Clinical Scenarios

Clinical Scenario



By the end of Family Medicine Clerkship, students will be able to:

1. Obtain an appropriate medical and sexual history (e.g. migraines, unprotected intercourse, smoking, depression, contraindications for common contraceptive methodologies)
2. Be able to list and explain the absolute contraindications for hormonal contraception.
3. Counsel patients on contraceptive options including:
a) patient preferences and values
b) risks and side effects
c) contraceptive methods and devices, both permanent and non-permanent
d) benefits & relative efficacy
e) barriers to access (e.g. cost)
f) proper use including initiation
g) potential drug interactions
h) emergency contraception
i) counsel patients on STI prevention and screen when appropriate
j) describe the role of family physicians in caring for patients with unintended pregnancy [this sub-objective overlaps with pregnancy care]

Clinical Cards



Recommended Resources Addressing the Objectives

Contraception in Canada – a review (methods, characteristics, adherence, approaches to counselling) (8 pages)

Objectives covered: Fully: 1,3abdfghi Partially: 2,3ce
Fisher WA, Black A. Contraception in Canada: a review of method choices, characteristics, adherence and approaches to counselling. CMAJ 2007 Mar 27;176(7):953-961.

Helping women choose appropriate hormonal contraception (8 pages) More “real-life” guide to hormonal contraceptives; with more explanation for contraindications of hormonal contraception & more emphasis on cost

Objectives covered: 2, 3abde
Spencer AL, Bonnema R, McNamara MC. Helping women choose appropriate hormonal contraception: update on risks, benefits, and indications. Am J Med 2009 Jun;122(6):497-506.

Contraception for adolescents (1 page – pg 386; read the rest for interest) Includes handy comparison chart, listing contraceptive methods from most to least effective

Objectives covered: Fully: 3abcdfghi. Partially: 1,2,3e
Upadhya KK. Contraception for adolescents. Pediatr Rev 2013 Sep;34(9):384-394.

Careful counsel: Management of unintended pregnancy

Objectives covered: 3j
O’Reilly M. Careful counsel: Management of unintended pregnancy. J Am Acad Nurse Pract 2009 Nov;21(11):596-602.

Patient Information

FAQs on emergency contraception