When a medical student sees you, consider it your lucky day

When a medical student sees you, consider it your lucky day

Medical students rotate through the clinic I work at. I love it. It brings me back to those days. Sure, it reminds me how old I am, but also reminds me of the incredible impact patients have in directing the course of our career paths.

We all have those memories. Our first delivery. Our first code. The first time we had to do an ABG. Our first surgery. The list goes on and each moment is seared into our memories.

I still have that picture. The one of me, the new mother, and her precious newborn. It was at that moment that I knew I’d rather be a pediatrician than an OB/GYN; the other specialty I was contemplating.

I remember vividly, conversations I had with struggling alcoholics, worried mothers, and pregnant teens.

It was a time when I could finally see where this long road of schooling was taking me. And it felt good.

So when I see parents become a bit annoyed or who outright refuse to see “the medical student”, I just want to say…

Today is your lucky day. You get a young burgeoning doctor unencumbered by time constraints. They don’t care about the waiting room full of patients. They are hopeful, enthusiastic, and not yet jaded by the realities of practicing medicine. The weight of those enormous medical school loans are not yet felt on their sturdy and cheery 26 year old backs.

They are there for you and your child. They listen intently. Maybe you think they’re asking too many questions, but they’re determined to get a complete history. They know their job is to listen and be meticulous about their physical exam.

Seriously, when was the last time you had someone listen to you so earnestly?

They will report back to the physician in charge; make sure you don’t leave without that handout about picky eaters or without that number for poison control. They don’t rush you or look at the clock as you describe in detail the last three years of your child’s life.

They care. They are young. They are at the magical intersection of theory and reality.

So, tomorrow, when you’re at your doctor’s office and you hear those words “the medical student will see you now”; instead of cringing, consider it your lucky day. Because not only will you get a budding doctor full of hope (and time); you might have the distinct privilege of being that one patient. The one that becomes instrumental in shaping a young doctor’s career path.

Just as that newborn was in mine.

Melissa Arca is a pediatrician who blogs at Confessions of a Dr. Mom.

Image credit: Shutterstock.com

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  • Ed

    We are supposed to be a training aid and pay the full exorbitant fee, never!

    • http://www.facebook.com/profile.php?id=1118820088 Terry Langfitt

      It’s like you didn’t even read the article. I am a medical student and it’s true that we are going to probably pay you more attention, so you are getting more time for your money. In addition, a licensed doctor will also go talk to you and make sure everything we have collected is accurate. This is good for you because then you get two people looking at your information and determining the right course of action. It is also entirely possible the student may pick up something the doctor may miss.

      Additionally, people who never agree to see students are preventing them from getting an education, making them less prepared as doctors in the future. How are we supposed to be trained? People that rely on others only to spend time with a medical student are much like those who refuse to get vaccinations, they are being protected by the herding effect which is selfish.

      • Ed

        We’re supposed to bare our body and soul to you because you claim we’ll receive better care; seems just a tad self serving don’t you think? Show me data from an objective third party and I may rethink my position. Dental schools routinely offer patients fee discounts; why not medical schools?

        • medstudent4

          If you don’t want to be seen by medical students or residents, don’t go to a teaching hospital. it’s as simple as that. Go to a community hospital or clinic where there are no physicians-in-training.

    • Canadian PhD

      Excellent point!!

  • Doug Capra

    Good article with much truth in it. But it’s a two-way street. Yes, patients are lucky to get that enthusiasm and attention. But the medical students are also lucky to get a teaching aid. Rather than hearing “the medical student will see you now” it would be more ethical to hear:

    “Hello. My name is ______. I’m a medical student and I’m working under Dr. _____ who is supervising me. I would truly appreciate it if you would let me examine you. I would consider it a
    privilege”

    It is not your “right” as a medical student to use patients as teaching tools. That is not the function of a patient. Most patients are pretty savvy. They realize medical students need hands on experience with real patients and most will grant that access if approached with respect. And respect doesn’t mean being approached with an entitlement mentality that basically says now that you’re in the hospital your body belongs to us.

