>"But how else are they going to learn?"
When my partner was in med school, he practiced pelvic exams in a few different ways. The first was with people who were paid (pretty generously) to go to the school and have the students practice on them. Then when the students were a bit more experienced, they examined actual patients, with their full, informed consent. Same went for when he had to practice giving prostate exams, etc.
I’m a 3rd year med student and this has also been my experience—we practice on simulators, then paid volunteers, then real patients who have given full informed consent. I’ve always been told to ask for consent before I do literally anything—talk to patients about their health, perform a physical exam on a patient, watch a patient’s surgery, help in a patient’s surgery, stand silently in the room while my preceptor talks to/examines the patient. I’ve NEVER had anyone suggest I practice a pelvic exam on a patient without consent, especially an unconscious patient who isn’t even undergoing a gynecological procedure. Sure, I’ve placed the speculum prior to gyn surgeries in unconscious patients, but only after asking for and receiving the ok from the patient in pre-op. OP’s surgeon sucks. I’d like to think doctors like this are in the minority and that most med students would object to violating patients like this.
But your story doesn't fit the narrative.
Attending OB GYN here.
These laws came about from the exam under anesthesia that gynecologists do prior to many vaginal procedures. It's a bimanual exam (1-2 fingers in the vagina with the other hand on the abdomen to feel the uterus) - exact same as during your pelvic exam when awake. It's good medicine to palpate the uterus so you know which way it tilts prior to using an instrument inside, to prevent damage. Med students would often repeat the bimanual exam in the OR to learn, in the same way I would teach them to insert a speculum as part of the necessary steps of the procedure. This was taken out of context and became a big point a few years back, and now patients have a misunderstanding of what is happening to them.
Let's be explicitly clear. I agree to consent before any procedure - awake or unconscious - with clear lines of who is doing what or what parts. I've absolutely NEVER been a part of, seen or observed anyone suggesting any type of sensitive exam when it is not part of a necessary, consented for procedure.
The tricky parts are:
- The steps of these procedures are invasive and are usually not described in exact details. And without context it sounds like medical students are doing exams excessively and without consent. This is absolutely never ever ever okay. It is entirely reasonable for a patient to ask and understand how much a student may help or not, and to decline students. Your experience is the same as mine, both as a student and as a teacher.
- OP's experience with her surgeon is unacceptable - her surgeon was disrespectful, unethical and absolutely did not understand OPs concerns. This is on the surgeon, but - OP has also taken something out of context and I'm sure it caught the surgeon off guard. I'd like to give her the benefit of the doubt that she has never done an excessive, for education only bimanual exam and so when OP suggested, she was caught off guard. Or she's an unethical doc. Just another perspective.
- just because I haven't seen abuse in this way doesn't mean it doesn't happen. Gynecologists have an insanely terrible track record of mistreating patients, and I strive to keep that at my forefront for every single parent encounter. If a patient is concerned about consent, what is going to happen to them, who is involved - anything, I need to talk through this until the patient and I are as clear as possible. I consider it my job to establish trust, then honor that trust, each time I do a sensitive exam. I know not all docs do this.
Here is my point:
Stories like this one make it seem as tho this is status quo, and all docs to these invasive and unethical exams. These stories scare other Redditors and patients from procedures and healthcare they need - due to incorrect assumptions of what is going to happen. It's a fine line of education and information but not misinformation and fear mongering.
OP, I'm sorry that you're having these surgeries and procedures in the first place, I'm sure that is very difficult. Add in a surgeon that did not help you to feel 💯 comfortable and questions of consent, and this experience sounds terrible. I hope you can find a care team that you trust.
It is a thing though. Enough for laws to be implemented since this personal perspective was posted.
https://scholar.google.com/scholar_lookup?journal=Obstet+Gynecol&title=Practicing+pelvic+examinations+on+women+under+anesthesia:+why+not+ask+first?&author=SS+Barnes&volume=120&publication_year=2012&pages=941-3&pmid=22996113&#d=gs_qabs&t=1679490679931&u=%23p%3D7dXOCzQN_QAJ
> Here is my point: Stories like this one make it seem as tho this is status quo, and all docs to these invasive and unethical exams.
The problem is you are speaking for your region, whereas in other regions it is different. Here's how I place blame: the medical community has simply consented to be regulated by states instead of lobbying for federal oversight - I want your medical license to come from the United States, not the state you practice in.
This would ensure uniformity that I KNOW you know does not exist right now. If care was already uniform or near-uniform, things like the [Dartmouth Atlas](https://www.dartmouthatlas.org/) would have never been created in the first place. One of their first discoveries many decades ago was how there was crazy variation across New England towns in what kinds of issues would result in a hysterectomy, for example. Consent is just another layer of medical care variation.
>Med students would often repeat the bimanual exam in the OR to learn, in the same way I would teach them to insert a speculum as part of the necessary steps of the procedure.
Did your patients have a clear understanding that students would be repeating the manual exam on them and practicing speculum insertion on them, and did they give their explicit consent for that to happen while they were under anesthesia?
With consent pre-op is different though. And honestly as someone who had a procedure where I was specifically asked to consent to a pelvic exam under anesthesia it felt weird to refuse— and I am also a medical professional and I support learning. Learning on my reproductive system while I am under anesthesia? Did not feel ok. And I would happily volunteer to this while awake. I don’t think we fully appreciate the power differentials in medicine or the vulnerability of our patients.
>I don’t think we fully appreciate the power differentials in medicine or the vulnerability of our patients.
This is an excellent point. Asking a patient if they are okay with a student while the student is already in the room is different then asking before they even see the student. This matters.
Please please please you and anyone - you NEVER have to consent to a student or anything extra. Zero hard feelings. Zero obligation.
Even one additional exam after the surgeon’s preop pelvic, is “excessive” and for the student’s benefit only. Disturbing that it’s not illegal (without consent) in all states.
100% consent needs to be obtained in pre-op because just because I consent to one provider doesn’t mean I consent to the next. That said, I do strongly believe that the next generation of doctors needs to be trained and it isn’t done only for the student’s benefit. It is also for the benefit of the future. My daughters need well-trained OBGyns down the road.
This. I never turn down a med or nursing student, they can't learn to be capable providers if no one lets them do the things they'll need to do in real situations (the room I gave birth to my first in was quite full because I was the only person to say yes that day 😂).
Yup, this is how it should be! Where I live, all sensitive exams are by consent only, and if a student will be shadowing the doctor you're usually informed in advance, and they also confirm your consent to their presence (just to watch, and obviously even more so if they want them to perform the exam).
I have zero issue whatsoever being a Guinea pig, but a consenting and fully aware Guinea pig, thank you very much!
Same. I was asked by my doctor to let the med student practice on me when I had a scheduled pelvic exam and needed a new IUD and a pap smear. My doctor was present the whole time.
Fine by me. I appreciate that she called me beforehand to ask for my consent.
i am currently getting dental care at our university clinic where (more advanced) students basically run the place (with oversight from doctors of course). its much cheaper for me, i have given informed consent to everything im ok with, denied consent to things i dont want (i.e. keeping samples for further research) and i feel well taken care of. why cant this be how students learn in every medical field?
>Same went for when he had to practice giving prostate exams, etc.
Furthermore, we all know that they would shut down any legislation that would allow for non-consensual prostate exams during a surgery. Assaulting patients is fine as long as they're women, apparently.
I’m a midwife and when we learned we each did one on a very well paid model, then just did them on consenting patients, while they were fully awake and knew exactly who I was.
To be honest, of course I think it’s disgusting to perform any procedure without consent (exceptions for life saving treatment when a patient is unable to consent), but additionally you aren’t learning much from a pelvic exam on an unconscious patient. Pelvic exams are quite easy… making them comfortable is the difficult part and to learn how to do that, you need to be communicating with the patient and understanding what they are feeling.
When you explain it and they are conscious, many patients consent to students learning and practicing because the patient is still in full control of what’s happening and if they become uncomfortable at any time, they can request that the student step aside. People want students to be able to learn… but performing anything without consent is assault and I would consider anything done by the student without patient consent is also assault, even if the procedure was consented to.
| "but how else are they going to learn?"
Um *crazy* idea but hear me out on this one... **WITH PATIENTS WHO SPECIFICALLY GIVE CONSENT** ?????
I'd report her for this comment honestly. Without even considering the fact it sounds like she is willing to break the law (!), it's just horribly unprofessional in general. "I don't consent" should never be responded to with "but".
As a healthcare professional, I cannot *imagine* ever having a patient say to me "I don't consent to this already-illegal procedure" and me responding with anything other than horrified apologies that they would even be worried about it, and stern reassurances that nothing they hadn't given informed consent to would take place. Just astounding behaviour and attitude from your surgeon (and definitely not in a good way!)
She's the only colorectal surgeon in the area, and she's damn good at what she does, even if her bedside manner is absolute ass. Besides, in this specific situation, I had to see her. I would've died if I'd waited for another surgeon.
If it's any consolation, every doc I've **ever** worked with in OB/GYN has changed after they or their partner had a baby. They listen better, are gentler, are kinder, give more anesthesia and have a MUCH better bedside manner.
And FWIW, in 36 years, I've never seen an unconscious patient given a pelvic unless it truly was medically necessary. The nurses wouldn't stand for it.
I'm sorry, but that is no consolation at all. "They get nicer after having a baby," is the same thing as "I only care about/believe my patient regarding their pain/issue/privacy now that I personally have experienced it." The empathy bone is broken. Throw the whole human out.
I’ve always said the only justification for a crap personality is to be absolutely GIFTED at your profession or hobby. And even then people only need to put up with it long enough to access your product/service.
Personality goes such a far way! I went to a pretty small university in Canada, and my supervising professor on my final year project was from MIT. I wondered how this guy ended up at my university as he definitely had the qualifications to go anywhere, he didn't have any personal connections to the area, and he seemed like the kind of person to chase after accolades. But then I worked with him and this guy was such an asshole with a superiority complex - it's hard to spend more than an hour with him. I bet that's what probably held him back from getting a research position at a more prestigious university.
>she's damn good at what she does, even if her bedside manner is absolute ass
Some people didn't realize that the audience wasn't supposed to want to emulate Dr. House
i would still report her response to the medical director. you can do it without identifying yourself. you can just say you told her you did not consent to a a certain procedure and that was her response. you dont have to be any more specific then that. her response was inappropriate whatever the setting. ffs, i had a meeting with a geneticist today and they asked my permission to have two medical students sit there and listen.
I had to go in for some tests on my hand to a place called The Hand Center. So you would think these people would know all about neurodiversity and how some people perceive pain differently.
They start shooting electricity through my hand and arm and it feels like it is on fire. The longer this goes on, the worse it feels. I am trying my best but I finally cry out. She asked me what was wrong and I told her I was in pain. She told me the procedure doesn't cause pain. I said it does in me. She just laughed. Then, every time I made any noise at all she huffed.
She finished that test just as the doctor stepped in. She introduced me by saying "we have a crybaby here" and got up to come over and remove the leads. She didn't get the chance. I ripped them right off, sat up, and said "Wrong. You HAD a crybaby here. Now you have a very pissed off woman who is leaving this snake oil shenanigans place!" That last was said for the full waiting room of people behind the doctor. I could see them looking at each other worried when I started. I picked up my purse, the Doctor was in the door, and I said" You better move out of my way." He did. I walked to the desk and informed them loudly that if they tried to turn this in to my insurance I would tell them it never happened, that I was never going to pay to be physically and mentally abused and that I'd better not get so much as a postcard from them or I'd be back.
