery
  • Principles of recovery

Lecture on recovery oriented practice.

  • Definition of palliative care
  • Kübler-Ross stages
  • Professional and medico-legal obligations
  • Psychological management strategies
  • Role of psychiatrist as a collaborator

Lecture on the principles of palliative care in psychiatry including in patients with dementia.

  • Smoking cessation interventions
  • Nicotine replacement therapy in depression
  • Smoking cessation in schizophrenia
  • Pharmacokinetic interactions

Lecture on nicotine use disorder and smoking cessation interventions.

  • Approach to a junior doctor in difficulty
  • Causes of junior doctor stress
  • Prevention of junior doctor burnout
  • Definition of impaired doctor
  • Professional and medico-legal obligations.

Lecture on the causes of junior doctors in difficulty and important aspects in the management of an 'impaired doctor'.

  • Criteria for metabolic syndrome
  • Important points in assessment
  • Principles in management

Lecture on the criteria and management of metabolic syndrome.

  • Evidence behind ECT
  • Electrode Placement
  • Stimulus Dosing
  • EEG monitoring and its interpretation
  • Assessing the quality of post ECT seizure

Lecture on the principles of Electroconvulsive Therapy.

  • CanMEDS Framework
  • Problem Solving Method
  • SMARTER method for goals

Lecture on the approach to consultant thinking using the CanMEDS and problem solving framework.

  • Managing depression in schools
  • Role of schools in supporting children with depression
  • Psychological and medication management of conduct disorder

Principles in the management of depression in schools. Principles in the management of conduct disorder.

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