    • googler

      ‘the medical student will see you now’ rarely occurs in real life.

      Usually the patient has been asked for consent on whether a student can come in and see them. In addition, most medical students are aware that it is a privilege and not a right. We pay the university/hospital for education not the patients. That said most of the medical students who see patients will begin by introducing them as medical student and ask if they’re okay with them being interviewed by a patient.

      Nothing in the article suggested that it is a ‘right’ for a student to be able to see the patient, and most medical students understand that.

      We’re human too

    • klm

      Here is my spiel. “Hello my name is _______ ________. I am the medical student working with Dr. _______ in (field). Is it ok if I come talk to you and get some history first and then the Dr and I will come in together?” My introduction is not going to be dripping with praise for you like yours suggested. And it’s not a right for us to see you but in general, it is truly in the best interest of the patient. Remember that while we may be awkwardly fumbling with our stethescope, we have the tendency to catch things the Dr missed. It happens a lot more than you’d think. Dr’s aren’t perfect at their jobs as much as we’d like to think they are. Every extra set of examinations and history is really a bonus for the patient in most circumstances.

    • MD2BE

      Anyone who needs to be told that it’s a privilege to be in their presence needs a serious reality check. When have YOU told someone that it would be a “privilege” to be in their presence? Probably never. So why would you expect a medical student, who can CONTRIBUTE to your care, to do so? Ridiculous.

  • JC

    I’m a medical student, and I really appreciate this post. I’ve already met some of those important patients for me, but I’ve also met several patients who refused to cooperate or refused to see me just because I haven’t completed training. Considering all of the work and time that’s gone into getting even this far, and the fact that my school employs simulators and standardized patients (meaning, actors who are our first patients to TRAIN us before we see people paying for medical care), I must admit that it feels a tad unfair to be turned away as inexperienced and not worth the patient’s time.

    People like ‘Ed’ below don’t seem to understand–the patient does pay to be seen by the student, yes, but also to be seen by the attending AND often a resident or fellow, and often to have their case reviewed by the team or instructor to whom the student reports for their grade, so they are getting a lot of extra attention and care. Also, we are students, so guess what? WE have to pay tuition and fees to see YOU, too–and in case you’re worried, we get no part of the fees you pay for medical care, we only get the experience and joy of helping you do and feel better.

    As far as arguing about how the student is introduced and that it isn’t respectful–of the many doctors I’ve shadowed and clinics and hospitals I’ve worked with over the last few years, I have never been rude or disrespectful and neither has the doctor or nurse or office assistant or whoever else could have been introducing me to their patient. Though it probably happens from time to time, I have also never seen or heard about a patient who was not asked and given the option to say no–in fact, some have said no to me quite rudely, and I just thanked them for the consideration and told them I would send in someone else.

    Medical students are people too, so how would you like to be treated? Do you remember applying for your first job and being turned down because you didn’t have experience? Wasn’t that frustrating, to need a job to get experience but to need experience to get a job? That is what you are doing to the student every time you refuse them–and that’s your right, I can respect it as there are some procedures or situations where I might not want a student either, but be kind about it, please.

  • Doug Capra

    JC

    My point was in reference directly to the article. It seemed to suggest that this was a one-sided relationship, i.e. that it was the patient who owed all the thanks to the medical student. I merely suggested that this was a quid pro quo situation, i.e. yes, the patient should be grateful, but the medical student should also be grateful. As I said, I do believe most patients will agree to working with students if they are approached in a way that “they” consider respectful. I do agree with you that this won’t always work with some patients. And, as you say, that’s their right. But there can be too much of an entitlement culture in some medical facilities, esp. teaching hospitals, that it’s just assumed that once you get in the hospital all these kinds of decisions as to who will treat you are already made and that the patient really has no say. Or, it may believed that patients have these rights de jure, but when it really comes right down to how things are run, de facto, they really aren’t given the choice — or, are manipulated into accepting whatever is offered. That’s my point. Personally, I understand the need for medical students to work with patients and in most cases I would agree myself. But there needs to be a balance here, and medical students need to clearly understand that they’re dealing with human beings who are not in the hospital for the med students’ personal learning or career advancement. These are my points.

