Case vignettes help us recognise situations, understand concepts, and achieve mastery in formulation of reasons for encounter and integrative interventions in the medical consultation. In this paper, we present 6 case vignettes based on real consultations to illustrate concepts in the extended consultation. The aim is to provide the reader with opportunities to share real world experience, albeit summarised, of incidents encountered in practice. The reader will recognise situations that can be linked back to concepts of the extended consultation, and also in the processes to achieve the beginning steps towards mastery in formulation of the patients’ reasons for encounter and integrative interventions in the medical consultation.