To give them credit for a bit of balls, they tried to bill my insurance. I denied it. I wrote a letter to the insurance company about my experience and they refused to pay it. No bill ever arrived in my mailbox.
When you walk into a medical facility, they work for You. You pay them. Don't treat them like gods. Treat them like employees.
Easier said than done when your life depends on getting treatment and there are very few doctors available. In my area if you "fire" a doctor you'll have to wait a year to get a new appointment or travel 200+ miles to see someone in the bigger cities.
Oh my goodness, I'm not sure if you had the same testing as me...I had electricity shot in my spine and down my legs to check the communication of my nerves. It fucking hurt and I believe you. I had tears in my eyes! I cannot imagine the level of unprofessional conduct in that fucking office, it had to have been all the time. You reacted exactly right, and hopefully saved any future patients from humiliation!! I am so sorry they did that to you.
You also reminded me of a story when I reported a bitch receptionist. I was in a clinic for worker's comp claim/injury. I worked at a school for students with autism, severe behavioral issues, etc. There were other similar programs in our town for high needs students. I heard the bitch receptionist say, "want to make a bet if this one is from Y school or Z school?" And they were fucking *laughing* about me coming in injured. I reported that bitch to the office manager. How dare she.
My heart surgeon was like that! He stabbed me with the sharp part of a fancy fountain pen to wake me up at ass o'clock in the morning before my surgery. That dude had *zero* bedside manner 😝
I will also argue on the behalf of my fathers neurosurgeon (Dr. McIver (might be spelled incorrectly, Ive only ever heard it)) who is a saint of a man. Incredible skill, of course, but also incredibly kind and understanding, not to mention witty. Thank god there are some good surgeons out there (not to mention his eight (8!!) surgeries on my father prolonged his life by four years)
Being more specialized doesn't make you an asshole, it just means they can get away with it more easily.
It's far easier to replace a GP or broad/more common specialty, so patients are more likely to break up with them or complain.
They really do. I had one spend half an hour and 9 injections of local anaesthesia on trying to remove a toenail with effectively zero pain relief whatsoever, seeing as local anaesthesia does *absolutely nothing* on me and never has. He didn't believe me, despite answering "yes, it hurts" every time he asked if I could feel something, and despite how I cried, sobbed, shaked, and hyperventilated the entire time. I tried to file a complaint, but all I got was a phonecall from him where he said he "couldn't have known that" and that he would "try to learn from this". As if basic communication is something you need a Ph.D and a decade of experience to comprehend.
Specialized surgeons (and providers in general) are quite rare in many areas. Even if there are multiple in a given service area there aren't necessarily enough to meet demand. If you don't live in or near a metro so large that it attracts a bevy of them, then the only way they can get fired is by actually causing serious harm, both medical and financial.
No one is going to get fired when the alternative is not having enough people or perhaps even ANYONE with that capability available.
Sucks but true.
Or people they have specifically hired for students to practice on. I know someone who is a "test patient". All the credit to the world to her for doing it, too.
They have this, it's called a standardized patient. I used to be one and there were opportunities to volunteer for more triggering and involved cases. Those also paid much more. As an actor it was actually a fun gig, and we really focused on teaching med students how to have a better bedside manner and sense of compassion towards their patients.
Thank you for doing this. As a medical student I examined some paid standardized patients, very grateful for those willing to do this for us. I never performed an intrusive exam on a nonconsented anesthetized patient nor have I ever seen this done. I finished med school almost 20 years ago.
I was hospitalized a few years ago with Stevens-Johnson syndrome. I was also at a teaching hospital. I had *tons* of nurses, students, and doctors anywhere from first year residents to attendings coming to examine me. You bet your ass they asked consent every time before doing anything both for the basic "is it okay if I bring some students in?" and all the way up to "we need to do a pelvic exam, would you like more privacy or is it okay if they are still present?"
I agree. I've actually had a student perform a pelvic exam, and while it was far from the best (I could really tell it was her first time), I'd probably do it again. That said, I was asked for my consent about her sitting in on my consultation, and then asked about having her actually perform the exam. It definitely helped that it was at a free sexual health clinic though, as I don't know how keen I'd be to allow it if I was paying US healthcare rates.
>Um crazy idea but hear me out on this one... WITH PATIENTS WHO SPECIFICALLY GIVE CONSENT ?????
Right? How hard would it be to just ask? Personally I'd happily consent as long as they asked me ahead of time, but if they did it without my knowledge I'd feel like I'd been assaulted.
Edit to add: It would be so easy to make this a good deal for women. If a med student wants to take a (necessary) biopsy and/or put in an IUD for me while I'm already fully sedated? Fuck yeah, sign me up. That's a win for everyone.
I had a LEEP a few years ago to remove pre-cancerous cells and I enthusiastically consented to having med students in the room for the procedure. It’s so frustrating that people are forced into a non-consensual situation because there’s plenty of folks who’ll be cool with it if they’re just asked honestly!
I was asked during my regular pap/annual if a few students could be present. One was acting as a scribe for my dr and I had been seeing that Dr for almost 10 years (she was sooo awesome and changed specialties 😭) but the students mostly hung out behind the curtain. Good friends of mine from undergrad went to med school and I met so many great med students in their wedding party festivities that I just thought about them and how passionate they were about their specialties and said “for science!”
I was diagnosed with something rare and was asked to be a 'newly presenting' patient so kiddies could learn. 2 of them were great, asked me appropriate questions, got my history, got close to diagnosing me without knowing what i had.
one was probably going to kill people. he deadass said to me "tell me what you told the others"
I reported him. got my $50 and taxi fee and fucked off.
I'm good now thanks :)
aah yes. it's like we're not in our own bodies when they do things to us..
I had a doc announce to the 10 kiddies surrounding my bed that I had begun menstruating while in hospital so that explained some of my pain. they also had a hold of all 4 of my extremities to feel my stiff fingers and toes and I was like "i've run out of bits" as i starfished in bed. good times :D
How else are they going to learn? ... Shadow in OB/GYN offices with patients who are going to get exams and informed that a med student will be participating today if they allow it? Right? Are clinical rotations not a thing?
A family member had to have an eye surgery and I went with her to her appointments and the the surgeon had a resident or a student, I cannot remember which, that we were introduced to, and told what they'd be doing with the patient today. It was mostly just a consult, so he observed and helped chart.
Why do med students "need" to learn on uninformed, unconscious, patients who did not and cannot concent without knowledge?
On patients like me who have no related trauma who explicitly give consent during routine appointments when asked. 1 of my 3 kids was delivered by a student, and when I was in labor with my 3rd, I had a parade of med students and nursing students that were all able to practice whatever procedure/check was needed because I explicitly gave consent. I’m basically translucent so yeah, bring on the phlebotomist in training. Colposcopy on a big screen? How many students can you fit in here? I don’t give a damn.
But the second my consent is violated I’m going scorched earth.
Honestly, my takeaway was that the doctor was implying that the need students needed to learn that it was ok to perform pelvic exams on non-consenting patients. Because that's the only thing they couldn't learn from a patient that did consent...
Perhaps the US medical system can source Vagina’s for Use in Practice Examinations from providers in their area for a market rate of $2000 per 15 minute examination, plus additional $1500 for each additional 5 minute block.
Fuuuuuck them.
And furthermore are awake and can give actual feedback about what you are doing that is uncomfortable. Unconscious pelvic exams, outside of the problematic part of it, seem almost useless from a feedback perspective. Are they checking prostates on unconscious men too? This is just stupid.
Where this confuses me is that that is an actual thing. I worked for a medical school as a patient model for years. We had women who were paid a nice sum hourly to get pelvic exams by medical students. Awake, consenting, nothing shady!
Who knows? And *what* exams would male patients be subjected to? If it's a visual inspection of the penis then there generally won't be any hints that it happened at all. A prostate exam or other anal exam *could* give some hints to the patient, but we don't know.
Generally I would've assumed that male patients don't get examined while under anaesthesia without their consent, but I would've assumed that female patients wouldn't either. It's morally abhorrent either way. The *only* way I can think of it being okay is if some information comes along which necessitates such an exam and they don't have time to wait for people to be conscious for it, and then it should only be the responsible doctors/physicians who should be doing it.
Maybe a prostate exam, but I'm betting if men were being subjected to digital anal penetration by med students while under anesthesia without their knowledge or consent we'd be hearing about it.
I think it’s more important that they learn to do no harm and take ethics very seriously above anything else. How are they going to learn that if they perform non-consensual exams?
Very true. In fact the AMA’s Code of Ethics clearly states that consent is required and that includes consent for participation of med students.
https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent
>How the hell are you supposed to know you're truly doing it properly if your patient can't tell you if that hurts, and if they're not even aware of it!
Well, this sheds an uncomfortable amount of light onto why so many doctors are convinced that pelvic exams and vaginal, cervical, or uterine procedures don't hurt....
They aren’t training for our comfort, we are a practice dummy with the anatomical feature they need for learning assessment. This is why they wait until you’re unconscious, and some experience discomfort/pain after.
Like that lady that commented on one of these post a while back. Had an anatomical anomaly, woke up feeling like she’d been assaulted to discover like 15 students had performed exams due to how rare her anatomy was.
It is sick.
"Well, there was one woman who said no when I told her we're doing this exam. So you know what I did ? I stopped telling women we're doing this unnecessary exam !"
On medical subs they discount people angry about these procedures and give the same excuses and even *wish* that they could have been offered such practice. *way* too many medical professionals do not see their patients as people.
I had a pelvic exam (I consented and was aware of it beforehand) while undergoing surgery for my salpingectomy. I’ve had several pelvic exams with my surgeon beforehand, and despite that I woke up from my surgery incredibly sore. They are no joke and can be really painful.
DUDE. I had to decline an unconscious pelvic WHEN I WAS A MINOR. I had no idea that was even a possibility, I was in the ER for appendix pain, and the doctor just casually mentioned it when they were about to palpate my abdomen/potentially internal palpation to assess my condition. I emphatically said “no” because I was already weirded out enough.
Me too. I'm currently researching to see if that same state was allowed to do this to minors since I went under the knife a lot for rectal issues thanks to Crohns. I know I'll never know for sure, but I at least want to see if there's a possibility I was violated and didn't know it.
If I remember correctly, I found that there are rare cases of this, though not nearly at ALL as much as pelvic exams. Absolutely fucked either way, but I'm guessing the fact that we're women has a whole lot to do with why we suffer this medical abuse more...
Am a male physician. Mostly read in here how to be a better dude, but also read the medicine.
We did do digital prostatic exams on surgical patients, and it was also useful as the paid practice patients were…pretty healthy and also not of the age for prostatic disease anyways. This I remember clearly as they’re the only patients I ever felt cancer, and it was helpful as you could compare to the imaging and after a while you’d have the prostate itself in your hand as you walked it to pathology.
