The life of a standardized patient

Hey, it’s better than what medical students used to have to do:

The concept of the standardized patient has been around for decades, but only in recent years have medical schools made training with them a regular part of their curriculum. I talked to a 50-ish physician friend about my experiences, and he said when he was in medical school and it was time for the first rectal/genital exam, the students were told to pair off and examine each other. “So, do you pick someone you like, or someone you don’t like?” he recalled. “Either way, it’s lose-lose.”

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  • Medici

    Is it still true today that anesthesized female patients in the OR provide the opportunity for med students to practice pelvic/rectal exams in secret? Secret from the patient who has no idea this is happening to her? Supposedly the vague consent form the patient signs before the operation is the legal cover teaching hospitals and doctors hide behind to justify this clandestine procedure.

    I wonder if the surgeon would resent the patient should he or she be asked that the practice not be done. Or might the request not even be honored. The idea of medical students lining up to probe and examine the vagina of an unsuspecting unconscious patient for their own benefit, in my opinion, is nothing short of medical rape.

  • Michael Rack, MD

    Most medical students learn the basics of a pelvic exam from “standardized patients.”

    Below is a good link about standardized patients.

    http://uwnews.org/uweek/uweekarticle.asp?articleID=27384
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    However medical students still need to practice to get good, and many leave medical school without the ability to do a good pelvic exam. Some learn how to do it during OB/GYN rotations, but in many cases the patients on OB/GYN services don’t want students to examine them. Therefore many doctors don’t become proficient in pelvic exams until residency, if it all.

  • Michael Rack, MD
  • Anonymous

    All of which shows the importance of med students practicing on each other. It’s free, and they can practice as much as they want to. Thus, it will reduce the cost of medical education and improve training. Further, as doctors are always telling patients to get over their bashfulness, etc., the practice exams should present no problems. Physicians, examine thyselves.

  • Anonymous

    I’ve got no problem doing rectals and pelvics on my fellow classmates.

    Frankly for males its not really an issue.

    The female med students on the other hand, would NEVER allow such a system and would raise a huge stink about it and start labeling the school as mysoginist or however you spell it. The liberal politically correct med school administrations would be quick to outlaw the practice.

  • KoKo

    “Frankly for males its not really an issue”.

    Why wouldn’t it be an issue. I’ve always thought that males tended to be more modest than females.

    Am I wrong?

  • Anonymous

    Koko,

    You are wrong about every time you post here

  • Bongi

    we uised to have dutch students that rotated in our country. the one told us they did breast exams on each other. but for pelvic exams the university hired people form the street to allow pelvic exams. sometimes these ‘models’ were so experienced in having pelvic exams they could tell the students what it is that they are feeling at any given time.

    by the way, i’m male and there is and has never been any chance in hell that someone will ever practise internal examinations on me.

  • kathy g

    Atul Gawande in his book “Complications” said that medical students had to “steal” their learning from patients. The body is taken as “eminent domain hidden behind drapes and anesthesia.”

    In my case (a fully insured private patient) I had breast surgery in a major teaching hospital in Los Angeles. Several months later I accessed the operating report from my medical records. I noticed under “patient position” written “modified lithotomy” (for breast surgery?) Also it noted that 10 minutes prior to patient prep was devoted to “teaching”.

    On a routine visit to this hospital for blood tests, I questioned a group of nurses what this “teaching” might have been. Nobody would answer me even with an “I don’t know”. Their silence spoke volumes.

  • Anonymous

    I’m not a doctor or a med student, but I can say with much certainty that most men would not want to be examined by their fellow classmates. Women either.

  • Nanda

    Dear Doctors,
    I am a Psychiatric Social Worker in a General Hospital. Though my post is not relevant here, I earnestly request you to give me some advice to the following issue.
    One of the patients came today and told me that he has intense sexual urge after taking some medicine for his cardiac problem. But our psychiatrist’s diagnosis was that of Schizophrenia.Please let me know whether any medicine being prescribed for the management of cardiac problems can cause such sexual desires.
    Expecting your reply in this blog.
    Nanda, Trivandrum , India