This post at Women’s Health News reports:
The New England Journal of Medicine has a perspective piece by Adam Wolfberg in the current issue (1), “The Patient as Ally : Learning the Pelvic Examination,” which addresses the issue of teaching pelvic examinations to medical students. It provides some telling information about the history of how this exam was taught, stating, “in contrast to ambulatory care, the gynecologic operating room has historically provided medical students with an opportunity to learn this exam: they could perform it in anesthetized patients immediately before surgery.” This practice became extraordinarily controversial when it became more widely known that pelvic exams were often performed on anesthesized surgical patients without their knowledge or consent, as a teaching tool rather than for medical care. According to the piece, “Academic gynecologists were accused of using patients as unwitting “training dummies” : a reaction exacerbated by the report’s revelation that students who had completed an Ob/Gyn clerkship were less likely than other students to believe it is important to obtain the patient’s consent for such an exam.”
Read the full post here. The referenced Wolfberg article is available to New England Journal of Medicine subscribers here.
I’ve been aware of this issue for years thanks to the dedicated work of my friend and former South Carolina colleague Robin Fretwell Wilson, who has written several articles on the subject, including Autonomy Suspended: Using Female Patients to Teach Intimate Exams without their Knowledge or Consent and Unauthorized Practice: Teaching Pelvic Examination on Women Under Anesthesia.
–Ann Bartow