    • http://twitter.com/XReflection Richard

      I think you underestimate the mentality that medical students have toward seeing real patients. You make it sound like we don’t even realize what kind of privilege and resource patients are in our learning. Trust me, we fully realize this. We also realize how inexperienced we are too. But I’ve yet to talk to any of my classmates who, when they get into the room, act like they are all knowing and speak condescendingly to the patient. At the same time, I don’t think it’s the right approach to make the medical student automatically put themselves below their patient by praising them and thanking them for the opportunity, as you had in your suggested introduction. It is a privilege, but no one needs to belabor that fact.

      In my view, the issue addressed in the article is implying that medical students already realize the impact that these patients have on shaping their career. But many patients don’t necessarily appreciate that fact and thus look at medical students with disdain if they are looking for treatment.

  • Zach Landau

    Beautiful. Thanks.

  • Doug Capra

    I don’t disagree with much of what has been written in response to my comments. I do assume that most medical students are aware of the issues at hand. I don’t challenge their integrity. And, personally, in general I would regard it my lucky day to have a medical student working with me as a patient. There may be cases, however, where I would not want that. This is all contextual. But some of you assume that the ideal introduction and approach always exists in medicine. I’m giving you a different perspective that I’ve heard from several patients. It isn’t what happens most of the time, but it does happen, a significant amount of the time. And, frankly, it isn’t the medical student’s fault as much as it is his supervisor’s fault. Here’s what sometimes happens: “Hello,” says the doctor. “I’m doctor _______. This is
    _________ my medical student. He’ll/She’ll be working with me today.” Or, the doctor brings the medical student into the exam room while the patient is gowned and asks if it’s okay to have the med student present. Hardly the time to ask. It should be done beforehand. This does happen. I’ve talked with many patients who have learned, after the fact, that a medical student worked on them directly (under supervision, of course) in the OR. They didn’t appreciate not being “asked” or even “told” ahead of time. The patients knew the doctor but hadn’t even met the medical student. They would have appreciated being introduced and asked permission. Now, don’t tell me that the patient already “signed off” on that on the consent forms when they got to the hospital. Patients fill out many forms that are pages long, forms written by lawyers to protect the institution. These documents are not primarily written to really inform patients. Should patients read the fine print and try to figure out what’s being said? Certainly. Do they? Most do not? Do they share responsibility here? Yes. But where’s the true communication, the real informed consent?

    Having said all that — you medical students can work on me, assuming you approach me the way you’ve been taught. But I’m offering you a perspective that separates the ideal from what sometimes happens in reality — when the rubber meets the road, when there’s a time constraint, when “efficiency” becomes more important than communication, when the interests of the institution and the schedule and the bottom line take precedence over patient interests. It’s easy to talk about a patient-center philosophy. It’s more difficult to really implement it considering all stress under which medicine is working today.

  • EmilyAnon

    I’m a patient. I’m curious about something.

    When I accessed my records after my operation (OR Patient Care Report) it listed the names of the doctors and nurses in attendance. Even though there was a box to list “other healthcare personnel and observers” it was blank. But I know there were several medical students in the OR because I met them when they came to my room during rounds, one of whom proudly claimed to have participated in the skin stapling.

    But to read the report, it was as if they weren’t there. To have omitted from this 3 page (legal?) document, that detailed to the minute every step of my operation, the attendance and participation of these students leaves a big gap in the factual history of my operation, doesn’t it?

    Just wondering if this is common practice.

    • http://twitter.com/taytayalis Taylor H-S

      At the hospital I am at every person’s name is included in the nurse’s report. As a med student, I can’t tell you how many times I’ve had to repeat the spelling of my name so the nurse makes sure it is correctly entered into the record. But I have noticed that in the primary surgeon’s note, I’m often left out.

  • Canadian PhD

    This is ridiculous. My health is not in their hands! Listen but DO NOT TOUCH!!!!!!!!!