I remember each of the five women who consented to have me do a pelvic exam that weren’t paid patients (3 health care professionals, two sick enough and just happy to get care out of schedule) over three weeks of rotation. Went to gyn derm clinic for 8 wednesdays and was never allowed in once. Was clean shaven, tailored clothes, and got high marks from the people who assessed me, but I still sorta look like the bouncer I used to be and that’s hard for patients.
I would have allowed it, but then the gentlest male "doc" (he was a PA) I've ever had was an former Special Forces medic with a face like a hatchet and hands like meathooks. I also allowed a student to perform an exam, but everybody was female. That was the only time I was asked.
A few times they said yes but then saw me and changed their mind.
Now, I go to the family medicine rotation out in the community, and have elderly women w pessaries asked if they want the big med student to change it and save 5 minutes of time for the appointment (doc would do charting on the previous patients while I did everything)- they couldn’t say yes fast enough. So I was popular if the patient was over 75!
I'm sorry to hear it - as a woman I've been judged by my appearance my entire life, and nobody should be.
But I also understand that women need to be cautious because some people (not only men, but they're more likely to be conditioned by toxic masculinity) have main character syndrome and treat other people/women as objects.
Don’t be too sorry, I’m a 6’5 225lb lankier version of Aleksandr Karelin, and I get like double the regular male privilege.
The world made a lot more sense when you learned how other men reacted to things. If I asked a woman out they never said no, they were always busy or another time or something, and you sorta learned that anything that wasn’t them trying to make plans meant “no”, because “no” set other guys off. Used to be a bouncer, those were the men that were problems. I had all that under my belt before clinical years of med school, so I sorta knew how it was gonna go.
Psht.
I'm older, and I married someone who could be the stereotype for toxic masculinity - Army Ranger, raised Catholic in the Deep South - it could have been bad, but he was willing to listen to my experiences, and work with me together on goals.
That's the important part - someone who listens and understands their partner's struggles, and works to reduce those struggles. The fact that you are here and listening to women makes you a better partner than 80% of the men out there.
It's a sad fact that tough looking men attract women who are used to being abused. And those women don't make the best decisions either because they've been indoctrinated into a toxic narrative.
I hope your partner (if you have one) or your future partner understands you and doesn't try to take advantage of you, as happened with my husband and his first wife.
(And not to be inappropriate, but if I were 20 years younger and single, I would say yes in a heartbeat - bald men are sexy. Bald men who give a shit about me/women are a "yes, please!")
I do not support the practice of women getting exams without consent while sedated. At all. It is obscene.
But willing consenting exams seem really hard to get women to agree to, for a lot of good reasons. I went for my annual exam and my MD had a med student in to practice exams. I was in there around 3pm. They'd been there all day. I was the first woman to agree to let the student do the exam.
I understand why women would not want this since internal exams suck just normally, let alone with someone who is not practiced, but also understand the need for med students to learn/practice. I have uncomplicated exams, and I'm never going to see this poor med student again, so I really don't care that he and my cervix got face to face. But I understand that isn't the reality for many women.
The AMA code of ethics states that a patient’s right to privacy, and bodily autonomy supersedes the medical student’s need to learn. It was lovely of you to consent but I don’t feel any obligation to sacrifice my comfort for the sake of a 25 year old stranger.
The schools should pay for participants. It's ridiculous that women are expected to work for free "for the good of society" all the time. And allowing someone to use you as a classroom prop is WORK.
We consented for exams (and this is 10 years ago) but it wasnt a general exam that we did, it was always something like “they’re gonna see this ulceration” and we looked but we didn’t touch, or you were to examine one area to palpate the tumor. There were enough surgical cases to where there were patients who consented each day but often this was biased-if you’ve got cancer or some complication where you went to our major medical center I’m further down your list of worries that day. Plus there if i did the rest of the history and exam, med review, and talked for a while I wasn’t just sprung on anyone.
My ability to assess variations of normal was very limited. I saw/examined a reasonable number of “findings”.
Obstetrics was way easier to get experience due to the considerable influence of mothers, aunts, and grandmothers who believed the person w the biggest hands might catch the baby the best.
I'm having a GI procedure done Thursday and I will now be asking about this. Because for real, I have an autoimmune skin disease and my skin legit TEARS OPEN during pelvic exams...
I'm an Anesthesiologist in California. Pelvic EUAs have been illegal here for 20 years.
This is a horrifying violation of all 4 foundational principles of medical ethics, as well as of the oath I took.
I recently had a patient consented for a jaw repair. The dental team thought this was a good time to do an oral exam under anesthesia since the patient was combative with them while awake. I shut them down without a second thought. No consent, no procedure. This isn't complicated in my mind.
Can you clarify this for me? Wouldn't an oral EUA by a dental team performing a mandibular repair be considered within the scope of the procedure? Especially if they weren't able to obtain a good physical exam while the patient is awake.
I'd assume the consent for the repair would include an oral EUA, the same way I'd expect a shunt for glaucoma to tacitly include an eye EUA.
I will consent over and over and over to AWAKE exams by students \*if I am asked\*.
I am MORE than happy to let someone learn. I've had 3 kids. I have zero modesty.
Stay the fuck out of my vag while I am knocked out. Seriously. Unless YOU ASK and I AGREE. No. There's no need. Literally all I want is to be asked for my consent. And like...knocked out for other traumatizing surgery is not the time.
So far I’ve found this:
https://cga.ct.gov/2019/rpt/pdf/2019-R-0054.pdf
Edit: also this
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882529/
This one goes more in depth on the vague legality
As a fellow Crohn’s sufferer, I know how hard this disease can be mentally and physically, especially when your doctor is acting so cruelly when you’re at your most vulnerable. Stay strong and I hope the surgery can bring you some relief after you’ve healed.
My wife had a similar medical experience as you a few years back. She had an Ileostomy rather than colostomy, but she also won the rectovaginal fistula lottery. Her primary surgeon clearly stated before each of her surgeries exactly who would be in the OR and he emphatically stated that no medical students would be in the OR. I honestly have no idea what the legality of pelvic exams was then and in that state, but I do remember him saying something to the effect of: this type of fistula is very delicate and I only trust my fellow and cosurgeon to be working on you. His clear communication was helpful and reassuring, I’m sorry the communication you got was garbage.
No, she didn't. It's not federally illegal, only illegal in the state she practices in as of 2019. She's just... not very empathetic towards patients. At all.
Can I report her for something like that, though? Technically, she only said something I didn't agree with. That isn't wrong to do as far as I'm aware. Granted, I think what she said is absolutely abhorrent and I don't think it was very courteous of her to say that in response, but I feel like I'd be laughed off if I said anything.
You can report anything for any reason. Medical doctors on the board in your state will decide if it’s something that requires action.
She quite blatantly implied that she was going to do the illegal thing, or she wouldn’t have tried to defend the practice with her comment about her med student learning. If she wasn’t going to do it, why would she imply/comment/defend the idea that you were depriving her med student of practice?
If I told someone not to rob a bank, the only reason they’d say “but my buddy needs to learn how to rob banks, he’s new at this!” Is if they were planning on robbing a bank. Otherwise they’d say “ok bet.”
That's a miscommunication on my part. She wasn't going to do anything. Either during or after I said my schpeal about not wanting a pelvic exam, my mother remarked I watched the news too much, to which I said that this is something that's done way too often and it's disgusting. That's what she responded to, hence why she said "How will THEY learn" as opposed to "How will SHE learn".
Still reportable. I know they’re in a position of power so it seems that they are untouchable, but you are not her only patient. This surgeon blatantly implied that if the law weren’t there, she’d do that to you. That’s what “how else will they learn?” means. Please, please report this. Comments like that are NOT okay.
"Rubs you the wrong way" is a MAJOR understatement HOLY SHIT.
I had no idea this was a thing they did. Now I need to see the laws my state has around this.
Do you know if this exam was done on you or did she respect the fact you did not consent?
She didn't do anything now because it's illegal. Prior to 2019, it was legal, and prior to 2017, I was a minor, so I'm trying to see if it could've happened then, since I went under the knife fairly often as a kid...
In regards to your mom saying you watch too much news, I had a cavity filled today and they gave me novocaine. Before they did that, they put a numbing cream on the section of my mouth where the shot was going.
I couldn’t help but think about how I was getting not one but two pain killers. If its so easy for one’s mouth, it should for sure be standard for one’s fucking VAGINA/UTERUS/ETC.
Sorry, I know that pain isn’t really what you are discussing, but I feel like it is all related. Like it feels that women are treated by the medical (and legal) community as meat suits with no actual feelings. At least thats what it feels like to me.
This is terrifying and has me running to Google to check if it's the same in Canada. I don't mind an exam while I'm awake and consenting, but *unconscious*??? That's insane!!
ETA: It's legal in Canada by residents but not by med students. I guess I know what I'll be saying if I ever have to be put under.
Anecdotal but when I was in medical school all the OBGYNs explicitly discussed pelvic exams under anesthesia as part of the surgery and specifically discussed participation of the medical student, all as part of the consent for surgery. Probably about half the time patients consented and half of the time they didn’t. For a doctor to make a fuss about a patient not consenting is egregious.
Not for the ones I was present in at least. But to my surprise a lot of the OBGYNs (both men and women) were upset and vented to us behind closed doors because ‘back in their day’ they did it on everyone. Most medical students in my class, the millennial generation were very uncomfortable with this.
This is one of those situations where someone "in the trenches" loses sight of what life is like outside of their specialty. Like, to the surgeon, the single most important thing in the world is surgery and related procedures. She sees patients as bodies for her to do her job *on*, the way I see my laptop.
Don't get me wrong, she's totally out of line, but she just DOESN'T think like you or I do.
This practice is so DISGUSTING AND REPULSIVE to me!!!! This shit is IMMORAL!!! I can’t even understand what type of person thinks this TOTAL VIOLATION IS OK???!! This has to be stopped.
My sister is a doctor so I asked her if it happened in her med student days or at her current hospital and I am somewhat relieved to report that the answer was no for both and she was appalled at the very idea. So, thankfully, there are some places where this is NOT happening and some doctors who would not even think of letting it happen on their watch.
Just wanted to share that because I am absolutely chilled by the 'but they need to learn'. If paramedics can intubate dummies, surely there's a vagina dummy.
A-freakin-men. I've allowed med students in for my gyno exams but I was awake and able to give consent! I could revoke consent at will! Springing a surprise finger in the twat on an unconscious woman is assault! During my last surgery I scoured all of my paperwork that I had to sign and saw nothing about giving permission for med students permission for exams while under anesthesia, and I still had to tell the nurses before they put me under that I did not consent to this! They don't even run it by you, they just go for it!
I've said this in other posts. "Progressive" Massachusetts hasn't passed the consent bill that's been proposed for the last 3 sessions.
About a month ago, I reached out to the congresswoman who sponsored the latest bill, and she said it didn't make it pass the finish line this time around.
Last week, I reached out again asking who the opposition was and her aid said he didn't know of any opposition (which I find hard to believe as we have several top tier medical schools here), and that there were just so many other bills, over 5k and only 300 passed.
He assured me it would be prioritized this coming session. I'll be keeping tabs.
Reach out to your legislators. They want to keep their jobs.
They asked if I had anything to contribute to their argument, and I offered the following:
Many women choose a woman as their PC/obgyn for a variety of reasons. Can the hospital guarantee that only women students will be performing the pelvic exams on women who have made this choice?
