Adolescent Health

Adolescence is a critical period of physical, psychological and social development, often accompanied by unique health challenges and opportunities. Young people experience rapid changes that can affect their physical health and mental well-being. As trusted and accessible healthcare providers, GPs are ideally placed to support adolescent patients through this  stage of life, offering holistic care that addresses both medical and psychosocial needs. Consultations may encompass a wide variety of issues including mental health concerns, risk-taking behaviours to sexual health, chronic illness management and safeguarding. Effective adolescent care requires strong communication skills, respect for confidentiality (while also understanding the limitations of confidentiality where there are safeguarding concerns), and an awareness of the wider social determinants impacting young people's health. Building trust with adolescent patients can empower them to engage effectively with healthcare systems, adopt healthier lifestyles and develop the skills needed for lifelong health management.  

• AD1. Ensure patient-centred, culturally sensitive care that respects adolescent autonomy and empowers them to participate in their own healthcare.
• AD2. Promote an adolescent-friendly practice environment that recognises and responds appropriately to the often unpredictable and chaotic nature of adolescent healthcare needs. Provide inclusive care for LGBTQI+ adolescents, recognising their specific health needs and promoting their overall well-being.
• AD3. Provide support for adolescents experiencing gender incongruence and or questioning their gender.
• AD4. Assess and manage adolescent mental health conditions, recognising risk factors, understanding referral pathways, and providing appropriate support.
• AD5. Identify and address harms suffered by adolescent as defined by the Children’s First Act.
• AD6. Communicate effectively with adolescents and their families, fostering trust and creating a safe, supportive environment.
• AD7. Demonstrate awareness of the unique dynamics and challenges of adolescent consultations - including hesitant or monosyllabic communication, changing doctors, excluding parents, and "testing the waters" interactions.
• AD8. Balance the adolescent’s emerging need for independence with the essential role of parents or caregivers, working collaboratively to ensure the young person’s wellbeing while respecting confidentiality and encouraging open, honest dialogue.
• AD9. Engage adolescents in open, non-judgemental conversations about drug use, smoking, vaping, and experimentation to build trust, support honest disclosure, and promote early intervention through harm reduction and informed decision-making.
• AD10. Recognise the role of the GP in adolescent sexual health, promoting prevention of sexually transmitted infections, and patient education on sexual wellbeing and potential for harm related issues as per Children's First.
• AD11. Offer age-appropriate contraception counselling, ensuring adolescents have the information and support needed to make informed choices.
• AD12. Provide comprehensive care and support for adolescents facing unplanned pregnancies, ensuring access to appropriate resources and services.
• AD13. Manage chronic diseases in adolescents, facilitating the transition to adult care and empowering patients to take an active role in their own health.
• AD14. Address common adolescent health concerns including musculoskeletal presentations, skin and appearance related issues.
• AD15. Assess adolescent development, including physical, mental, and pubertal changes, ensuring appropriate guidance and care.
• AD16. Understand and apply legal and ethical principles in adolescent care, addressing issues of capacity, consent, and confidentiality.
• AD17. Support adolescent’s families by recognising the GP’s role in navigating family dynamics, and parental guidance.
• AD18. Recognise and reflect on the role of adolescents as carers, developing an understanding of the impact caregiving responsibilities can have on their physical, emotional, social, and educational well-being, and demonstrate an ability to provide appropriate support and signposting within the healthcare setting.

For each problem or disease, consider the following areas within the general context of primary care:  

• The natural history of the condition, including whether acute or chronic
• The incidence and prevalence, including in different demographic groups
• Typical and atypical presentations
• Recognition of normal variations throughout life
• Risk factors, including lifestyle, socio-economic and genetic factors
• Diagnostic features and differential diagnosis
• Recognition of ‘alarm’ or ‘red flag’ features
• Appropriate and relevant investigations
• Interpretation of test results
• Management, including initial and continuing care, chronic disease monitoring and emergency care
• Patient and carer information and education
• Prognosis

Symptoms, Signs and Presentations

Physical Health

• Acne and other skin conditions
• Chest pain (often musculoskeletal or anxiety-related)
• Fatigue / low energy
• Gastrointestinal complaints (abdominal pain, irritable bowel symptoms)
• Growth concerns (delayed or early puberty)
• Headaches
• Menstrual problems (e.g., dysmenorrhoea, amenorrhoea, heavy bleeding)
• Musculoskeletal pain (sports injuries, back pain)
• Palpitations
• Shortness of breath
• Sleep disturbances
• Weight concerns (underweight, obesity, rapid weight changes)