  • Ed

    It’s my ethical and legal right to choose who and to what degree a provider (physician, NP, nurse, medical assistant, chaperon, or ancillary staff) participates in my health care and I don’t have to justify my decision to anyone.

    “Usually the patient has been asked for consent on whether a student can come in and see them. In addition, most medical students are aware that it is a privilege and not a right. We pay the university/hospital for education not the patients. That said most of the medical students who see patients will begin by introducing them as medical student and ask if they’re okay with them being interviewed by a patient.”

    When discussing this issue, there is absolutely no place for “usually” and “most.” I’ve personally experienced the supervising physician and student specifically not asking permission. I “understand” perfectly and frankly could care less about your tuition and fees. I’m the patient and paying customer and expect to receive healthcare from fully qualified, board certified, licensed medical providers. There is a world of difference between a first job denial due to inexperience and a patient granting a student access to his or her healthcare; the comparison is ludicrous. Collectively, you have only yourselves to blame when a patient says no!

    • lauraj

      Denying a student the opportunity to see you because of fees is hogwash – you’re still going to be reviewed and seen by their supervisor (a fully qualified, board certified, licensed medical provider). Furthermore, your “fully qualified, board certified, licensed medical provider” was a student once too, you know. People like you sure didn’t help him/her get there. Patients, doctors and med students need to work together in order to achieve the level of care every patient deserves whilst allowing learners the opportunity to, well, learn. It boggles my mind that people don’t seem to be grasping the concept that training new doctors requires practical experience, like anything. The comparison isn’t ludicrous, really; medical experience arguably requires involvement in the intricate, higher stakes realm of patient healthcare, but that just means students are supervised more closely than in other situations. If you feel that your care is suffering, blame the doctor, not the student. It’s the attending physician’s responsibility to monitor their student(s) and ensure their patients receive complete care.

      • Ed

        With all due respect, why should a patient be a training aid for no other reason than the often repeated but unsubstantiated “better care” mantra or because patients must aid provider training because it’s in their self interest. I do grasp the concept and completely understand the need for practical experience but the vast majority of patients have never seen students and yet your predecessors managed just fine. Seems to me if the medical education system valued real patient participation, some method of inducement might be offered in the same manner dental schools entice patients through lower fees. Yes the comparison is ludicrous when you compare being turned down for “your first job for lack of experience” to a patient saying no to a student because at the end of the day it’s really all about the patient isn’t it? Furthermore, the patient assumes all the risk because as you say, if care is suffering, blame the attending vice student because it’s their responsibility. That predisposes the patient will recognize substandard care to adequately address the issue. While denying students access is no guarantee of standard care, even you must agree that the opportunity for mistakes is greater and that’s a risk I’m not willing to assume. Finally, you conveniently failed to address the reason I will not participate is because the system betrayed my trust and faith. As with all things in medicine, patient rights are sacrosanct and students will just have to deal with it.

        • lauraj

          Ah, but when our predecessors were training, informed consent was emphasized much less so than now (and for the record I do agree that the process is still far from perfect), AND paternalism in medicine ran rampant. So patients were being seen by students back then and didn’t even know it! I’m truly sorry that you feel betrayed by the system as I can guarantee that it was no individual’s intention to do so, and also sorry that you’ve had a negative experience with a med student (I’m presuming here, as you clearly feel strongly about the subject). I hope that in the future if you’re approached and properly consented, you’ll give us another chance.

          And just to address the idea of some sort of reduced fee training program – It’s a good thought, but I don’t think this will ever happen because then hospitals would lose a huge portion of their (FREE!) workforce. Students do all kinds of work in hospitals that would otherwise require the hiring of more staff – chart notes, writing requisitions and consults, following up on test results, etc – routine stuff that’s still pretty important and helps things run smoothly. I don’t know for sure but I think this is probably why there are no reduced free training type programs – we work for no fees in the hospital! :)

          • Ed

            Thanks Laura for the reasoned and thoughtful reply while acknowledging the shortcoming patients no doubt continue to experience. And you’re correct about the lack of informed consent with your predecessors. Unfortunately, it still happens today and I think to a degree students are having to deal with a much more educated patient population about this and other issues. While difficult, that is indeed a good thing for everyone. Thanks for listening and I’ll reconsider if asked appropriately.