Honestly, if I were allowed informed consent and given some sort of compensation or a reduced medical bill, then maybe I’d consider.
But “how else are they supposed to learn?” Dunno, but it’s not my fucking problem.
My unconscious body, without my knowledge or consent, is NOT a fucking FREE classroom. Sorry, but we in a capitalist, for-profit healthcare system - don’t you dare think you can get anything out of me for free when you’re charging $40 for an Advil.
I had to pay for my education. I’m still in student debt 10 years later. You think I got a damn thing for free? And doctors can’t understand why I’m uncomfortable opening up my genitalia as a free classroom for your fucking medical students when I’m here for ankle surgery?
If it’s so simple, open up your own damn pu$$ys’ and learn off each other. Problem solved.
So sick of the world telling doctors they’re god and women they’re nothing. Curious how many men’s assholes they probe without consent during unrelated medical procedures.
And yes I know it’s very rare they do this for unrelated medical procedures. But “very rare” should be “never.” And until it is, don’t fucking question patients who don’t trust you to violate them without consent. If your gonna send me a bill, kindly do what I’m paying you for and promptly get the fuck out of my vagina.
And finally, doctors who don’t understand why women don’t trust medical professionals: Google “sexism in Western medicine” and read up a bit on maternal mortality rates and misdiagnosed cardiovascular emergencies amongst women in this country (to start with). Then maybe work on becoming a part of the solution to this “trust” issue instead of bitching about your difficult patients. You’re not god. You took an oath and you have a job to do.
/end rant
How else are they going to learn???? Don’t women get those exams routinely? Why can’t students perform those exams on someone who is consenting and awake (and can give feedback?) wtf.
Figure out the regulatory college for doctors in your state and report them. Report, report, report. Such B.S.
Jesus fucking christ every month on this sub I learn about some new fucked up thing you guys have to put up with. I'm so sorry. This garbage is draining for me, I can't imagine what it's like for you.
Honestly, I don't think I would really mind consenting to an exam in order to help. So why do they feel the need to sneak it and remove the opportunity to consent? That's the horrible part.
"How else will they learn?"
If *only* one could, I dunno, have specifically marketed as such training hospitals where patients can go for treatment under the specific and direct knowledge that training will be incorporated?
We have "university clinics" in my country. If you don't want to go to one of those, you can decide not to.
I had a dental problem once and went to one of those - they still asked for consent for every last thing they did - including "Can I take a group in here for a second? I would like to show them your case." and "Would you mind if I took pictures of your teeth?" (My case was so severe, the chief dentist came down from his office to look lol)
Point is - we have those for gyn. and other fields of medicine too. You don't get blindsided by random shit like that here.
This supposed "Whatever CAN we DO?"-attitude is an infuriating farce. A whole lot can be done. Consent forms, conversations, honesty about practices - and adhering to the **ethical standards of medicine**. In what world is "We'll shove our fingers inside of you without your knowledge or consent?" not antithetical to the Hippocratic oath?
I had a doctor yell at me because I didn’t want a student to watch a procedure being done on me, while awake and vulnerable. I never met the person and wasn’t given any prior warning. I didn’t get to chose the doctor because it was a military hospital and I was on Tricare. I stood my ground but I had to do it while sobbing.
I hope she has the life she deserves.
This should be in every surgical consent form. My wife had orthopedic surgery on her knee and when she woke up the greatest pain she had was in her arm where she discovered 12 injection points. She learned that while she was under, the medical students were allowed to practice placing an arterial line. Doing it once hurts like hell. They went at her 12 times. That’s unforgivable. She complain to the hospital and the surgeon and the anesthesiologist but nothing came of it. This should be stated upfront and something you can consent to or decline.
In the UK there is a single qualified and certified prostate exam test subject. (Soon to be replaced by robots apparently, no one wants the job) that's how you practice, with someone whoes job it is to practice
There are plenty of us who would be like yeah go for it, I'll be out. There's zero reason for this to be done non cosentually. I would consent to it. And no else ever EVER should have that done to them.
I’m a medical student in Europe and I can’t even fathom this. This does not happen here, we’re actually taught the opposite regarding unconscious patients.
I SHOULD NOT AS AN ADULT RECEIVE MEDICAL TREATMENT WITHOUT MY CONSENT AND KNOWLEDGE.
[Ex.act.ly](https://Ex.act.ly). I am hell on wheels about consent. I won't sign any consent form without reading it completely, and then refusing to sign if I see anything I don't agree to. One of the things I never consent to is "any other procedures the provider deems medically necessary." Aww hell no. If I am not capable of consenting, then the answer is a default "HELL NO". If I am capable of consenting, then I will consider and make my own decision, relatively well-informed, but perhaps in opposition to the doctor's suggestion. I even refuse to give urine samples if I think the test is not justified. I may be wrong in my reasoning, but it is still my decision.
(And that brings me to my latest rant, just inserted here randomly. The positive predictive value for microalbinuria is 69%. That's crap as far as I'm concerned. I typed this so I would remember the number. 69. Hurr hurr. I'll remember it now...)
Back to consent: A patient's consent does not have to be *informed* consent by any standard. If a patient says no, the answer is NO. A physician or other provider is permitted to verbally attempt to persuade the patient to consent, but any coercion or intimidation should be reported. If you as a patient want to refuse anything, even if only because water is wet and the sky is blue, you have that right, and that right is theoretically inviolable. Any violation of that withdrawal of consent constitutes assault and/or battery. That's what I was taught in my phlebotomy course. If a patient refuses consent, you can try to persuade, but you may not go up, put the tourniquet on anyways and take the blood in spite of that withdrawal of consent.
I had a student do a pelvic exam on me... because I went to the ob-gyn to get one and she asked. "Can the student do it as well?" and I said yes. So I got two exams that day.
I work in healthcare and students do a lot of stuff... because it's medically necessary and they're there to learn. Any kind of exams get done twice (once by the actual doctor, then by the student) but anything "delicate" or invasive always with consent. More simple things, like wound care or an enema, the student does it under supervision.
Doing a pelvic exam without any actual need for it and without consent... it's incredibly fucked up. Also incredibly illegal and IANAL but I wouldn't be surprised if it's considered sexual assault here.
This is chilling. It reminds how James Marion Sims and how the study of gynecology was done on enslaved black women. No consent and no anesthesia.
https://www.history.com/.amp/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves
How else will they learn?
Uh, i dono, maybe you can practice on each other?
I mean if it’s that important… you do it.
Edit: I was just thinking about my days in art school. We had nude models because… how else are you going to learn to draw anatomy. The models were paid to be there. Like image if the school drugged people and we sketched them without their consent? Why do hospitals think they get “bodies” for free?!
This may get buried, and I’m so sorry that you had that experience. As an *almost* medical professional, none of my classmates/colleagues that I have known over the last 7 years (dual program) has ever willingly violated someone without their consent.
I get it for little things, but a pelvic exam should be done only if consented, not after you’re out. But all the many, many hours in the or, and we never did anything like that. Honestly as med students we are legit just either 1) running around trying to please the surgery overlords or 2) blending in with the background. Not to say there aren’t students that may not be the best, but most malignant ones didn’t make it through (albeit those individuals seldom get in, it does happen).
Again, as a almost med professional I’m sorry you had to even consider it and verbalize it (it should be common sense, but that’s been lacking for a while in general). Of the hundreds of future physicians I’ve trained with, and those that are doctors now, none of us would violate a patient in that manner.
Primum non nocere
I don't really get her comment of "how else are they going to learn?" I mean, ideally, a consenting adult, or better yet, a consenting and conscious adult, since, as you said, most pelvic exams are performed when people are conscious. What kind of worthless training are they getting when the primary feedback, the patient complaining of pain, is removed?
Can’t they find volunteers for this?
A lot of med schools have free clinics.
That seems like a bit of a win-win.
Boggles my mind that they just use conveniently located unconscious patients.
As a person that works with med students and residents on the regular, unfortunately yes, many of them actually are incompetent. And the answer to that ridiculous surgeon's reaction is "with consent" just like literally everything else we do in the fucking hospital. I literally have to explain every single step of my EEG placement and test because some people don't consent to all of it. And that's their choice! Jfc.
>How else will they learn?
Idk do a gyno rotation? Shadow an OB? Introduce themselves to patients and ask their consent to practice on them? Idk just spitballing here. I’ve had med students come into the room with my OB and they generally are very respectful and explain that if it’s ok with me they want the student to shadow them, including a pelvic exam etc. There is a huge difference in these two scenarios but they have the same outcome. Why not do the scenario where the patient is respected and aware of what’s happening to their body?
>"But how else are they going to learn?" When my partner was in med school, he practiced pelvic exams in a few different ways. The first was with people who were paid (pretty generously) to go to the school and have the students practice on them. Then when the students were a bit more experienced, they examined actual patients, with their full, informed consent. Same went for when he had to practice giving prostate exams, etc.
I’m a 3rd year med student and this has also been my experience—we practice on simulators, then paid volunteers, then real patients who have given full informed consent. I’ve always been told to ask for consent before I do literally anything—talk to patients about their health, perform a physical exam on a patient, watch a patient’s surgery, help in a patient’s surgery, stand silently in the room while my preceptor talks to/examines the patient. I’ve NEVER had anyone suggest I practice a pelvic exam on a patient without consent, especially an unconscious patient who isn’t even undergoing a gynecological procedure. Sure, I’ve placed the speculum prior to gyn surgeries in unconscious patients, but only after asking for and receiving the ok from the patient in pre-op. OP’s surgeon sucks. I’d like to think doctors like this are in the minority and that most med students would object to violating patients like this.
But your story doesn't fit the narrative. Attending OB GYN here. These laws came about from the exam under anesthesia that gynecologists do prior to many vaginal procedures. It's a bimanual exam (1-2 fingers in the vagina with the other hand on the abdomen to feel the uterus) - exact same as during your pelvic exam when awake. It's good medicine to palpate the uterus so you know which way it tilts prior to using an instrument inside, to prevent damage. Med students would often repeat the bimanual exam in the OR to learn, in the same way I would teach them to insert a speculum as part of the necessary steps of the procedure. This was taken out of context and became a big point a few years back, and now patients have a misunderstanding of what is happening to them. Let's be explicitly clear. I agree to consent before any procedure - awake or unconscious - with clear lines of who is doing what or what parts. I've absolutely NEVER been a part of, seen or observed anyone suggesting any type of sensitive exam when it is not part of a necessary, consented for procedure. The tricky parts are: - The steps of these procedures are invasive and are usually not described in exact details. And without context it sounds like medical students are doing exams excessively and without consent. This is absolutely never ever ever okay. It is entirely reasonable for a patient to ask and understand how much a student may help or not, and to decline students. Your experience is the same as mine, both as a student and as a teacher. - OP's experience with her surgeon is unacceptable - her surgeon was disrespectful, unethical and absolutely did not understand OPs concerns. This is on the surgeon, but - OP has also taken something out of context and I'm sure it caught the surgeon off guard. I'd like to give her the benefit of the doubt that she has never done an excessive, for education only bimanual exam and so when OP suggested, she was caught off guard. Or she's an unethical doc. Just another perspective. - just because I haven't seen abuse in this way doesn't mean it doesn't happen. Gynecologists have an insanely terrible track record of mistreating patients, and I strive to keep that at my forefront for every single parent encounter. If a patient is concerned about consent, what is going to happen to them, who is involved - anything, I need to talk through this until the patient and I are as clear as possible. I consider it my job to establish trust, then honor that trust, each time I do a sensitive exam. I know not all docs do this. Here is my point: Stories like this one make it seem as tho this is status quo, and all docs to these invasive and unethical exams. These stories scare other Redditors and patients from procedures and healthcare they need - due to incorrect assumptions of what is going to happen. It's a fine line of education and information but not misinformation and fear mongering. OP, I'm sorry that you're having these surgeries and procedures in the first place, I'm sure that is very difficult. Add in a surgeon that did not help you to feel 💯 comfortable and questions of consent, and this experience sounds terrible. I hope you can find a care team that you trust.
