Does practicing the physical exam on your classmates make you feel uncomfortable

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Or, you could save a whole student's tuition and just stop being a baby.

Your learning experience sucks because you're not participating. How shocking. I didn't go to path lab because the specimens look gross! Somehow I didn't learn what they look like! What the hell!

How is feeling uncomfortable about something make me "a baby"? I never said I refused to participate, threw tantrums in class about it, or that I ever raised any objections outside of my own head (and this thread). It's rather closed-minded to say that being uncomfortable stripping down and touching your classmates is "being a baby". I would say it's rather normal, and would venture a guess that the majority of your patients will be uncomfortable when they're sitting in your office in their underwear getting ready to be examined by you. Will they also be acting like babies?

And I'm not entirely sure why my school needs to go to efforts to "save a whole student's tuition", when that tuition would be going towards educational matters--isn't that why I'm paying it? My school is not expanding (even if they were, we have donors for that), our lecturers are MDs or PhDs who do not get paid a single additional cent to teach us. I guess I'd rather they use that tuition for an educational tool like standardized patients as opposed to doing something as invaluable as paying for the 20th employee of the Testing Office to run scantrons and pick up attendance sheets.

:thumbup:
How are standardized patients any more "patients" than your classmates? Mind going through your reasoning there?

1) They are strangers. My classmates are peers who I see every day, 5 days per week for the last 14 months, and for the next three years. I study with them, have small-group with them, sit next to them in lecture. You treat them differently, approach them differently, and look at them differently than you do someone you've never met (e.g., a patient)

2) They at least try to mimic a clinical scenario, presenting with a problem, and are equipped with the ability to give you feedback. While it's far from an actual clinical encounter, it's a hell of a lot closer than doing this all on my classmate.

I'm with you dude. People are so quick to say "Get over it" and "Everyone is doing it and in the same position" but it really is different strokes for different folks. I used to be about 75 pounds overweight for the majority of my life and even though I'm at a "normal" weight now, I'm unhappy with my body image and worry about things like this. I know I'm going to have to get over it at SOME point and not worry what other people think, but I don't think I should be forced to get over it in a medical school classroom.

It's a huge psychological barrier to lose 75 pounds, yet still have pseudogynecomastia, excess skin and stretch marks from a time when I didn't really grasp proper nutrition. I lift weights, I exercise daily, I eat right now, but my body won't let me forget how I used to treat it. I'm a pretty outgoing guy too and am not embarrassed by much, but when it comes to taking my shirt off in front of peers, it's a huge deal for me.

So before anyone really wants to say suck it up, I say think twice. I may have to get over my body image issues, but it won't be easy. Just think if you had to face one of your biggest fears in front of a group of people.

inb4 cut, not bulk

Yeah, same here. I was an overweight kid, "normal" weight now. Unfortunately, when you grow up or spend a good chunk of time being self-conscious about your body, that stuff makes a mark, it sticks with you and does not just magically disappear if you've changed physically. I don't think people realize that it's fairly insensitive to say **** like "get over it" when it's something that makes people uncomfortable, especially in modern Western society, when weight and body image is a tremendous issue for the majority of the population, and asking them to strip down can potentially be a significant struggle for anyone.

Aside from any personal body image issues, those of us who just aren't "touchy" people experience discomfort with so much touching of someone you know personally. Okay, that's fine, this is something I might just have to get used to. I get it. But the fact remains that, if standardized patients were used to resolve other issues, this would not have to be something anyone would have to deal with in the first place.

But, like I said, even those of my classmates who are extreme extroverts, gym rats, and have seemingly endless amounts of self-confidence talk about how much they dread and dislike these sessions. It seems like a fairly universal thing to me.

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I think it's totally inappropriate to practice certain types of physical exams on classmates... I can understand bp or pulse, but anything that involves drapping is too much. I KNOW how it feels to be a patient, I've been to a doctor many times, I don't need to learn that at all. I am SO glad my school does not do that. We have SPs who WANT to be practiced on and actually know how things should be done.
 
I have to agree, practicing with classmates is kinda of awkward. When you get in the clinic and start doing real physicals it's quite normal and fun. You're searching for signs and symptoms on the physical and whether or not you find anything on the physical is partly determined by how good you are.

With respect to working with classmates, I was crazy enough to make a youtube video explaining how to do the physical exam with a classmate. Yeah, I'm pushing the boundary of weird medical student.

Here it is if you're curious.

http://www.youtube.com/watch?v=c9UiwA8BBLI
 
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Serious Question: What if a female student is feeling for your femoral and you get a boner?
 
This is definitely an instance where being a DO helps (for the love of Christ anyone who starts DO vs MD will die). OMM, as much as I dislike it, has made my classmates and me pretty damn comfortable doing PEs. Once you do an ischioanal fossa release, nothing else really seems that personal.
 
