Can you opt out of classmates doing physicals on you?

[420 blaze it]

I heard from a 4th year that when we learn PEs in first year, we pair up with a same-sex classmate and do them on each other. Basically I am uncomfortable with this and dread having even physicians examine me (and don't even consent to allowing midlevels to do so) so the thought of a classmate doing so is horrifying. Basically I had back acne and it has subsided but it left a lot of keloid scars on my entire back. I really don't want to "suck it up" but I'm not sure if somehow I signed or agreed to something in the technical standards that mandates I have to have them performed on me in order to pass. can I?

---

Members don't see this ad.

 

[deleted763299]

I really don't want to "suck it up" but I'm not sure if somehow I signed or agreed to something in the technical standards that mandates I have to have them performed on me in order to pass

This question really can only be answered definitively by someone at your school. However, it is unlikely that you absolutely must allow your peers to examine you.

a lot of keloid scars on my entire back

It is understandable that you would be self-conscious about this, so a request to your school that your peers not examine your back would likely be seen as very reasonable. However, is there a similar reason that you would not want your classmates performing an orthopedic exam on your knee for example? Testing your reflexes? Looking into your ears with an otoscope? You will, in all likelihood, still be practicing your physical examination skills on your classmates. I would encourage you to be flexible in allowing your classmates to examine you in at least some ways, in which you are more comfortable.

 

[Warderino92]

Probably a question best for your schools administration since every schools policies are different.

 

[psychhopefull2016]

A girl at my school wears hijab and was not forced to have people practice on her.

 

[Entadus]

You're that ashamed of some scars? Remember that you're not the body; you are the everlasting omnipresent soul. Why should your skin define you? Work on your self-esteem!

(For the record I have the same thing; it's a non-issue)

"It's the body (the universe/God/evolution/etc) gave me."

 

[psychhopefull2016]

You're that ashamed of some scars? Remember that you're not the body; you are the everlasting omnipresent soul. Why should your skin define you? Work on your self-esteem!

(For the record I have the same thing; it's a non-issue)

"It's the body (the universe/God/evolution/etc) gave me."

I had terrible acne in high school and there are no photos of me that exist for 3 years because I would not let people photograph me. Telling someone to stop being uncomfortable does little to actually make them less uncomfortable.

 

[TheBDP]

I had terrible acne in high school and there are no photos of me that exist for 3 years because I would not let people photograph me. Telling someone to stop being uncomfortable does little to actually make them less uncomfortable.

Your question has been answered. Talk to your school about deferring the aspects of PE that have to do with looking at/touching your back. Otherwise don't deprive your classmates of their education and let them look in your ears, etc.

 

[420 blaze it]

Ok, thanks guys. I didn't realize the PE was learned in sections and for some reason thought it would be a comprehensive exam from the start... I will plan on opting out of only whats necessary becasue I don't care about for example the abdomen or ears

 

[FindMeOnTheLinks]

Honestly when you practice with your classmates, you can probably just wear a T-shirt and keep it on. Structures on the back and shoulders are easily palpable through a t-shirt. Technically you are supposed to remove the shirt in order to auscultate directly on the skin, but when you are with your classmates it's informal and you can still hear what you need to with the shirt on. In fact when practicing with my classmates I don't remember ever taking my shirt off completely.

My biggest advice is to just not make a big deal of it. You are going to be subjected to things that are wayyyy more uncomfortable than this (though in different ways). Try it out, see how it goes. It might not be as bad as you think. If it is, then go talk to someone. But don't start off being the guy who makes a fuss before you even know what's gonna happen. It's better to just do things the right way rather than try to wiggle your way out of it and let it get all awkward. I.e. You're practicing PE in partners, when it comes time for your partner to palpate your spine or sternum or whatever, you say "sorry I don't feel comfortable with that, can you please do it on somebody else." Your partner then will have to awkwardly ask another group of he can jump in, while you are awkwardly standing off to the side watching and doing nothing. That situation sounds way worse to me than to have somebody see the acne scars on my back. (Yes I also had/still have pretty bad bacne, so I know your pain).


