Station 66
Raj Patel
Age: 48 years old male
Full Case
Patient’s Data
Patient’s name: Raj Patel
Age: 48-year-old male
Past medical history
- Hepatitis C (treated with antivirals 7 years ago)
Drug and Allergy History
- Not currently on any medication
- No known drug allergies
Recent Notes/Consultations
Recently re-registered with the practice
Patient booked a routine telephone consultation to discuss concerns.
Patient's Story (Role player’s brief)
Patient’s Story
Opening statement: Hi doctor, I’ve just started a new job and had to fill out a medical form, I noticed Hepatitis C is still on my records. I would like this to be removed from my records.
You are Raj Patel, a 48-year-old gay man. You were diagnosed with Hepatitis C and treated successfully with antiviral medication 7 years ago. At the time, you were under the care of a hospital specialist, but you moved to Dubai to work as a real estate developer and missed some of your follow-up appointments.
You have recently returned to the UK and have just started a new job as a restaurant manager. As part of your employment, you were asked to fill out a medical history form, which made you concerned about Hepatitis C still being listed on your medical record and whether this might affect your job.
You feel completely well, have no symptoms, and have not noticed any health issues.
Social History: You do not smoke, drink alcohol, or use recreational drugs. You live alone, but you’ve recently started a new relationship with a man.
Ideas: You believe that since your Hepatitis C was treated years ago and you’ve had no symptoms since, it should no longer be listed on your medical records.
Concerns: You’re worried that having Hepatitis C recorded in your medical history might impact your ability to work, particularly in your new role in the restaurant industry.
Expectations: You want to know if the Hepatitis C entry can be removed from your medical records now that you’ve been treated.
Questions for the Doctor:
You’ve just started a new relationship and want to know if it’s safe to have unprotected sex now
If it turns out that Hepatitis C is still present, will that prevent you from working as a restaurant manager?
Say NO to any other questions asked outside of the details already provided in the scenario. Accept anything offered to you by the doctor.
Marking Scheme
Data Gathering and Diagnosis
- Ask when he was diagnosed with Hepatitis C and for details about his treatment 7 years ago, including why he disengaged from gastroenterology follow-up
- Ask about his current general health — any ongoing symptoms or concerns
- Ask if he has experienced any symptoms suggestive of liver disease (e.g. jaundice, abdominal pain, pale stools, dark urine, or generalised itching)
- Ask if he has had any recent blood tests, liver function monitoring, or follow-up for Hepatitis C since completing treatment
- Ask about his alcohol intake, smoking habits, and any history of intravenous drug use.
- Clarify his current relationship status and any relevant sexual health concerns
- Ask whether his employer’s medical form is requesting confirmation of Hepatitis C resolution, or if it is simply asking for a general medical history.
Example of explanation to patient
Raj, I completely understand your concern about having Hepatitis C on your medical record, especially now that you’re starting a new job. It’s completely natural to want to, move on from something that feels like it’s in the past.
However, I would like to explain that we can’t remove past medical conditions from your records, even if they’ve been treated. Medical records are kept as an accurate account of your health history, not just for formality, but to help keep you safe. If a doctor were to see you in the future for something like liver-related problem, having that Hepatitis C history available could help them make the right decisions about your care quickly.
That said, having had Hepatitis C in the past, even if it’s still present, does not stop you from working in a restaurant. Hepatitis C is only spread through blood-to-blood contact, not through food or casual contact. So, you wouldn’t pose a risk to anyone as long as you don’t have any open wounds and you’re following normal hygiene practices. If your employer has any concerns, they can contact occupational health for proper guidance.
In terms of next steps, I would like to arrange a blood test to check whether the virus is still active and how your liver is doing. Regardless of the result, I would also suggest referring you back to the liver doctors, since it’s been several years and you missed some of the follow-up. They can confirm whether everything has resolved and whether any long-term monitoring is needed.
Does that all sound okay to you?
You asked about unprotected sex with your partner, that’s a really sensible question, Raj, and I’m glad you brought it up.
If your Hepatitis C has been successfully treated and completely cleared, then there’s no risk of passing it on, even during unprotected sex.
However, until we’ve confirmed that the virus is no longer present, which we can do with a simple blood test, I would recommend using protection (condoms) for now, just to be on the safe side.
Management
Management
- Explain that it would not be appropriate or safe to remove the Hepatitis C diagnosis from his medical record
- Inform the patient that medical records are kept accurately to protect his health and ensure that any future healthcare professional involved in his care has the full information needed to make safe and effective decisions; if Hepatitis C were relevant to a future treatment or condition, missing this information could lead to inappropriate or delayed care.
- Inform the patient that even if Hepatitis C is still present, it should not prevent him from working in a restaurant. Hepatitis C is a blood-borne virus and is not transmitted through food or casual contact. As long as he has no open wounds or cuts, there is no risk to others. If the employer has concerns, they can be directed to occupational health for further guidance.
- Arrange blood tests to check for active Hepatitis C infection, liver function tests and other baseline blood tests.
- Regardless of test results, refer the patient back to gastroenterology or hepatology for specialist follow-up, as he was previously treated but lost to follow-up
- Advise on practising safe sex, especially in the context of a new relationship, until current Hepatitis C status is confirmed
- Safety-net: advise the patient to seek medical attention if he develops symptoms such as jaundice, unusual fatigue, abdominal pain, or dark urine.
Learning point from this station:
This case highlights the importance of handling sensitive medical history with care, particularly in the context of employment, stigma, and sexual health. Hepatitis C, although curable, remains a clinically relevant diagnosis and must not be removed from medical records, as doing so would be unethical and potentially unsafe for future care. Accurate record-keeping is essential to guide appropriate clinical decisions, particularly if complications arise later in life.
Under data protection law (GDPR), patients have the legal right to ask for factual mistakes in their records to be corrected or removed.
However, patients cannot ask for a healthcare professional’s opinion or a confirmed diagnosis to be changed, just because they disagree with it. A request to change a record should only be accepted if the clinician believes it is a genuine error and agrees that the information is factually incorrect.
If a medical record contains a factual error, this can be corrected but the original entry should not be deleted. When it is corrected, it must be immediately clear what was changed, who made the amendment, and when the change was made, including the date and time.