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Serious Question: What if a female student is feeling for your femoral and you get a boner?

Then you have a boner in front of your classmate and you need to get laid more often....way more often.
 
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Then you have a boner in front of your classmate and you need to get laid more often....way more often.

I don't see how getting laid more often is going to help me not get a boner. If an attractive classmate is getting close, I'd imagine most people who get semi-erect at the least.
 
I don't see how getting laid more often is going to help me not get a boner. If an attractive classmate is getting close, I'd imagine most people who get semi-erect at the least.

Maybe if you're 15...
 
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Since this topic has come up.. I have a question as how I should handle this issue in the next year or so.

I have a both a urostomy and ileostomy-- which = bags on my stomach. When my school (and I know its required) asks the females to wear a sports bra and shorts to do exams on each other-- what should I do?

Should I ask to wear a tank top (while covering my surgical scars and bag up) still will draw attention to me b/c no one else will be wearing a tank top.

Should I make a huge announcment the first day of class? Just get it over with? Or should I tell each of my partners, one by one, about it.

Plus... sometimes you can hear noises (sometimes loud) from the bags, and also while it fills up with fluid (so I can't just drain them and pray they remain "quiet" for the 2 or so hours during class)...

What should I do? I've seen docs for years due to my condition, and have no qualms about my disease and showing it to them, but the future students in my class, (although future docs) are not MY docs... and I'm honestly, just really nervous.

I need advice, please. And not just "talk to prof" but also, how to handle the issue with my future classmates. I know this likely will be many other students first encounters with an ostomy, and a don't want anyone to get 'grossed out' and me to feel bad about myself.


wow. you sure wrote alot.

I suggest talking to a tutor.

Call 911 if you feel your life is threatened.
 
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We've practiced some aspects of physical exam on one another, like say eyes and ears and maybe knees, but certainly nothing that involved removing clothing or wearing special underclothing. And it was never mandatory; if you didn't want to be practiced on, not a problem. And I go to a large US MD school that turns out plenty of competent physicians with plenty of PE experience. So I don't really get the whole current of mandatory sports-bra sessions being some totally normal and necessary thing that everyone reasonable is cool with. Nuh uh.
 
We've practiced some aspects of physical exam on one another, like say eyes and ears and maybe knees, but certainly nothing that involved removing clothing or wearing special underclothing. And it was never mandatory; if you didn't want to be practiced on, not a problem. And I go to a large US MD school that turns out plenty of competent physicians with plenty of PE experience. So I don't really get the whole current of mandatory sports-bra sessions being some totally normal and necessary thing that everyone reasonable is cool with. Nuh uh.

Interesting, so how do you learn abdominal and chest PE? Real patients? Model patients?

That's the thing, a lot of people in this thread seem to get in a huff if someone suggests that we shouldn't be practicing on each other, but you like at examples like your school, where I'm sure you're all coming out just as well prepared as the rest of us, and I honestly doubt you're paying any extra tuition for the patients you practice on.
 
Interesting, so how do you learn abdominal and chest PE? Real patients? Model patients?

That's the thing, a lot of people in this thread seem to get in a huff if someone suggests that we shouldn't be practicing on each other, but you like at examples like your school, where I'm sure you're all coming out just as well prepared as the rest of us, and I honestly doubt you're paying any extra tuition for the patients you practice on.

Patients in the hospital, mostly. Who had agreed in advance to be examined by medical students, and were not paid. Standardized patients for the most sensitive parts.
 
For most guys, I think it is a bit uncomfortable. Especially, because it's a young, fit woman. It's one thing to ask a 70 year old obese woman to excuse me while I move her breast to the side, it's another when it's a classmate who I know. Here's a tip though, if the dude is making you uncomfortable in his technique...TELL HIM! It may be awkward, but it's going to help him develop a more conscientious way to perform the exam.


Ha ha ha ha I get uncomfortable just reading this thread !!
 
I'm not comfortable doing it to my classmates, and I'm certainly not comfortable with my significant other (also a US med student) removing their shirt and having their classmates palpate them for 3 hours. I don't do any of the more awkward physicals on my peers though (just shoulder, arm, neck, etc.), and the S.O. can't help it anyway.
 
After reading this thread it’s obvious that everyone feels uncomfortable with classmates performing even non-intimate clothed exams on each other because you are not strangers to each other. I get that but I am curious about something. When you have all finished residency and start working in a hospital for example, would you get your medical care, procedures, surgery, etc. at the hospital where you work or will you go somewhere else where nobody knows you?
 
Yes, I do choose to get my care from people who are not my personal colleagues. Like to have those boundaries between relationships, and the area is large enough to allow it.
 
After reading this thread it’s obvious that everyone feels uncomfortable with classmates performing even non-intimate clothed exams on each other because you are not strangers to each other. I get that but I am curious about something. When you have all finished residency and start working in a hospital for example, would you get your medical care, procedures, surgery, etc. at the hospital where you work or will you go somewhere else where nobody knows you?
Little late on this question, no?
 