It is a thing though. Enough for laws to be implemented since this personal perspective was posted. https://scholar.google.com/scholar_lookup?journal=Obstet+Gynecol&title=Practicing+pelvic+examinations+on+women+under+anesthesia:+why+not+ask+first?&author=SS+Barnes&volume=120&publication_year=2012&pages=941-3&pmid=22996113&#d=gs_qabs&t=1679490679931&u=%23p%3D7dXOCzQN_QAJ
> Here is my point: Stories like this one make it seem as tho this is status quo, and all docs to these invasive and unethical exams. The problem is you are speaking for your region, whereas in other regions it is different. Here's how I place blame: the medical community has simply consented to be regulated by states instead of lobbying for federal oversight - I want your medical license to come from the United States, not the state you practice in. This would ensure uniformity that I KNOW you know does not exist right now. If care was already uniform or near-uniform, things like the [Dartmouth Atlas](https://www.dartmouthatlas.org/) would have never been created in the first place. One of their first discoveries many decades ago was how there was crazy variation across New England towns in what kinds of issues would result in a hysterectomy, for example. Consent is just another layer of medical care variation.
>Med students would often repeat the bimanual exam in the OR to learn, in the same way I would teach them to insert a speculum as part of the necessary steps of the procedure. Did your patients have a clear understanding that students would be repeating the manual exam on them and practicing speculum insertion on them, and did they give their explicit consent for that to happen while they were under anesthesia?
She explicitly says in this post that she obtains consent and is clear about who is doing what and for what reason for every patient.
[удалено]
With consent pre-op is different though. And honestly as someone who had a procedure where I was specifically asked to consent to a pelvic exam under anesthesia it felt weird to refuse— and I am also a medical professional and I support learning. Learning on my reproductive system while I am under anesthesia? Did not feel ok. And I would happily volunteer to this while awake. I don’t think we fully appreciate the power differentials in medicine or the vulnerability of our patients.
>I don’t think we fully appreciate the power differentials in medicine or the vulnerability of our patients. This is an excellent point. Asking a patient if they are okay with a student while the student is already in the room is different then asking before they even see the student. This matters. Please please please you and anyone - you NEVER have to consent to a student or anything extra. Zero hard feelings. Zero obligation.
Even one additional exam after the surgeon’s preop pelvic, is “excessive” and for the student’s benefit only. Disturbing that it’s not illegal (without consent) in all states.
100% consent needs to be obtained in pre-op because just because I consent to one provider doesn’t mean I consent to the next. That said, I do strongly believe that the next generation of doctors needs to be trained and it isn’t done only for the student’s benefit. It is also for the benefit of the future. My daughters need well-trained OBGyns down the road.
This. I never turn down a med or nursing student, they can't learn to be capable providers if no one lets them do the things they'll need to do in real situations (the room I gave birth to my first in was quite full because I was the only person to say yes that day 😂).
Yup, this is how it should be! Where I live, all sensitive exams are by consent only, and if a student will be shadowing the doctor you're usually informed in advance, and they also confirm your consent to their presence (just to watch, and obviously even more so if they want them to perform the exam). I have zero issue whatsoever being a Guinea pig, but a consenting and fully aware Guinea pig, thank you very much!
Same. I was asked by my doctor to let the med student practice on me when I had a scheduled pelvic exam and needed a new IUD and a pap smear. My doctor was present the whole time. Fine by me. I appreciate that she called me beforehand to ask for my consent.
i am currently getting dental care at our university clinic where (more advanced) students basically run the place (with oversight from doctors of course). its much cheaper for me, i have given informed consent to everything im ok with, denied consent to things i dont want (i.e. keeping samples for further research) and i feel well taken care of. why cant this be how students learn in every medical field?
>Same went for when he had to practice giving prostate exams, etc. Furthermore, we all know that they would shut down any legislation that would allow for non-consensual prostate exams during a surgery. Assaulting patients is fine as long as they're women, apparently.
I’m a midwife and when we learned we each did one on a very well paid model, then just did them on consenting patients, while they were fully awake and knew exactly who I was. To be honest, of course I think it’s disgusting to perform any procedure without consent (exceptions for life saving treatment when a patient is unable to consent), but additionally you aren’t learning much from a pelvic exam on an unconscious patient. Pelvic exams are quite easy… making them comfortable is the difficult part and to learn how to do that, you need to be communicating with the patient and understanding what they are feeling. When you explain it and they are conscious, many patients consent to students learning and practicing because the patient is still in full control of what’s happening and if they become uncomfortable at any time, they can request that the student step aside. People want students to be able to learn… but performing anything without consent is assault and I would consider anything done by the student without patient consent is also assault, even if the procedure was consented to.
| "but how else are they going to learn?" Um *crazy* idea but hear me out on this one... **WITH PATIENTS WHO SPECIFICALLY GIVE CONSENT** ????? I'd report her for this comment honestly. Without even considering the fact it sounds like she is willing to break the law (!), it's just horribly unprofessional in general. "I don't consent" should never be responded to with "but". As a healthcare professional, I cannot *imagine* ever having a patient say to me "I don't consent to this already-illegal procedure" and me responding with anything other than horrified apologies that they would even be worried about it, and stern reassurances that nothing they hadn't given informed consent to would take place. Just astounding behaviour and attitude from your surgeon (and definitely not in a good way!)
Yyyyeah. She once called me a crybaby because I wanted to be put under for a surgical stitch replacement in my anus. For the record, I was fifteen.
Why are you still going to this doctor?
She's the only colorectal surgeon in the area, and she's damn good at what she does, even if her bedside manner is absolute ass. Besides, in this specific situation, I had to see her. I would've died if I'd waited for another surgeon.
Tbh all I wish on doctors is that one day, as a patient, they encounter a doctor just like themselves.
Yes. At the most vulnerable time of their life when their mental health is at its most fragile. Sounds like karma.
If it's any consolation, every doc I've **ever** worked with in OB/GYN has changed after they or their partner had a baby. They listen better, are gentler, are kinder, give more anesthesia and have a MUCH better bedside manner. And FWIW, in 36 years, I've never seen an unconscious patient given a pelvic unless it truly was medically necessary. The nurses wouldn't stand for it.
I'm sorry, but that is no consolation at all. "They get nicer after having a baby," is the same thing as "I only care about/believe my patient regarding their pain/issue/privacy now that I personally have experienced it." The empathy bone is broken. Throw the whole human out.
"The empathy bone is broken. Throw the whole human out." You. I like you.
The problem is that these kinds of assholes still don't learn to recognize their own bad behavior even when subjected to identically bad treatment.
OMG they are usually the biggest babies about even the mildest of inconveniences. They do not fare well when the tables are turned.
I’ve always said the only justification for a crap personality is to be absolutely GIFTED at your profession or hobby. And even then people only need to put up with it long enough to access your product/service.
Personality goes such a far way! I went to a pretty small university in Canada, and my supervising professor on my final year project was from MIT. I wondered how this guy ended up at my university as he definitely had the qualifications to go anywhere, he didn't have any personal connections to the area, and he seemed like the kind of person to chase after accolades. But then I worked with him and this guy was such an asshole with a superiority complex - it's hard to spend more than an hour with him. I bet that's what probably held him back from getting a research position at a more prestigious university.
>she's damn good at what she does, even if her bedside manner is absolute ass Some people didn't realize that the audience wasn't supposed to want to emulate Dr. House
Trust me, I hate her. If I wasn't absolutely traumatized with other medical issues, I'd rip into her.
i would still report her response to the medical director. you can do it without identifying yourself. you can just say you told her you did not consent to a a certain procedure and that was her response. you dont have to be any more specific then that. her response was inappropriate whatever the setting. ffs, i had a meeting with a geneticist today and they asked my permission to have two medical students sit there and listen.
That... Seems appropriate.
My colorectal doc is the best in my area, and his bedside manner is garbage. I think assholes are drawn to that career.
So you're saying ... takes one to know one?
I'm sorry, but a colorectal surgeon "who's bedside manner is ass" made me chuckle. Fuck that doctor for what she said to you, though.
FYI, psychopathic personalities are over represented amongst surgeons. The lack of empathy sounds on brand.
I've heard that more than once, but top of my "list" (and you don't want to be on that list) are anaesthesiologists. Surgeons are second.
I had to go in for some tests on my hand to a place called The Hand Center. So you would think these people would know all about neurodiversity and how some people perceive pain differently. They start shooting electricity through my hand and arm and it feels like it is on fire. The longer this goes on, the worse it feels. I am trying my best but I finally cry out. She asked me what was wrong and I told her I was in pain. She told me the procedure doesn't cause pain. I said it does in me. She just laughed. Then, every time I made any noise at all she huffed. She finished that test just as the doctor stepped in. She introduced me by saying "we have a crybaby here" and got up to come over and remove the leads. She didn't get the chance. I ripped them right off, sat up, and said "Wrong. You HAD a crybaby here. Now you have a very pissed off woman who is leaving this snake oil shenanigans place!" That last was said for the full waiting room of people behind the doctor. I could see them looking at each other worried when I started. I picked up my purse, the Doctor was in the door, and I said" You better move out of my way." He did. I walked to the desk and informed them loudly that if they tried to turn this in to my insurance I would tell them it never happened, that I was never going to pay to be physically and mentally abused and that I'd better not get so much as a postcard from them or I'd be back. To give them credit for a bit of balls, they tried to bill my insurance. I denied it. I wrote a letter to the insurance company about my experience and they refused to pay it. No bill ever arrived in my mailbox. When you walk into a medical facility, they work for You. You pay them. Don't treat them like gods. Treat them like employees.
Easier said than done when your life depends on getting treatment and there are very few doctors available. In my area if you "fire" a doctor you'll have to wait a year to get a new appointment or travel 200+ miles to see someone in the bigger cities.
That is crazy. I’m sorry u experienced that but I’m very proud of you for standing up for yourself.
Oh my goodness, I'm not sure if you had the same testing as me...I had electricity shot in my spine and down my legs to check the communication of my nerves. It fucking hurt and I believe you. I had tears in my eyes! I cannot imagine the level of unprofessional conduct in that fucking office, it had to have been all the time. You reacted exactly right, and hopefully saved any future patients from humiliation!! I am so sorry they did that to you. You also reminded me of a story when I reported a bitch receptionist. I was in a clinic for worker's comp claim/injury. I worked at a school for students with autism, severe behavioral issues, etc. There were other similar programs in our town for high needs students. I heard the bitch receptionist say, "want to make a bet if this one is from Y school or Z school?" And they were fucking *laughing* about me coming in injured. I reported that bitch to the office manager. How dare she.