Sent from my iPhone using SDN mobile

 

[tick_tock400]

Just opt out. Shouldn't be a big deal. People opted out at my school last year and it was no biggie, but I'm guessing more than a few students and faculty had problems using students as practice patients. Now they're using standardized patients for all of our practice-test-taking this year.

 

[cbrons]

Ofc with how much med school costs, PE learning should be taking place on volunteer or paid standardized patients.

Sent from my SM-N910P using SDN mobile

 

[TBV]

Ofc with how much med school costs, PE learning should be taking place on volunteer or paid standardized patients.

Sent from my SM-N910P using SDN mobile

It was at my school and then practiced on real patients

 

[AMEHigh]

Ofc with how much med school costs, PE learning should be taking place on volunteer or paid standardized patients.

Sent from my SM-N910P using SDN mobile

They are using volunteers....those volunteers are fellow med students!

And OP, just FYI, when we practiced on each other for some exam skills we remained fully clothed and didn't have to examine skin or anything like that. So if it's scars on your back you are worried about, no one would need to see that if you're not comfortable with it.

 

[Donald Juan]

At my school any practicing with each other was informal and leaving clothes on was perfectly ok other than the rectal and vaginal exams. For clinical testing and the more formal practice sessions we always used standardized patients.

 

[Warderino92]

We learn ultrasound starting from year 1 and integrate it into our curriculum, for example first semester it's apart of anatomy, second semester physiology, etc. it was never required to make anyone take their shirt off and lay on the table but we had more than enough volunteers from the class willing to do so.

 

[Goro]

Interesting. At my school a similar student wanted only female classmates to examine her and was told no.

A girl at my school wears hijab and was not forced to have people practice on her.

 

[cbrons]

Interesting. At my school a similar student wanted only female classmates to examine her and was told no.

That could get the school in legal trouble.

Frankly, I don't know why they still have school-run sessions where medical students are encouraged to practice on each other, especially given today's legal environment.

And with the cost of tuition, there is really is no excuse for the school not seeking outside volunteers or paid SPs. Schools should prioritize student comfort over cost-savings...

almost said that last sentence without laughing.

 

[FCMike11]

I heard from a 4th year that when we learn PEs in first year, we pair up with a same-sex classmate and do them on each other. Basically I am uncomfortable with this and dread having even physicians examine me (and don't even consent to allowing midlevels to do so) so the thought of a classmate doing so is horrifying. Basically I had back acne and it has subsided but it left a lot of keloid scars on my entire back. I really don't want to "suck it up" but I'm not sure if somehow I signed or agreed to something in the technical standards that mandates I have to have them performed on me in order to pass. can I?

Midlevels?

?

Sent from my Nexus 6P using SDN mobile

 

[420 blaze it]

Midlevels?

?

Sent from my Nexus 6P using SDN mobile

the future overlords of our profession

 

[FCMike11]

the future overlords of our profession

I know that brother, just seemed odd "I don't let them examine me." Just didn't understand, but it's personal.

Sent from my Nexus 6P using SDN mobile

 

[420 blaze it]

I know that brother, just seemed odd "I don't let them examine me." Just didn't understand, but it's personal.

Sent from my Nexus 6P using SDN mobile

i just dont feel like midlevels are at the same level as physicians are, so i dont feel comfortable letting them examine something that i'm self conscious about. just like someone wanting a lawyer to handle a sensitive case rather than a paralegal

 

[Phloston]

I heard from a 4th year that when we learn PEs in first year, we pair up with a same-sex classmate and do them on each other. Basically I am uncomfortable with this and dread having even physicians examine me (and don't even consent to allowing midlevels to do so) so the thought of a classmate doing so is horrifying. Basically I had back acne and it has subsided but it left a lot of keloid scars on my entire back. I really don't want to "suck it up" but I'm not sure if somehow I signed or agreed to something in the technical standards that mandates I have to have them performed on me in order to pass. can I?

Of course you can reject examinations on you. You don't lose your autonomy just because you're a student.

That being said I rejected having my eye dilated for practice fundoscopy probably five times during rotations and would say, 'I do not consent to being examined.' The bluntness was meant to be a half-joke, but once you say it no one can object. Seriously, if you don't want to be examined just say no.