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I worked with a gas attending in gyn and 2 days later she was on the gyn table getting operated on. both I and the attending asked her twice if it was OK and she was really cool with it. It wasnt weird at all (and yes, she was a young, fit doctor).
 
When I was a PGY-2, For my cholecystectomy, I went to a surgeon not affiliated with my residency who had a good rep. Didn’t feel like having colleagues putting Foley’s in me, and wanted to avoid VIP treatment (which is known to lead to bad outcomes).
 
Yeah to that. I also don’t share that I am a physician unless there is some compelling reason to.

What do you say you do for a living then?


Sent from my iPhone using Tapatalk
 
What do you say you do for a living then?


Sent from my iPhone using Tapatalk

I’m not a doctor yet, but I am in the military, and for various reasons, I don’t typically tell people what I do. When I met my wife, I told her I was a blimp mechanic for Goodyear.
 
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Most people don’t ask. When asked I have said. It’s not that I’m determined to hide it, just that I’m not eager to reveal.
 
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For another perspective on the issue of examining fellow classmates...

It’s intriguing to me that so many people are more concerned with the possibility of finding their classmates too attractive than they are with how people will perceive their shirtless bodies. Me, I’m about 40 lbs overweight. Working on it and have lost 20/60 lbs so far, but socially all that really matters is that you don’t look fit to other people, no matter what the underlying reason for the extra baggage is (PCOS in my case, so say my doctors) or how far you’ve come. So during our first PE workshop, I really had to muster up some guts to get on the table.

Displaying a chubby body in clothes is hard enough without having to lift up your shirt and assume the lateral decubitus position, jelly rolls abounding. But I did it anyway. After all, we should be viewing our classmates as patients in the workshop setting, assessing exactly what we are supposed to be assessing about them rather than evaluating their bodies for attractiveness.

I’m in a happy relationship with a very attractive person but still found myself feeling insecure that the other people around, save for one other girl struggling with obesity in our group, were fit and happy to show off their figures. What I reminded myself of is that this is all about medicine. I volunteered so my peers would have a less-than-perfect body to palpate, because fitness is way over-represented in medicine, and physicians who balk at the sight of body fat are not exercising their greatest capabilities for empathy. Hopefully having a few chubby but brave people in our group will help the others see the human body as a medical object that holds a real person inside rather than a sexual object that is simply being showcased in a medical setting.

Also, not everyone is heterosexual, so the assumption of same-sex practice being more comfortable for everyone is kind of outdated. Just something to think about. In my opinion, the person’s gender shouldn’t matter. This is a practice patient, and we should treat them all with equal respect, as we should treat our future patients. Unfortunately, though, doctors are not immune from the biases and toxic attitudes that permeate our society, and I’ve heard many a physician talk crap and make assumptions about patients who have overweight bodies. Let’s all try to leave that in the dusty, gray medical past rife with stereotyping and middle school social politics. We are millennials who are becoming physicians: empathetic, creative, and in search of meaning. I hope we all keep that alive instead of focusing on how attractive or unattractive we find people’s bodies in the context of professional education.
 
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Yes, its common to feel uncomfortable. For many reasons. For me, I like to take my time practicing and sometimes get embarassed when I can't hear or palpate/percuss the thing appropriately. So, I've learned to practice on myself or a friend more than doing it during class with the whole group and even the teacher watching.

On feeling uncomfortable being the one examined, I haven't personally felt that at all, not even when one of my classmates tried to palpate my sigmoid colon.
But, I have seen others get very uncomfortable (even if the same gender) to even take their shirts off. I think as long as you do it respectfully its fine to practice on fellow students.
 
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Definitely not my favorite it but it's part of the process. When I think about the fact that I've done WAY more uncomfortable things with patients does make me feel a little better though. If they can get through that then I can get through having my shirt off an hour or two a week in front of people.
 
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For another perspective on the issue of examining fellow classmates...

It’s intriguing to me that so many people are more concerned with the possibility of finding their classmates too attractive than they are with how people will perceive their shirtless bodies. Me, I’m about 40 lbs overweight. Working on it and have lost 20/60 lbs so far, but socially all that really matters is that you don’t look fit to other people, no matter what the underlying reason for the extra baggage is (PCOS in my case, so say my doctors) or how far you’ve come. So during our first PE workshop, I really had to muster up some guts to get on the table.

Displaying a chubby body in clothes is hard enough without having to lift up your shirt and assume the lateral decubitus position, jelly rolls abounding. But I did it anyway. After all, we should be viewing our classmates as patients in the workshop setting, assessing exactly what we are supposed to be assessing about them rather than evaluating their bodies for attractiveness.