          • medstudent4

            How about this? If you don’t want to risk being seen by a medical student or resident, do not go to any hospital or clinic that contains med students or residents. It’s entirely your right to say no to being seen by students and residents, but you really ARE missing out on the opportunity of having your issue checked on multiple levels. The opportunity for mistakes is not greater. Logic dictates that the risk is less when multiple levels of checks and balances are in place. To say otherwise indicates that you’re not thinking logically. It’s as simple as that.

            If you seriously think a medical student has ANY control over your health care, you have no idea what you’re talking about and whoever told you otherwise is wrong. The attending physician (you know, the board-certified one?) has final authority on diagnosis and treatment. As a student, I can do absolutely nothing to influence your care. The attending will come see you after I do, he/she will ask you the same exact questions, and he/she will diagnose you and he/she will come up with a plan of action. Not me. Not any medical student in the US.

            That being said, med students DO spend more time with patients (because we don’t have time constraints like the attending does), and we occasionally do pick up a detail that the resident or attending may not (since we spend more time with you). Even then, the attending has to confirm our findings with you, the patient, before making any decisions — they’re not going to go on our word by itself since it’s their license on the line.

  • A. A.

    I always specify at appointment check-ins that I do not want to be seen by a student. I appreciate the value of medical students getting clinical experience, but when given the (unfortunate) choice between my schedule and a medical student’s training, I’m going to prioritize my life.

    Here’s why:

    Nine times out of ten, physicians are late to patient appointments. So if I have a 9:00 appointment, I won’t be shown to the examination room until 9:15 or 9:30, after which I have to wait (once again) for the physician to arrive. At that point I need to get seen and get out. I have a life and it does not revolve around my physician’s schedule.

    It is an unfortunate reality that physicians are generally egoistic with respect to scheduling.

    On the one or two times I’ve been seen by a medical student, it inevitably involves a lot of time for the medical student to walk back and forth to the licensed MD to ask and answer questions, and then eventually the MD strolls in to redo much of the examination. The appointment usually takes 2-3x as long as it otherwise might.

    That’s why I always specify at my appointment check-in that I do not have time to see a medical student.

    I support the experiential learning process, but not at my expense. I’m fine with seeing a medical student, so long as the supervising physician hustles and organizes it so that my day isn’t needlessly inconvenienced. That can happen by starting the appointment on time and working to ensure that the patient isn’t left sitting around without cues as to what is going on.

    I have doubts a physician would, if given the choice, take his/ her car to get an oil change someplace where the mechanic was in-training and would take 3x as long to get back on the road.

    • Ed

      Well said and completely agree!

    • Canadian PhD

      This is the same issue across the border in Canada….their mentality will never change. I am more informed than the doctor about my health. Mainly go for the prescriptions. Many in Canada consider the doctors as the middle man/woman towards a required prescription.

    • MD2BE

      Why do you think your time is so much more valuable than the student’s? Also, do you know WHY most physicians are late to appointments? Because they were taking care of someone else. Yes, someone other than you. My comment to you is the same I left for Ed. If you’re not comfortable being a training aid, then I don’t think you deserve service from an attending physician. The only reason you value their opinion is because they have EXPERIENCE. How would they get that experience if they didn’t see patients as a student? Your sense of entitlement is disgusting.

      • Ed

        Because, we’re paying for quality healthcare administered in a timely manner. Your sense of absolute entitlement to using my body as your personal training aid is disgusting and reprehensible!

  • Ed

    In my opinion, its doubtful an objective study would ever be published that casts any doubt on the decades old and ingrained manner medical students are trained. As stated previously, my primary reason is a physician and student specifically not asking prior permission; that betrayal cannot be erased! The paternalistic attitude you and others have voiced here reinforces my decision. As with virtually all things in life we see things differently and this issue is no exception. Medical students require training. I get that but I’m not comfortable as the training aid. Thanks for listening!

