“Doc, I Don’t Want To Get a Pap!”

Family Medicine Exam Prep > Blog > CCFP > “Doc, I Don’t Want To Get a Pap!”

A woman in white dress holding her crotch

“Doc, I Don’t Want To Get a Pap!”

April 15, 2023 | Family Medicine Exam Prep Course | CCFP

We are excited to see so many of you join our fall FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!

Just a reminder… pay attention to the questions. Here are our general tips one more time:

1. Pay attention to the questions. Look carefully at how many items you are being asked to list. If the question asks for five items, you will not get more marks if you list eight items; the examiner will look at the first five and allocate marks only for the first five answers – so be careful. On a SAMP, if it is not clearly stated how many items you should list, look at the amount of points/marks being allocated for the question to get an idea of how many answers the examiner may be anticipating you write down.

2. Do not write lengthy answers. Most questions can be answered in 10 words or less!

3. Be specific when writing down investigations (hemoglobin instead of CBC; CT abdomen instead of CT).

4. Remember that trade names and generic names are both acceptable when writing down medications.

5. For more helpful tips, you can refer to CCFP’s SAMP instructions by clicking here.



Darlene Winters is a 27 year old female who is new to your practice. She is engaged to her fiancé and is sexually active. You ask her if she has had a PAP. She tells you she is not comfortable with the procedure and asks you “Doc, is it really necessary?†(5 points)

1. True or false: HPV vaccination does not reduce the risk of cervical cancer. (1 point)

    • False. The risk of cervical cancer can be reduced through HPV vaccination, screening, and treatment of pre-cancers.

2. True or false: HPV is the most common STI and it is estimated that 80% of unvaccinated sexually-active people have had HPV. (1 point)

    • True

3. True or false: Your body can clear an HPV infection on its own. (1 point)

    • True

4. How often is it recommended to provide PAP tests to women? (1 point)

    • Screening every 3 years is recommended. Screening every 3 years provides 80-90% protection against cervical cancer and there is little additional benefit in more frequent screening

5. After a thorough discussion, Darlene agrees to undergo a PAP with you. Her results return 1 week later showing atypical squamous cells of undetermined significance (ASCUS). What is your next step? (1 point)

    • Repeat cytology in 12 months

Helpful Resources:
Cancer Care Ontario: https://www.cancercareontario.ca/en/guidelines-advice/cancer-continuum/screening/resources-healthcare-providers/cervical-screening-guidelines-summary/abnormal-cytology-recommendations
Canadian Task Force on Preventive Health Care: https://canadiantaskforce.ca/guidelines/published-guidelines/cervical-cancer/