 

[Psai]

Interesting. At my school a similar student wanted only female classmates to examine her

 

[ThoracicGuy]

Interesting. At my school a similar student wanted only female classmates to examine her and was told no.

If only I could have requested female only examiners...

 

[Goro]

It's odd because even when a lawyer drives by our school, the Administration usually ducks under their desks, like in the movies of old nuclear test drills.

That could get the school in legal trouble.

Frankly, I don't know why they still have school-run sessions where medical students are encouraged to practice on each other, especially given today's legal environment..

 

[girlofgrace7]

At my med school, we learned each area separately. Any area that could be considered "sensitive," we didn't perform on each other. We did head and neck exams as well as neuro exams on one another and we learned blood draws on each other, but other than that, we had SPs (including for heart/lung exams). Clothing was never removed and exams never involved touching uncomfortable areas. That said, DOs usually wear sport bras (for girls) and shorts for their manipulation sessions on each other.

 

[Mad Jack]

My classmates and I had all sorts of interesting weird **** going on here and there. You learn things from the flaws people have. I was all nervous about it at first, but really, you stop caring. It's just a PE. Ask to be excused from it if you'd like, but honestly it's something that'd probably help you on a personal level to get over.

 

[prettylittlebird]

Your question has been answered. Talk to your school about deferring the aspects of PE that have to do with looking at/touching your back. Otherwise don't deprive your classmates of their education and let them look in your ears, etc.

ffs it is NOT OPs job to educate his/her classmates in any way. Are you trying to guilt them into feeling like they're depriving someone else of an education because they have the very reasonable desire of not wanting to be examined by their peers? It's ridiculous that this is an expectation. I have no body image issues but I wouldn't let a classmate examine me during a school-scheduled practice exam unless you were paying me as an SP or I specifically volunteered for an event in which basic exam skills (stethoscope etc.) were being taught.

 

[Mad Jack]

ffs it is NOT OPs job to educate his/her classmates in any way. Are you trying to guilt them into feeling like they're depriving someone else of an education because they have the very reasonable desire of not wanting to be examined by their peers? It's ridiculous that this is an expectation. I have no body image issues but I wouldn't let a classmate examine me during a school-scheduled practice exam unless you were paying me as an SP or I specifically volunteered for an event in which basic exam skills (stethoscope etc.) were being taught.

Traditionally it kind of is. Medicine is very much a field of tradition, and much of what trainee physicians learn is on one another, as it has been for far longer than you have been alive. That you expect standardized patients (a relatively new learning tool that has only been around for a few decades and is used in a very limited capacity by most schools) to be your only source of physical exam practice and that you believe you owe nothing to your fellow students speaks very much to the entitlement mentality of millennials ("we deserve everything better, without sacrifice, and through as little work of our own as possible ").

 

[ortnakas]

My classmates and I had all sorts of interesting weird **** going on here and there. You learn things from the flaws people have. I was all nervous about it at first, but really, you stop caring. It's just a PE. Ask to be excused from it if you'd like, but honestly it's something that'd probably help you on a personal level to get over.

Participation is mandatory in H&P and OMM at my school, too. Not sure what would happen if anyone ever had strong objections to participating. (I know a few people who wanted to avoid a few specific techniques/maneuvers/etc and flew under the radar without being made to act as "patient," but you wouldn't get away with that if you were never participating at all).

 

[HuskyBabe]

This reminds me of an incident from my first year. My school has students build on our physical exam skills every week, so we often practice on each other. This one week we had gotten to the part where you listen to the femoral artery and palpate the inguinal nodes. One of our "non-clinical" preceptors told us that we needed to change into gowns and take everything off except our underwear and our bras. Literally our entire group looked at her and was like, "No, that's not happening." I'm sorry but my classmates are not palpating my groin while I lay on the table in my underwear. Thankfully they all felt the same and needless to say every stayed in their pants

So the moral of the story is that some stuff you're gonna have to give a little because the best people to practice on (besides patient instructors) is each other. But if there's a part that makes you really uncomfortable for some reason, just tell them upfront and explain why. No one should be forced to have to remove clothing for practice


Sent from my iPhone using SDN mobile app

 

[futuremdforme]

At my school any practicing with each other was informal and leaving clothes on was perfectly ok other than the rectal and vaginal exams. For clinical testing and the more formal practice sessions we always used standardized patients.