    • alex

      “show me data!”
      someone presents an article
      “In my openion its doubtful an objective study would ever be published”

      Here is my opinion. If you’re never going to change your view, why ask for someone to try to begin with?

      Oh right this is the internet and everyone’s opinion is important. I forgot how important you are my deepest, sincerest, most heart felt apology goes out to you.

      • Canadian PhD

        The pubmed article you refer to is very questionable and published in a VERY low impact journal!

    • MD2BE

      If you’re not comfortable being a training aid, then I don’t think you deserve service from an attending physician. The only reason you value their opinion is because they have EXPERIENCE. How would they get that experience if they didn’t see patients as a student? Your sense of entitlement is disgusting.

  • MD2BE

    As a medical student (and also a patient), I think it’s extraordinarily selfish for anyone to refuses to let a student be a part of their care. Plain and simple. How do you think the attending physician you’re seeing got to the point he/she is at?! By seeing patients… as a student! Imagine that. When I’m an attending, I will refuse to see a patient if he/she refuses to see a student. Someone that selfish doesn’t deserve my service. They can take their business elsewhere. (And yes, this is possible in private practice). Good thing patient’s like “Ed and A.A.” are in the minority or we would have a society crippled with health ailments and no physicians with any real training.

    • Ed

      You are ethically and legally required, as a student and physician, to solicit the patients’ permission, correct? If you agree, patients can decline and there nothing you can do about it; it’s called patient autonomy. If not, you’re long overdue a medical ethics review course. While I’m no lawyer, I seriously doubt any medical board or court would support your decision to deny a patient needed medical care, especially if there was an established physician patient relationship in place. Frankly, the condescending and patronizing attitude you express here likely permeates your entire discourse with patients; they won’t forget it. Good luck in your medical career, you’re going to need it.

      • MD2BE

        Yes, you are legally required to solicit the patient’s permission. If the patient declines, however, and the the physician has not already established a relationship with that patient, he/she has no legal obligation to provide his/her services (unless in the emergency room, which is a whole different ball game). If the physician has already established a relationship, he/she can still refuse to see the patient if the patient is properly “fired” (which involves numerous steps, but can be done). I’m no lawyer either, but I do understand the legality of seeing patients. Good luck finding a doctor who’s willing to put up with your selfishness, you’re going to need it.

        P.S. The attending physician will know you refused to see the medical student working with him/her and it will reflect poorly on you. Don’t be surprised if your “coveted” attending physician correspondingly treats you poorly.

        • Ed

          Your paternalistic attitude and disrespect toward patients is truly stunning! While we disagree on the relative merits of student participation in patient care, I’ll never have difficulty obtaining quality health care from physicians without student assistance; true for the vast majority of patients. On what planet did you learn patient autonomy was subservient to your personal beliefs and values? And you have the audacity to label me selfish; we’re done here.

  • EmilyAnon

    When you say that a patient’s sense of entitlement is disgusting, I guess that judgment doesn’t apply if the patient is a doctor, resident or medical student.

    In Dr. Atul Gawande’s book “Complications” chronicling his resident training, he admitted that when his own child got sick, he refused the offer of care from a Fellow that specialized in his child’s illness,instead opting for the chief of the department. At least he did admit the double standard, and ease at making this arrangement, but claimed that he only wwanted the “best care for his son.”

    from his book:

    “There is an uncomfortable truth about teaching. By traditional ethics and public insistance, a patient’s right to the best care possible must trump the objective of training novices. So, in teaching hospitals learning (must be stolen) is hidden, behind drapes and anesthesia and the elisions (deliberate act of omission) of language. The body is taken as eminent domain.”

    “If learning is necessary but has the potential for harm, then above all it ought to apply to everyone alike. Given a choice, people wriggle out, and those choices are not offered equally. They belong to the connected and the knowledgable, to insiders over outsiders, to the doctor’s child but not the truck driver’s. If choice cannot go to everyone, maybe it is better when it is not allowed at all.