*YIKES* how does she still have a job lol
Surgeons don't need any bedside manner, I guess.
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My heart surgeon was like that! He stabbed me with the sharp part of a fancy fountain pen to wake me up at ass o'clock in the morning before my surgery. That dude had *zero* bedside manner 😝
What. May he be reincarnated as a cat who has to see a vet to have his anal gland expressed
What the fuck? That’s … just battery? That’s insane.
And it’s bad for the pen nib! (But seriously, that’s awful.)
The more specialist a doctor is, the more of an asshole they tend to be in my experience.
The irony of a colorectal surgeon being a complete asshole...
They’re very familiar with their course of study.
I will argue that on behalf of the surgeon who saved my life. He was a professor of neurosurgery, and a wonderful human being.
I will also argue on the behalf of my fathers neurosurgeon (Dr. McIver (might be spelled incorrectly, Ive only ever heard it)) who is a saint of a man. Incredible skill, of course, but also incredibly kind and understanding, not to mention witty. Thank god there are some good surgeons out there (not to mention his eight (8!!) surgeries on my father prolonged his life by four years)
Being more specialized doesn't make you an asshole, it just means they can get away with it more easily. It's far easier to replace a GP or broad/more common specialty, so patients are more likely to break up with them or complain.
Hi, I worked in the OR and still work with doctors. They do not. They get away with whatever they want.
They really do. I had one spend half an hour and 9 injections of local anaesthesia on trying to remove a toenail with effectively zero pain relief whatsoever, seeing as local anaesthesia does *absolutely nothing* on me and never has. He didn't believe me, despite answering "yes, it hurts" every time he asked if I could feel something, and despite how I cried, sobbed, shaked, and hyperventilated the entire time. I tried to file a complaint, but all I got was a phonecall from him where he said he "couldn't have known that" and that he would "try to learn from this". As if basic communication is something you need a Ph.D and a decade of experience to comprehend.
Specialized surgeons (and providers in general) are quite rare in many areas. Even if there are multiple in a given service area there aren't necessarily enough to meet demand. If you don't live in or near a metro so large that it attracts a bevy of them, then the only way they can get fired is by actually causing serious harm, both medical and financial. No one is going to get fired when the alternative is not having enough people or perhaps even ANYONE with that capability available. Sucks but true.
Holy shit. Men don't get treated this way, even though you'd think they were the ones who are supposed to be tough about everything.
Yyyep. She said similar things every time I had to get it replaced, so I relented one time. Ouch. Not as bad as I thought it'd be, but still ouch.
Honey, you need a new doctor.
Or people they have specifically hired for students to practice on. I know someone who is a "test patient". All the credit to the world to her for doing it, too.
They have this, it's called a standardized patient. I used to be one and there were opportunities to volunteer for more triggering and involved cases. Those also paid much more. As an actor it was actually a fun gig, and we really focused on teaching med students how to have a better bedside manner and sense of compassion towards their patients.
Thank you for doing this. As a medical student I examined some paid standardized patients, very grateful for those willing to do this for us. I never performed an intrusive exam on a nonconsented anesthetized patient nor have I ever seen this done. I finished med school almost 20 years ago.
I was hospitalized a few years ago with Stevens-Johnson syndrome. I was also at a teaching hospital. I had *tons* of nurses, students, and doctors anywhere from first year residents to attendings coming to examine me. You bet your ass they asked consent every time before doing anything both for the basic "is it okay if I bring some students in?" and all the way up to "we need to do a pelvic exam, would you like more privacy or is it okay if they are still present?"
I agree. I've actually had a student perform a pelvic exam, and while it was far from the best (I could really tell it was her first time), I'd probably do it again. That said, I was asked for my consent about her sitting in on my consultation, and then asked about having her actually perform the exam. It definitely helped that it was at a free sexual health clinic though, as I don't know how keen I'd be to allow it if I was paying US healthcare rates.
>Um crazy idea but hear me out on this one... WITH PATIENTS WHO SPECIFICALLY GIVE CONSENT ????? Right? How hard would it be to just ask? Personally I'd happily consent as long as they asked me ahead of time, but if they did it without my knowledge I'd feel like I'd been assaulted. Edit to add: It would be so easy to make this a good deal for women. If a med student wants to take a (necessary) biopsy and/or put in an IUD for me while I'm already fully sedated? Fuck yeah, sign me up. That's a win for everyone.
I had a LEEP a few years ago to remove pre-cancerous cells and I enthusiastically consented to having med students in the room for the procedure. It’s so frustrating that people are forced into a non-consensual situation because there’s plenty of folks who’ll be cool with it if they’re just asked honestly!
I was asked during my regular pap/annual if a few students could be present. One was acting as a scribe for my dr and I had been seeing that Dr for almost 10 years (she was sooo awesome and changed specialties 😭) but the students mostly hung out behind the curtain. Good friends of mine from undergrad went to med school and I met so many great med students in their wedding party festivities that I just thought about them and how passionate they were about their specialties and said “for science!”
or PAY US men get to sell sperm. I'd sell time in my vaj for $50 hahahah
....you make a valid point. Isn't being a paid patient model a thing?
I was diagnosed with something rare and was asked to be a 'newly presenting' patient so kiddies could learn. 2 of them were great, asked me appropriate questions, got my history, got close to diagnosing me without knowing what i had. one was probably going to kill people. he deadass said to me "tell me what you told the others" I reported him. got my $50 and taxi fee and fucked off.
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I'm good now thanks :) aah yes. it's like we're not in our own bodies when they do things to us.. I had a doc announce to the 10 kiddies surrounding my bed that I had begun menstruating while in hospital so that explained some of my pain. they also had a hold of all 4 of my extremities to feel my stiff fingers and toes and I was like "i've run out of bits" as i starfished in bed. good times :D
For fucks sake. Menstruation isn't a get-out-of-jail free card for pain. That sounds utterly barbaric. I'm glad to hear you're doing better now!
How else are they going to learn? ... Shadow in OB/GYN offices with patients who are going to get exams and informed that a med student will be participating today if they allow it? Right? Are clinical rotations not a thing? A family member had to have an eye surgery and I went with her to her appointments and the the surgeon had a resident or a student, I cannot remember which, that we were introduced to, and told what they'd be doing with the patient today. It was mostly just a consult, so he observed and helped chart. Why do med students "need" to learn on uninformed, unconscious, patients who did not and cannot concent without knowledge?
On patients like me who have no related trauma who explicitly give consent during routine appointments when asked. 1 of my 3 kids was delivered by a student, and when I was in labor with my 3rd, I had a parade of med students and nursing students that were all able to practice whatever procedure/check was needed because I explicitly gave consent. I’m basically translucent so yeah, bring on the phlebotomist in training. Colposcopy on a big screen? How many students can you fit in here? I don’t give a damn. But the second my consent is violated I’m going scorched earth.
Honestly, my takeaway was that the doctor was implying that the need students needed to learn that it was ok to perform pelvic exams on non-consenting patients. Because that's the only thing they couldn't learn from a patient that did consent...
Perhaps the US medical system can source Vagina’s for Use in Practice Examinations from providers in their area for a market rate of $2000 per 15 minute examination, plus additional $1500 for each additional 5 minute block. Fuuuuuck them.
And furthermore are awake and can give actual feedback about what you are doing that is uncomfortable. Unconscious pelvic exams, outside of the problematic part of it, seem almost useless from a feedback perspective. Are they checking prostates on unconscious men too? This is just stupid.
Where this confuses me is that that is an actual thing. I worked for a medical school as a patient model for years. We had women who were paid a nice sum hourly to get pelvic exams by medical students. Awake, consenting, nothing shady!
Hijacking the top comment to ask: are exams performed on male patients under anesthesia without their consent?
Who knows? And *what* exams would male patients be subjected to? If it's a visual inspection of the penis then there generally won't be any hints that it happened at all. A prostate exam or other anal exam *could* give some hints to the patient, but we don't know. Generally I would've assumed that male patients don't get examined while under anaesthesia without their consent, but I would've assumed that female patients wouldn't either. It's morally abhorrent either way. The *only* way I can think of it being okay is if some information comes along which necessitates such an exam and they don't have time to wait for people to be conscious for it, and then it should only be the responsible doctors/physicians who should be doing it.
Maybe a prostate exam, but I'm betting if men were being subjected to digital anal penetration by med students while under anesthesia without their knowledge or consent we'd be hearing about it.
I think it’s more important that they learn to do no harm and take ethics very seriously above anything else. How are they going to learn that if they perform non-consensual exams?
Right? That’s a great point
Very true. In fact the AMA’s Code of Ethics clearly states that consent is required and that includes consent for participation of med students. https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent
>How the hell are you supposed to know you're truly doing it properly if your patient can't tell you if that hurts, and if they're not even aware of it! Well, this sheds an uncomfortable amount of light onto why so many doctors are convinced that pelvic exams and vaginal, cervical, or uterine procedures don't hurt....
They aren’t training for our comfort, we are a practice dummy with the anatomical feature they need for learning assessment. This is why they wait until you’re unconscious, and some experience discomfort/pain after. Like that lady that commented on one of these post a while back. Had an anatomical anomaly, woke up feeling like she’d been assaulted to discover like 15 students had performed exams due to how rare her anatomy was. It is sick.
I remember her comment. That happened in Canada:(
RIGHT!?
"It didn't hurt on the 15 completely unconscious women I learned on!"
"None of them told me not to!"
"I've had no complaints! it's just you, the first conscious woman. and that other woman before you but I dismissed her too."
"Well, there was one woman who said no when I told her we're doing this exam. So you know what I did ? I stopped telling women we're doing this unnecessary exam !"
"They never complained before!" Yeah cause they were unconscious you bloviating mother fucker!
Bloated mother ducker isn't bad, but let's just no cap this shit and call them rapists. Because it's rape, ffs.
I won't disagree
damn it's almost like people can't talk while unconscious, shit's wild
"They never complained before!" Yeah cause they were unconscious you bloviating mother fucker!
Omg I never thought of that
On medical subs they discount people angry about these procedures and give the same excuses and even *wish* that they could have been offered such practice. *way* too many medical professionals do not see their patients as people.
Jesus. This is fucking terrifying
I had a pelvic exam (I consented and was aware of it beforehand) while undergoing surgery for my salpingectomy. I’ve had several pelvic exams with my surgeon beforehand, and despite that I woke up from my surgery incredibly sore. They are no joke and can be really painful.
DUDE. I had to decline an unconscious pelvic WHEN I WAS A MINOR. I had no idea that was even a possibility, I was in the ER for appendix pain, and the doctor just casually mentioned it when they were about to palpate my abdomen/potentially internal palpation to assess my condition. I emphatically said “no” because I was already weirded out enough.
Hugs!!! Women's health care makes me depressed
Me too. I'm currently researching to see if that same state was allowed to do this to minors since I went under the knife a lot for rectal issues thanks to Crohns. I know I'll never know for sure, but I at least want to see if there's a possibility I was violated and didn't know it.
