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The Annual Poke & Prod – Helping Along the Medical Students

November 4, 2009

Yesterday I went for my pelvic exam, which I often talk a little bit about here just because a) it’s obviously theme-related, and b) I figure the more open discussion, the better. I saw my provider in the workplace’s fancy new off-campus clinic, and had the chance to use the self check-in kiosk (where I updated my info and paid my co-pay) and to get one of the restaurant-style buzzers that would let me know when they were ready for me. Some people may find that impersonal, but idea behind the buzzers is that the clinic is located in a shopping area, so with this piece of technology people can wander away from the waiting area and shop.

I was more excited that it allowed me to wander off to the restroom without worrying that they would call me during that time and I wouldn’t know it. Yes, these are the things I worry about in waiting rooms, and in airports, and in lectures and movies – missing something because I’m peeing.

Anyway, my provider is a women’s health nurse practitioner I’ve used for several years, so while the setting was unfamiliar, the provider was familiar…but then she asked if it was okay if her med student participated. And I said yes, because it’s an academic medical center, and these kids have to learn…

and…

Oh, damn, it’s a dude.

With the exception of my very first pelvic exam years and years ago, I’ve deliberately chosen women providers. I’ve heard the arguments that it shouldn’t make a difference, but that has been my choice. After being initially taken aback (I just wasn’t thinking about the high probability of any given med student being a man), I decided it was okay. I had a number of things to talk frankly with my provider about, so the poor guy got an earful – he’ll probably specialize in dermatology after this.

She (my NP) did the breast exam, but the student did the pelvic/Pap. There was an “ow” moment of slightly too much pressure, and the provider took a look to see what was going on, righted the course so to speak, and turned it back over to the student. He actually apologized that he was not well-practiced in the exam, but she and I both told him, “That’s okay, this is how you learn!”

Of course, your provider should always ask first and you always have the right to refuse, but if you are comfortable letting a medical student participate in your care you might consider allowing them to observe/participate – they might not be perfect at it yet, but you may help them get better.

5 Comments leave one →
  1. Polly permalink
    November 4, 2009 1:10 pm

    Felt your pain…literally…exactly the same thing happened to me at my last exam…male med student and all. 🙂

    • November 4, 2009 2:43 pm

      Next time maybe I should ask first, “How many of these have you done?”🙂

  2. Maggie permalink
    November 5, 2009 6:54 am

    A friend of mine used to have a paid job as a first-pelvic-exam trainer. She gave a lecture to the students and then provided clear feedback as they examined her. “No, that’s not an ovary, it’s probably a ball of stool. You want to be a little more to my left and anterior” and so on. Including, “not so hard! You wouldn’t want me to poke your testicle like that, would you?”

    I have often thought of her kindness to the rest of us, that most of the providers we see have decently well-trained hands.

  3. November 9, 2009 4:58 pm

    Yeah, that’s exactly why I agreed to let a med student observe my daughter’s birth – they have to learn somehow right?🙂 I’m just glad that’s all he did was observe and not try to deliver her!

  4. December 6, 2010 1:34 am

    For medical students everywhere, I thank you. We actually have a night of training when “standardized patients” are paid to receive exams so that we can learn. It’s 8a stressful night, but I learned a lot. Thankfully, the visiting faculty are very passionate about the subject — some enough to serve as patients. They do this so we can become great practitioners.

    If you’d be interested in reading about my experience, come over to my co-written blog at http://www.mypatraining.com. “My First Real Patient” is the specific post.

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