Mental Health

• Anxiety symptoms
• Behavioural changes (aggression, withdrawal)
• Eating disorders (anorexia nervosa, bulimia, binge eating)
• Low mood or depression
• Risk-taking behaviours (e.g., reckless driving, unsafe sex)
• School refusal or academic difficulties
• Self-harm behaviours (including cutting)
• Substance misuse (alcohol, drugs)
• Suicidal ideation

Sexual and Reproductive Health

• Concerns about puberty and body image
• Contraceptive advice and provision
• Pregnancy (planned or unplanned)
• Questions or concerns about sexuality and gender identity
• Requests for emergency contraception
• Sexually transmitted infections (STIs) symptoms (e.g., discharge, pelvic pain)

Social and Family Factors

• Bullying
• Caring responsibilities at home (young carers)
• Domestic violence exposure
• Family conflict or breakdown
• Peer pressure and social media-related stress
• Safeguarding concerns (neglect, abuse)

Chronic Conditions Management

• Adherence issues with long-term medication or treatment
• Asthma management
• Epilepsy care
• Type 1 diabetes management and transition to adult services

Common and Important Conditions

• Acne vulgaris
• Anxiety disorders
• Asthma (and poor control during adolescence)
• Attention-deficit hyperactivity disorder
• Autism spectrum disorder (ASD) issues emerging in adolescence
• Behavioural difficulties (including conduct disorders)
• Contraceptive needs (including LARC—long-acting reversible contraception)
• Depression
• Dysmenorrhoea
• Eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder)
• Exposure to domestic violence
• Gastrointestinal disorders (IBS, functional abdominal pain)
• Homelessness or unstable living arrangements
• Impact of parental separation or divorce
• Musculoskeletal injuries
• Obesity
• Polycystic ovary syndrome (PCOS)
• Primary and secondary amenorrhoea
• Self-harm and suicidal ideation
• Sexually transmitted infections (STIs) (e.g., chlamydia, gonorrhoea)
• Substance misuse (alcohol, drugs, vaping)
• Teenage pregnancy
• Thyroid disorders (e.g., hypothyroidism)
• Type 1 diabetes mellitus (management and transition to adult care)
• Young carers (caring for ill or disabled family members)

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed 

Blended Learning Resources (Education Platform)

Adolescent Mental Health

Useful Websites

Jigsaw – adolescent counselling

Adolescent Mental Health Blended Learning Module

Workplace Based Learning

Workplace-based learning offers a valuable opportunity to build practical skills and confidence in managing adolescent health. In both hospital rotations and general practice, trainees will encounter a wide range of adolescent presentations. Real-world consultations allow trainees to develop essential skills to communicate appropriately with adolescent patients. Observing how experienced clinicians navigate complex issues, such as managing risk-taking behaviours or supporting young people with chronic illnesses, provides important learning on holistic, adolescent centred care. Through repeated exposure, feedback, and reflection, trainees can develop the knowledge and skills needed to effectively care for adolescents in a primary care setting.

Day Release

Day release sessions provide an excellent opportunity to explore the complexities of adolescent health in a supportive, interactive environment. Through case-based discussions, trainees can examine a wide range of common presentations such as anxiety, menstrual problems, sexual health concerns, and risk-taking behaviours. Group learning fosters a deeper understanding of the physical, psychological, and social aspects of adolescent care and provides a safe space to discuss sensitive communication techniques, safeguarding issues, and approaches to confidentiality.

Registrar Tutorials

Registrar tutorials offer a focused and personalised space to build skills and confidence in adolescent health. These sessions can be used to discuss recent cases from practice, such as managing a young person with mental health concerns, supporting an adolescent with chronic illness, or navigating a consultation about contraception or substance use. Tutorials allow trainees to reflect on the challenges of balancing confidentiality with safeguarding responsibilities, practice communication strategies, and review the latest best practice guidelines. With the guidance of a trainer, trainees can develop a structured approach to adolescent consultations that promotes trust, empowers young patients, and ensures holistic, safe care.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

 EPA 7: Manage the mental health needs of adolescents (12–18)

A young person presenting with low mood, social withdrawal, and declining school attendance provides an opportunity to demonstrate EPA 7. If the GP Trainer observes the consultation, a PIP-C can be used to assess sensitive history-taking, risk assessment for self-harm, and development of a collaborative care plan. A succinct case entry could be: “assessment of low mood in adolescent.” Reflection should explore approaches to building rapport in hesitant consultations, balancing confidentiality with family involvement, and addressing specific safeguarding considerations under Children First.

Core Knowledge Test (CKT)

• Contraceptive advice for a 15-year-old

• Management of depression in a teenager

• Management of disordered eating in an adolescent

Clinical Competency Test (CCT)

• An adolescent wishes to discuss contraception options.
• An adolescent presents with anxiety.
• A young person attends to request STI testing.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.