Sensitive

We learn the "sensitive" exams in the second year at my med school.  By "sensitive exams" I mean Male GU (kidneys, penis, testicles, hernia, and rectal exams) and female breast and gyn exam (speculum, bimanual, and rectal-vaginal exam).  The way it works is that we go to a clinical site where several professionals act as highly trained standardized patients (SPs).  They first demonstrate these exams, and then talk us through doing the exams on themselves.  To a non-medical person, it probably sounds kind of odd, but it was one of the most valuable experiences I've had in my medical school career.  The SPs not only teach us the mechanics of how to perform the exam, but help us to develop our technique of sensitively explaining what is going on in the exam and avoiding any pitfalls like saying "I'm now going to feel your breast" (as opposed to "I'm not going to examine your breast") and help us to learn how to make the patient feel as comfortable as humanly possible.

A few weeks ago, I had just learned the male GU exam and was later telling a few non-medical friends about it while we were visiting (I would never divulge any of the details, but just shared that I had learned the exam, how it was taught, and what a great learning experience it was).  I was genuinely really proud of myself for having gotten through that hurdle, and was excited to share my experience because it was such a major part of my education.  While I didn't expect them to want to hear all of the details (which I wouldn't share anyway out of respect to my SP), I was surprised by their response.  They were a bit disgusted and shocked (in a really negative way) to hear that there were people who would voluntarily submit themselves to the experience of being an SP.  Now I know that there are things in medicine that most people would rather not hear about, but I was really disappointed in their reaction.  I have so so much respect for the SPs who were our teachers and am so incredibly grateful for what they did for my education.  These are people who are incredibly comfortable in their bodies, are extremely knowledgable, and who must work tirelessly to develop their teaching skills.  They truly deserve nothing but the highest level of respect and gratitude from anyone who has ever been on the receiving end of one of these exams.  The fact that anyone could feel differently (even if they are a little weirded out) completely blows my mind.  I think they were also uncomfortable with how comfortable I was with the whole experience, which also defys logic.  Does anyone honestly think that physicians who perform those exams are uncomfortable while performing them?  That would be a disaster, and a disservice to the patent.  I left the conversation feeling offended and frustrated that none of them respected or recognized the significance of the experience.

Today, I learned how to do the GYN exam.  The woman who taught us was amazing.  She was so incredibly thorough in working with us on every aspect of the exam, from how we place our body relative to the patient to how to describe what we see and feel during the exam.  Words can't express how grateful I am to have had her at my teacher.  I left the experience more confident in my current interest to pursue OB/GYN as my specialty.  I like the challenge of making a patient comfortable in a situation that is incredibly uncomfortable for most.  There is a certain level of frankness coupled with warmth that you have to find, and that suits me, I think.

We are doing the lottery for our 3rd year rotations this month, and I should know the order and where all of my rotations will be by the end of the month.  I'm definitely going to make sure OB/GYN is in the middle so I can do my best and hopefully get a good letter for residency applications.