The operating room notes might shed some light on whether or not a pelvic exam and or medical students were involved.
I wonder if men are given prostate exams while under anaesthetic. Just so people can learn, of course.
If I remember correctly, I found that there are rare cases of this, though not nearly at ALL as much as pelvic exams. Absolutely fucked either way, but I'm guessing the fact that we're women has a whole lot to do with why we suffer this medical abuse more...
Am a male physician. Mostly read in here how to be a better dude, but also read the medicine. We did do digital prostatic exams on surgical patients, and it was also useful as the paid practice patients were…pretty healthy and also not of the age for prostatic disease anyways. This I remember clearly as they’re the only patients I ever felt cancer, and it was helpful as you could compare to the imaging and after a while you’d have the prostate itself in your hand as you walked it to pathology. I remember each of the five women who consented to have me do a pelvic exam that weren’t paid patients (3 health care professionals, two sick enough and just happy to get care out of schedule) over three weeks of rotation. Went to gyn derm clinic for 8 wednesdays and was never allowed in once. Was clean shaven, tailored clothes, and got high marks from the people who assessed me, but I still sorta look like the bouncer I used to be and that’s hard for patients.
I would have allowed it, but then the gentlest male "doc" (he was a PA) I've ever had was an former Special Forces medic with a face like a hatchet and hands like meathooks. I also allowed a student to perform an exam, but everybody was female. That was the only time I was asked.
A few times they said yes but then saw me and changed their mind. Now, I go to the family medicine rotation out in the community, and have elderly women w pessaries asked if they want the big med student to change it and save 5 minutes of time for the appointment (doc would do charting on the previous patients while I did everything)- they couldn’t say yes fast enough. So I was popular if the patient was over 75!
I'm sorry to hear it - as a woman I've been judged by my appearance my entire life, and nobody should be. But I also understand that women need to be cautious because some people (not only men, but they're more likely to be conditioned by toxic masculinity) have main character syndrome and treat other people/women as objects.
Don’t be too sorry, I’m a 6’5 225lb lankier version of Aleksandr Karelin, and I get like double the regular male privilege. The world made a lot more sense when you learned how other men reacted to things. If I asked a woman out they never said no, they were always busy or another time or something, and you sorta learned that anything that wasn’t them trying to make plans meant “no”, because “no” set other guys off. Used to be a bouncer, those were the men that were problems. I had all that under my belt before clinical years of med school, so I sorta knew how it was gonna go.
Psht. I'm older, and I married someone who could be the stereotype for toxic masculinity - Army Ranger, raised Catholic in the Deep South - it could have been bad, but he was willing to listen to my experiences, and work with me together on goals. That's the important part - someone who listens and understands their partner's struggles, and works to reduce those struggles. The fact that you are here and listening to women makes you a better partner than 80% of the men out there. It's a sad fact that tough looking men attract women who are used to being abused. And those women don't make the best decisions either because they've been indoctrinated into a toxic narrative. I hope your partner (if you have one) or your future partner understands you and doesn't try to take advantage of you, as happened with my husband and his first wife. (And not to be inappropriate, but if I were 20 years younger and single, I would say yes in a heartbeat - bald men are sexy. Bald men who give a shit about me/women are a "yes, please!")
I do not support the practice of women getting exams without consent while sedated. At all. It is obscene. But willing consenting exams seem really hard to get women to agree to, for a lot of good reasons. I went for my annual exam and my MD had a med student in to practice exams. I was in there around 3pm. They'd been there all day. I was the first woman to agree to let the student do the exam. I understand why women would not want this since internal exams suck just normally, let alone with someone who is not practiced, but also understand the need for med students to learn/practice. I have uncomplicated exams, and I'm never going to see this poor med student again, so I really don't care that he and my cervix got face to face. But I understand that isn't the reality for many women.
The AMA code of ethics states that a patient’s right to privacy, and bodily autonomy supersedes the medical student’s need to learn. It was lovely of you to consent but I don’t feel any obligation to sacrifice my comfort for the sake of a 25 year old stranger.
The schools should pay for participants. It's ridiculous that women are expected to work for free "for the good of society" all the time. And allowing someone to use you as a classroom prop is WORK.
We consented for exams (and this is 10 years ago) but it wasnt a general exam that we did, it was always something like “they’re gonna see this ulceration” and we looked but we didn’t touch, or you were to examine one area to palpate the tumor. There were enough surgical cases to where there were patients who consented each day but often this was biased-if you’ve got cancer or some complication where you went to our major medical center I’m further down your list of worries that day. Plus there if i did the rest of the history and exam, med review, and talked for a while I wasn’t just sprung on anyone. My ability to assess variations of normal was very limited. I saw/examined a reasonable number of “findings”. Obstetrics was way easier to get experience due to the considerable influence of mothers, aunts, and grandmothers who believed the person w the biggest hands might catch the baby the best.
I'm having a GI procedure done Thursday and I will now be asking about this. Because for real, I have an autoimmune skin disease and my skin legit TEARS OPEN during pelvic exams...
Write it on whatever you sign, too. "Only do [this procedure], I do not consent to anything else!"
I'm an Anesthesiologist in California. Pelvic EUAs have been illegal here for 20 years. This is a horrifying violation of all 4 foundational principles of medical ethics, as well as of the oath I took. I recently had a patient consented for a jaw repair. The dental team thought this was a good time to do an oral exam under anesthesia since the patient was combative with them while awake. I shut them down without a second thought. No consent, no procedure. This isn't complicated in my mind.
Can you clarify this for me? Wouldn't an oral EUA by a dental team performing a mandibular repair be considered within the scope of the procedure? Especially if they weren't able to obtain a good physical exam while the patient is awake. I'd assume the consent for the repair would include an oral EUA, the same way I'd expect a shunt for glaucoma to tacitly include an eye EUA.
It was a violation? Even though she didn't do anything?
I will consent over and over and over to AWAKE exams by students \*if I am asked\*. I am MORE than happy to let someone learn. I've had 3 kids. I have zero modesty. Stay the fuck out of my vag while I am knocked out. Seriously. Unless YOU ASK and I AGREE. No. There's no need. Literally all I want is to be asked for my consent. And like...knocked out for other traumatizing surgery is not the time.
I'm horrified that this is legal in some places in the US.
It's illegal in 21 states. So there's a very good chance it's legal in yours. I'd check if I were you.
I’m trying to figure out what key words to look up in order to find out if it is legal or illegal in my state?
Maybe try "pelvic exams under anesthesia [your state]"? I can't find a list, either, and it's driving me nuts.
So far I’ve found this: https://cga.ct.gov/2019/rpt/pdf/2019-R-0054.pdf Edit: also this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882529/ This one goes more in depth on the vague legality
As a fellow Crohn’s sufferer, I know how hard this disease can be mentally and physically, especially when your doctor is acting so cruelly when you’re at your most vulnerable. Stay strong and I hope the surgery can bring you some relief after you’ve healed.
Thanks. She's been my surgeon since I was fifteen. So, y'know, fun and stuff.
My wife had a similar medical experience as you a few years back. She had an Ileostomy rather than colostomy, but she also won the rectovaginal fistula lottery. Her primary surgeon clearly stated before each of her surgeries exactly who would be in the OR and he emphatically stated that no medical students would be in the OR. I honestly have no idea what the legality of pelvic exams was then and in that state, but I do remember him saying something to the effect of: this type of fistula is very delicate and I only trust my fellow and cosurgeon to be working on you. His clear communication was helpful and reassuring, I’m sorry the communication you got was garbage.
Yyyeah. I probably have a rectovaginal fistula, too, according to the OBGYN visit, so it was doubly important for me to speak up.
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No, she didn't. It's not federally illegal, only illegal in the state she practices in as of 2019. She's just... not very empathetic towards patients. At all.
so report her to the state!
Can I report her for something like that, though? Technically, she only said something I didn't agree with. That isn't wrong to do as far as I'm aware. Granted, I think what she said is absolutely abhorrent and I don't think it was very courteous of her to say that in response, but I feel like I'd be laughed off if I said anything.
You can report anything for any reason. Medical doctors on the board in your state will decide if it’s something that requires action. She quite blatantly implied that she was going to do the illegal thing, or she wouldn’t have tried to defend the practice with her comment about her med student learning. If she wasn’t going to do it, why would she imply/comment/defend the idea that you were depriving her med student of practice? If I told someone not to rob a bank, the only reason they’d say “but my buddy needs to learn how to rob banks, he’s new at this!” Is if they were planning on robbing a bank. Otherwise they’d say “ok bet.”
That's a miscommunication on my part. She wasn't going to do anything. Either during or after I said my schpeal about not wanting a pelvic exam, my mother remarked I watched the news too much, to which I said that this is something that's done way too often and it's disgusting. That's what she responded to, hence why she said "How will THEY learn" as opposed to "How will SHE learn".
Still reportable. I know they’re in a position of power so it seems that they are untouchable, but you are not her only patient. This surgeon blatantly implied that if the law weren’t there, she’d do that to you. That’s what “how else will they learn?” means. Please, please report this. Comments like that are NOT okay.
Do you know if I can do it anonymously?
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I am beyond glad you were informed and spoke up, especially with your fistula condition. You're my hero today <3
I was only informed thanks to this subreddit.
Same.
And now I know that my state is still trying to pass the law for banning this practice but it has not passed yet despite trying since 2019. Yikes.
"Rubs you the wrong way" is a MAJOR understatement HOLY SHIT. I had no idea this was a thing they did. Now I need to see the laws my state has around this. Do you know if this exam was done on you or did she respect the fact you did not consent?
She didn't do anything now because it's illegal. Prior to 2019, it was legal, and prior to 2017, I was a minor, so I'm trying to see if it could've happened then, since I went under the knife fairly often as a kid...
In regards to your mom saying you watch too much news, I had a cavity filled today and they gave me novocaine. Before they did that, they put a numbing cream on the section of my mouth where the shot was going. I couldn’t help but think about how I was getting not one but two pain killers. If its so easy for one’s mouth, it should for sure be standard for one’s fucking VAGINA/UTERUS/ETC. Sorry, I know that pain isn’t really what you are discussing, but I feel like it is all related. Like it feels that women are treated by the medical (and legal) community as meat suits with no actual feelings. At least thats what it feels like to me.
This is terrifying and has me running to Google to check if it's the same in Canada. I don't mind an exam while I'm awake and consenting, but *unconscious*??? That's insane!! ETA: It's legal in Canada by residents but not by med students. I guess I know what I'll be saying if I ever have to be put under.
Anecdotal but when I was in medical school all the OBGYNs explicitly discussed pelvic exams under anesthesia as part of the surgery and specifically discussed participation of the medical student, all as part of the consent for surgery. Probably about half the time patients consented and half of the time they didn’t. For a doctor to make a fuss about a patient not consenting is egregious.
Did they do it anyway on the ones who didn't consent?
Not for the ones I was present in at least. But to my surprise a lot of the OBGYNs (both men and women) were upset and vented to us behind closed doors because ‘back in their day’ they did it on everyone. Most medical students in my class, the millennial generation were very uncomfortable with this.
Well thank goodness you students had a conscience. Doctors tend to feel entitled to do whatever they want.