    So, even though the public can’t take advantage of insider perks such as Guwande did, I hope you new doctors aren’t scratching your heads wondering why a patient might be spooked to have a trainee treat them. After all, we too, want only the “best care” for ourselves or family.

    • http://www.facebook.com/people/Ailan-Medici/1409476759 Ailan Medici

      I read this book also. Gawanda is a wonderful writer. He certainly pulled back the hospital drapes on how new doctors are trained. His revelations must be true because in the hundreds of positive reviews of this book by people in the medical community, none of his disclosures were challenged. Here’s another quote from the book:

      “`Do we (trainees) ever tell patients that because we are still new at something, their risks will inevitably be higher, and that they’d likely do better with others who are more experienced? Do we ever say that we need them to agree to it anyway? I’ve never seen it. Given the stakes, who in their right mind would agree to be practiced on?“`

  • Ed

    If the patronizing and paternalistic comments by the aspiring medical “professionals” here haven’t convinced patients to simply decline student participation in their healthcare, read the following links:

    http://blog.timesunion.com/mdtobe/should-med-students-obtain-consent-before-genital-exams/2868/

    http://www.ourbodiesourblog.org/blog/2012/09/conversations-we-shouldnt-still-be-having-pelvic-exams-under-anesthesia

    Shawn Barnes, a 4th year medical student at the University of Hawaii, John A. Burns School of Medicine states in testimony to the Hawaii legislature states:

    “Asking for consent for pelvic exams is important not only because it respects the rights of the patient, but also because it re-affirms the value doctors in training should place in such rights. A statement by Ubel et al bears repeating: “An ethical medical education should teach the precedence of patients’ rights.” What are students taught when consent for an intimate examination is bypassed? One answer to this question is suggested by a disturbing 2003 report. In a survey of over 2,000 American medical students, those students that had completed a 3rd year OB/GYN clerkship thought that
    consent was significantly less important than those students who had not yet completed a 3rd year OB/GYN clerkship. This effect was specific to the OB/GYN clerkship, as the total number of other clerkships completed was not associated with any significant change in attitude toward consent. Perhaps it should not come as a surprise that obtaining medical education unethically, through an unconsented and intensely personal exam, creates doctors with a significantly lower valuation of the idea of consent, doctors who become residents and attendings who assume unconsented pelvic exams are standard practice, and pass that attitude on to the next generation of medical students.”

    For a complete transcript of his testimony as well as the position of the ACLU, Planned Parenthood, AMA, ACOG, and the AAMC, follow this link:

    http://www.capitol.hawaii.gov/session2012/Testimony/HB2232_TESTIMONY_JDL_03-27-12.pdf

  • Ed

    Besides the patronizing and paternalistic comments made by the aspiring medical “professionals” here, read the following comments by Shawn Barnes, a 4th year medical student at the University of Hawaii John A. Burns School of Medicine to the Hawaii legislature.

    “Asking for consent for pelvic exams is important not only because it respects the rights of the patient, but also because it re-affirms the value doctors in training should place in such rights. A statement by Ubel et al bears repeating: “An ethical medical education should teach the precedence of patients’ rights.” What are students taught when consent for an intimate examination is bypassed? One answer to this question is suggested by a disturbing 2003 report. In a survey of over 2,000 American medical students, those students that had completed a 3rd year OB/GYN clerkship thought that consent was significantly less important than those students who had not yet completed a 3rd year OB/GYN clerkship. This effect was specific to the OB/GYN clerkship, as the total number of other clerkships completed was not associated with any significant change in attitude toward consent. Perhaps it should not come as a surprise that obtaining medical education unethically, through an unconsented and intensely personal exam, creates doctors with a significantly lower valuation of the idea of consent, doctors who become residents and attendings who assume unconsented pelvic exams are standard practice, and pass that attitude on to the next generation of medical students.”

    http://www.capitol.hawaii.gov/session2012/Testimony/HB2232_TESTIMONY_JDL_03-27-12.pdf

    http://blog.timesunion.com/mdtobe/should-med-students-obtain-consent-before-genital-exams/2868/

    And you wonder why patients don’t trust either you or physicians; you have only yourselves to blame!

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