Are you saying you didn't do rectal exams or that you had to remove clothes...?

 

[TheBDP]

ffs it is NOT OPs job to educate his/her classmates in any way. Are you trying to guilt them into feeling like they're depriving someone else of an education because they have the very reasonable desire of not wanting to be examined by their peers? It's ridiculous that this is an expectation. I have no body image issues but I wouldn't let a classmate examine me during a school-scheduled practice exam unless you were paying me as an SP or I specifically volunteered for an event in which basic exam skills (stethoscope etc.) were being taught.

Damn, Gina I was just voicing my opinion. And yeah actually if my classmate deferred literally every exam opportunity I might get a little mad. I understand it for certain things such as body issues, which I acknowledged in my previous post. Get up out my face.

 

[HelpPleaseMD]

This reminds me of an incident from my first year. My school has students build on our physical exam skills every week, so we often practice on each other. This one week we had gotten to the part where you listen to the femoral artery and palpate the inguinal nodes. One of our "non-clinical" preceptors told us that we needed to change into gowns and take everything off except our underwear and our bras. Literally our entire group looked at her and was like, "No, that's not happening." I'm sorry but my classmates are not palpating my groin while I lay on the table in my underwear. Thankfully they all felt the same and needless to say every stayed in their pants

So the moral of the story is that some stuff you're gonna have to give a little because the best people to practice on (besides patient instructors) is each other. But if there's a part that makes you really uncomfortable for some reason, just tell them upfront and explain why. No one should be forced to have to remove clothing for practice


Sent from my iPhone using SDN mobile app

and they thought this was a good idea.. lol

 

[StrongIslandDoc]

I have some pretty graphic tattoos on my back and torso including one across my lower abdomen with arrows pointing to my groin saying "The Legend" - I love volunteering for the PE lol

 

[Promethean]

It is a good reminder of how it feels for many patients whose conditions cause them to have to endure our examinations of their bodies.

Also, it sounds as if this is something that is troubling enough to you that it is impairing your life. Maybe it is worth talking with someone about it, like therapy. Maybe you don't have to feel so uncomfortable about your own body.

At the very least, talking with a therapist might get you a letter to support your reason for not wanting to have someone examine you. If it is a substantiated issue, it may be more accommodated than if the school just thinks you are being difficult or whatever.

 

[StrongIslandDoc]

I feel really fortunate that my school afforded us the opportunity to learn these skills on actual patients

I don't think one precludes the other. It's good to practice before hand so you can learn more meaningfully from a patient without flying blind on an empty tank.

 

[ortnakas]

You should be examining real patients with the guidance of a practiced physician. That's all you need. It's not magic.

Not arguing, just honestly curious-- your school had you learn physical exam skills on real patients in the pre-clinical years?

 

[prettylittlebird]

Damn, Gina I was just voicing my opinion. And yeah actually if my classmate deferred literally every exam opportunity I might get a little mad. I understand it for certain things such as body issues, which I acknowledged in my previous post. Get up out my face.

It doesn't really matter if you'd get a little mad about not being able to practice on your classmates. It's the responsibility of the school to provide an education for their students, not for students to be responsible for the learning of their peers.
Also, dude, you're voicing your opinion on an internet forum...sometimes people disagree with you. I'm not getting my knickers in a twist over it

 

[prettylittlebird]

Traditionally it kind of is. Medicine is very much a field of tradition, and much of what trainee physicians learn is on one another, as it has been for far longer than you have been alive. That you expect standardized patients (a relatively new learning tool that has only been around for a few decades and is used in a very limited capacity by most schools) to be your only source of physical exam practice and that you believe you owe nothing to your fellow students speaks very much to the entitlement mentality of millennials ("we deserve everything better, without sacrifice, and through as little work of our own as possible ").