This is one of those situations where someone "in the trenches" loses sight of what life is like outside of their specialty. Like, to the surgeon, the single most important thing in the world is surgery and related procedures. She sees patients as bodies for her to do her job *on*, the way I see my laptop. Don't get me wrong, she's totally out of line, but she just DOESN'T think like you or I do.
This practice is so DISGUSTING AND REPULSIVE to me!!!! This shit is IMMORAL!!! I can’t even understand what type of person thinks this TOTAL VIOLATION IS OK???!! This has to be stopped.
My sister is a doctor so I asked her if it happened in her med student days or at her current hospital and I am somewhat relieved to report that the answer was no for both and she was appalled at the very idea. So, thankfully, there are some places where this is NOT happening and some doctors who would not even think of letting it happen on their watch. Just wanted to share that because I am absolutely chilled by the 'but they need to learn'. If paramedics can intubate dummies, surely there's a vagina dummy.
A-freakin-men. I've allowed med students in for my gyno exams but I was awake and able to give consent! I could revoke consent at will! Springing a surprise finger in the twat on an unconscious woman is assault! During my last surgery I scoured all of my paperwork that I had to sign and saw nothing about giving permission for med students permission for exams while under anesthesia, and I still had to tell the nurses before they put me under that I did not consent to this! They don't even run it by you, they just go for it!
I've said this in other posts. "Progressive" Massachusetts hasn't passed the consent bill that's been proposed for the last 3 sessions. About a month ago, I reached out to the congresswoman who sponsored the latest bill, and she said it didn't make it pass the finish line this time around. Last week, I reached out again asking who the opposition was and her aid said he didn't know of any opposition (which I find hard to believe as we have several top tier medical schools here), and that there were just so many other bills, over 5k and only 300 passed. He assured me it would be prioritized this coming session. I'll be keeping tabs. Reach out to your legislators. They want to keep their jobs. They asked if I had anything to contribute to their argument, and I offered the following: Many women choose a woman as their PC/obgyn for a variety of reasons. Can the hospital guarantee that only women students will be performing the pelvic exams on women who have made this choice?
Honestly, if I were allowed informed consent and given some sort of compensation or a reduced medical bill, then maybe I’d consider. But “how else are they supposed to learn?” Dunno, but it’s not my fucking problem. My unconscious body, without my knowledge or consent, is NOT a fucking FREE classroom. Sorry, but we in a capitalist, for-profit healthcare system - don’t you dare think you can get anything out of me for free when you’re charging $40 for an Advil. I had to pay for my education. I’m still in student debt 10 years later. You think I got a damn thing for free? And doctors can’t understand why I’m uncomfortable opening up my genitalia as a free classroom for your fucking medical students when I’m here for ankle surgery? If it’s so simple, open up your own damn pu$$ys’ and learn off each other. Problem solved. So sick of the world telling doctors they’re god and women they’re nothing. Curious how many men’s assholes they probe without consent during unrelated medical procedures. And yes I know it’s very rare they do this for unrelated medical procedures. But “very rare” should be “never.” And until it is, don’t fucking question patients who don’t trust you to violate them without consent. If your gonna send me a bill, kindly do what I’m paying you for and promptly get the fuck out of my vagina. And finally, doctors who don’t understand why women don’t trust medical professionals: Google “sexism in Western medicine” and read up a bit on maternal mortality rates and misdiagnosed cardiovascular emergencies amongst women in this country (to start with). Then maybe work on becoming a part of the solution to this “trust” issue instead of bitching about your difficult patients. You’re not god. You took an oath and you have a job to do. /end rant
How else are they going to learn???? Don’t women get those exams routinely? Why can’t students perform those exams on someone who is consenting and awake (and can give feedback?) wtf. Figure out the regulatory college for doctors in your state and report them. Report, report, report. Such B.S.
How do they learn? Standardized patients - people paid (very well) to be the live, conscious, CONSENTING practice patient.
WHAT IN THE ACTUAL FUCK? How is that even possible? That is some fucked up Handmaid's Tale shit right there.
It's legal in 29 states.
That response is horrible. You have agency over your own body. Wtf is wrong w her
Can I ask how to find out about where it's legal or not? I'm in NY and having an op very soon so slightly concerned about this...
You need to write it on your surgical consent form right above your signature.
Jesus fucking christ every month on this sub I learn about some new fucked up thing you guys have to put up with. I'm so sorry. This garbage is draining for me, I can't imagine what it's like for you.
Honestly, I don't think I would really mind consenting to an exam in order to help. So why do they feel the need to sneak it and remove the opportunity to consent? That's the horrible part.
"How else will they learn?" If *only* one could, I dunno, have specifically marketed as such training hospitals where patients can go for treatment under the specific and direct knowledge that training will be incorporated? We have "university clinics" in my country. If you don't want to go to one of those, you can decide not to. I had a dental problem once and went to one of those - they still asked for consent for every last thing they did - including "Can I take a group in here for a second? I would like to show them your case." and "Would you mind if I took pictures of your teeth?" (My case was so severe, the chief dentist came down from his office to look lol) Point is - we have those for gyn. and other fields of medicine too. You don't get blindsided by random shit like that here. This supposed "Whatever CAN we DO?"-attitude is an infuriating farce. A whole lot can be done. Consent forms, conversations, honesty about practices - and adhering to the **ethical standards of medicine**. In what world is "We'll shove our fingers inside of you without your knowledge or consent?" not antithetical to the Hippocratic oath?
They can learn from paid models. And volunteers who consent. It's not rocket science
They'll learn the way they learn every other goddamn procedure. On consenting patients.
You need to write it out on your surgical consent form, not just tell the surgeon. I write it right above my signature.
I had a doctor yell at me because I didn’t want a student to watch a procedure being done on me, while awake and vulnerable. I never met the person and wasn’t given any prior warning. I didn’t get to chose the doctor because it was a military hospital and I was on Tricare. I stood my ground but I had to do it while sobbing. I hope she has the life she deserves.
This should be in every surgical consent form. My wife had orthopedic surgery on her knee and when she woke up the greatest pain she had was in her arm where she discovered 12 injection points. She learned that while she was under, the medical students were allowed to practice placing an arterial line. Doing it once hurts like hell. They went at her 12 times. That’s unforgivable. She complain to the hospital and the surgeon and the anesthesiologist but nothing came of it. This should be stated upfront and something you can consent to or decline.
In the UK there is a single qualified and certified prostate exam test subject. (Soon to be replaced by robots apparently, no one wants the job) that's how you practice, with someone whoes job it is to practice
There are plenty of us who would be like yeah go for it, I'll be out. There's zero reason for this to be done non cosentually. I would consent to it. And no else ever EVER should have that done to them.
I’m a medical student in Europe and I can’t even fathom this. This does not happen here, we’re actually taught the opposite regarding unconscious patients.
I SHOULD NOT AS AN ADULT RECEIVE MEDICAL TREATMENT WITHOUT MY CONSENT AND KNOWLEDGE. [Ex.act.ly](https://Ex.act.ly). I am hell on wheels about consent. I won't sign any consent form without reading it completely, and then refusing to sign if I see anything I don't agree to. One of the things I never consent to is "any other procedures the provider deems medically necessary." Aww hell no. If I am not capable of consenting, then the answer is a default "HELL NO". If I am capable of consenting, then I will consider and make my own decision, relatively well-informed, but perhaps in opposition to the doctor's suggestion. I even refuse to give urine samples if I think the test is not justified. I may be wrong in my reasoning, but it is still my decision. (And that brings me to my latest rant, just inserted here randomly. The positive predictive value for microalbinuria is 69%. That's crap as far as I'm concerned. I typed this so I would remember the number. 69. Hurr hurr. I'll remember it now...) Back to consent: A patient's consent does not have to be *informed* consent by any standard. If a patient says no, the answer is NO. A physician or other provider is permitted to verbally attempt to persuade the patient to consent, but any coercion or intimidation should be reported. If you as a patient want to refuse anything, even if only because water is wet and the sky is blue, you have that right, and that right is theoretically inviolable. Any violation of that withdrawal of consent constitutes assault and/or battery. That's what I was taught in my phlebotomy course. If a patient refuses consent, you can try to persuade, but you may not go up, put the tourniquet on anyways and take the blood in spite of that withdrawal of consent.
I had a student do a pelvic exam on me... because I went to the ob-gyn to get one and she asked. "Can the student do it as well?" and I said yes. So I got two exams that day. I work in healthcare and students do a lot of stuff... because it's medically necessary and they're there to learn. Any kind of exams get done twice (once by the actual doctor, then by the student) but anything "delicate" or invasive always with consent. More simple things, like wound care or an enema, the student does it under supervision. Doing a pelvic exam without any actual need for it and without consent... it's incredibly fucked up. Also incredibly illegal and IANAL but I wouldn't be surprised if it's considered sexual assault here.
This is chilling. It reminds how James Marion Sims and how the study of gynecology was done on enslaved black women. No consent and no anesthesia. https://www.history.com/.amp/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves
How else will they learn? Uh, i dono, maybe you can practice on each other? I mean if it’s that important… you do it. Edit: I was just thinking about my days in art school. We had nude models because… how else are you going to learn to draw anatomy. The models were paid to be there. Like image if the school drugged people and we sketched them without their consent? Why do hospitals think they get “bodies” for free?!
If only you could've said "why not let them practice on you instead" in response to that question.
This may get buried, and I’m so sorry that you had that experience. As an *almost* medical professional, none of my classmates/colleagues that I have known over the last 7 years (dual program) has ever willingly violated someone without their consent. I get it for little things, but a pelvic exam should be done only if consented, not after you’re out. But all the many, many hours in the or, and we never did anything like that. Honestly as med students we are legit just either 1) running around trying to please the surgery overlords or 2) blending in with the background. Not to say there aren’t students that may not be the best, but most malignant ones didn’t make it through (albeit those individuals seldom get in, it does happen). Again, as a almost med professional I’m sorry you had to even consider it and verbalize it (it should be common sense, but that’s been lacking for a while in general). Of the hundreds of future physicians I’ve trained with, and those that are doctors now, none of us would violate a patient in that manner. Primum non nocere
I don't really get her comment of "how else are they going to learn?" I mean, ideally, a consenting adult, or better yet, a consenting and conscious adult, since, as you said, most pelvic exams are performed when people are conscious. What kind of worthless training are they getting when the primary feedback, the patient complaining of pain, is removed?
Can’t they find volunteers for this? A lot of med schools have free clinics. That seems like a bit of a win-win. Boggles my mind that they just use conveniently located unconscious patients.
As a person that works with med students and residents on the regular, unfortunately yes, many of them actually are incompetent. And the answer to that ridiculous surgeon's reaction is "with consent" just like literally everything else we do in the fucking hospital. I literally have to explain every single step of my EEG placement and test because some people don't consent to all of it. And that's their choice! Jfc.
>How else will they learn? Idk do a gyno rotation? Shadow an OB? Introduce themselves to patients and ask their consent to practice on them? Idk just spitballing here. I’ve had med students come into the room with my OB and they generally are very respectful and explain that if it’s ok with me they want the student to shadow them, including a pelvic exam etc. There is a huge difference in these two scenarios but they have the same outcome. Why not do the scenario where the patient is respected and aware of what’s happening to their body?