I disagree. Traditionally there are a lot of things about medicine that are changing for the better and I think this is one of those areas. Medical schools are not non-profits, they are businesses that provide a service. They educate future doctors. It is ridiculous for them to expect students to practice on each other without providing an alternative. I'm not saying that I don't practice with classmates that I'm close with or that I wouldn't go over, say, cranial nerve exams with a friend who was struggling with them if I felt particularly confident in that area but honestly a trained SP is going to be better at teaching this than I am anyway and should be the primary source. My school has an excellent clinical skills program that they put a lot of thought and effort into and I think this is one of the reasons why students from my school are very well prepared when it comes to rotations. Learning on a fellow student simply does not compare and I see no reason why other schools shouldn't have similar programs. Please do not assume that because I believe that schools should be required to provide the resources needed to teach necessary skills that means I also believe I "owe nothing to [my] fellow students" because this is not true and using the tired argument about "the entitlement mentality of millennials" is a cheap way to try and discredit my thoughts on this matter. Expectations do not equal entitlement. If I assumed my school would serve up SPs for me on a silver platter any time I wanted to practice my clinical skills on someone that would be entitled. Expecting that my school, which I pay a significant amount to attend, educates me on a very important competency that is required for my training as a physician...that is not entitlement.

 

[VA Hopeful Dr]

Yup. The only exception was special SP sessions for the GU exams, and some random days where we would go like to the eye clinic and practice retinal exams on each other.

For our regular clinical skills class:
We were paired in groups for 3-4 with a faculty preceptor. That faculty would take us to the hospital and we would see and examine real patients together on a biweekly basis.

We had both - one afternoon/week for like 2 months of organ system-based physical exams learned on a standardized patient, then twice a month in the hospital with a physician doing full H&Ps head to toe on actual sick people.

I'd be pretty pissed off paying 40-50k/year to learn exam skills on my classmates...

 

[psychhopefull2016]

We had both - one afternoon/week for like 2 months of organ system-based physical exams learned on a standardized patient, then twice a month in the hospital with a physician doing full H&Ps head to toe on actual sick people.

I'd be pretty pissed off paying 40-50k/year to learn exam skills on my classmates...

We did skills on SPs, real patients, and each other in 3 different sessions

 

[Stagg737]

At my school any practicing with each other was informal and leaving clothes on was perfectly ok other than the rectal and vaginal exams. For clinical testing and the more formal practice sessions we always used standardized patients.

I think this thread is about doing practice exams on each other in lab, not after dinner under the sheets...

 

[TheBDP]

It doesn't really matter if you'd get a little mad about not being able to practice on your classmates. It's the responsibility of the school to provide an education for their students, not for students to be responsible for the learning of their peers.
Also, dude, you're voicing your opinion on an internet forum...sometimes people disagree with you. I'm not getting my knickers in a twist over it

Fair enough, I just think it might make it easier if someone didnt opt out of the whole exam for one issue. To each their own. And dude, I don't really have my knickers in a twist. I was trying to be funny and I failed as I usually do.

 

[Pepe18]

.

 

[420 blaze it]

I'm not saying this in an argumentative way and I know this applies to only a few people and that I sound really dramatic: Med school should not be your therapy session and just because someone looks like they stop caring, doesn't mean they do. I'm one of last people you'd think would have a problem if you met me in person, but I made this account specifically to message a certain user about navigating this issue. I have a visible medical history and I only just started wearing tee-shirts in public for the first time in 7 years. I know it's a problem and it is something I've been working on, but you don't get over it by being put in an uncomfortable situation that you aren't prepared for. There are probably people who don't choose to opt out and they have to manage the mental health consequences on top of all their school work. Heck, there could even be sexual assault victims who feel too uncomfortable to make a fuss and then have to deal with an intense discomfort. And anyone who has any kind of medical history shouldn't be put in the awkward position of either sucking it up and revealing their history to the class or making a big administrative hassle of rearranging partners/groups since you're not participating. Again, this doesn't effect the majority of people, but it's kind of an unnecessary problem

With DO schools, you know what you are signing up for. But with MD schools, I don't really see why we can't simply have the people who want to volunteer, volunteer and those who don't, don't have to. It would also be a lot more useful if we were practicing on someone who could tell us if we're doing things right as well.

That being said, @420 blaze it I had absolutely no trouble opting out. The course director did not ask invasive questions and he made arrangements for me

thanks Pepe