I’m in a happy relationship with a very attractive person but still found myself feeling insecure that the other people around, save for one other girl struggling with obesity in our group, were fit and happy to show off their figures. What I reminded myself of is that this is all about medicine. I volunteered so my peers would have a less-than-perfect body to palpate, because fitness is way over-represented in medicine, and physicians who balk at the sight of body fat are not exercising their greatest capabilities for empathy. Hopefully having a few chubby but brave people in our group will help the others see the human body as a medical object that holds a real person inside rather than a sexual object that is simply being showcased in a medical setting.

Also, not everyone is heterosexual, so the assumption of same-sex practice being more comfortable for everyone is kind of outdated. Just something to think about. In my opinion, the person’s gender shouldn’t matter. This is a practice patient, and we should treat them all with equal respect, as we should treat our future patients. Unfortunately, though, doctors are not immune from the biases and toxic attitudes that permeate our society, and I’ve heard many a physician talk crap and make assumptions about patients who have overweight bodies. Let’s all try to leave that in the dusty, gray medical past rife with stereotyping and middle school social politics. We are millennials who are becoming physicians: empathetic, creative, and in search of meaning. I hope we all keep that alive instead of focusing on how attractive or unattractive we find people’s bodies in the context of professional education.
Very well said. I really appreciate this post. Make it part of the curriculum before workshops.
 
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I think it helps build maturity to have the students practice on each other. It is awkward but that is good. Less distancing and dehumanizing than if you only ever exposed them to patients they don't know. Students chose to be in medical school, and it seems a fair sacrifice that you must guinea pig on each other before being let loose on patients. I don't deny it's awkward but I still see it as a good thing overall.
 
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Because being seen shirtless and palpated while by people you hardly know/will work with professionally for 4 years... is a little more intimate than a lot of people are used to being with anyone that isn't their doctor.

Or is that not really so strange to you?
 
Not really. Ive showered naked with over 100 people at once for 6 months straight, and in nursing school I took my shirt off so they could demonstrate the auscultation points for the heart and lungs. Its not like you're taking off all of your clothes, and its not like you have to take your pants off.

Doesn't anyone go to the beach? Guys typically have no shirt on, and gals usually have a bikini top on. Just wear an athletic bra if you're a female, and if you're a male, what's the issue?

I don't see how getting laid more often is going to help me not get a boner. If an attractive classmate is getting close, I'd imagine most people who get semi-erect at the least.
Wait till you hit your 30s.
 
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Yeah, I'm definitely way ahead of you in terms of comfort with public nudity. Not really what I meant.

You can't see why other people might feel uncomfortable in this situation, even though you don't? Uh, OK.
 
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I really don't. Considering they wont be nude, and at least would have underclothes on.

Hasn't everyone at very least been swimming in public, taken gym class, or something?

If it was complete nudity, especially coed, I totally got you. But stripping down to underclothes I don't see the issue. We're all adults.
 
Not really. Ive showered naked with over 100 people at once for 6 months straight, and in nursing school I took my shirt off so they could demonstrate the auscultation points for the heart and lungs. Its not like you're taking off all of your clothes, and its not like you have to take your pants off.

Doesn't anyone go to the beach? Guys typically have no shirt on, and gals usually have a bikini top on. Just wear an athletic bra if you're a female, and if you're a male, what's the issue?


Wait till you hit your 30s.

If you're volunteering to take your top off then you must be fine with it and probably have a good posture. Otoh, some people, are not a big fan of showing their body even if it's for science and that's fine because it should be voluntary. If I'm learning something from a classmate then I'm all up for taking my shirt off, but if it's for a group then no, the instructors themselves or the school should find a volunteer.

Also, age has nothing to do how we look..well at least not in the 30s.
 
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I really don't. Considering they wont be nude, and at least would have underclothes on.

Hasn't everyone at very least been swimming in public, taken gym class, or something?

If it was complete nudity, especially coed, I totally got you. But stripping down to underclothes I don't see the issue. We're all adults.

Are you ever able to not see things only from your perspective?
 
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If you're volunteering to take your top off then you must be fine with it and probably have a good posture. Otoh, some people, are not a big fan of showing their body even if it's for science and that's fine because it should be voluntary. If I'm learning something from a classmate then I'm all up for taking my shirt off, but if it's for a group then no, the instructors themselves or the school should find a volunteer.

Also, age has nothing to do how we look..well at least not in the 30s.
I'm not saying age has anything to do with how we look, I'm saying it has to do with whether you'll pop a boner just by seeing an attractive woman in her undergarments. We're not 16 anymore.

Are you ever able to not see things only from your perspective?
I'm just trying to understand why. And no I don't understand. I'm willing to accept that there are different perspectives, obviously since this is a topic, but I don't understand why someone would be uncomfortable with someone seeing them with clothes on. Maybe I will gain insight.
 
Because it's hardly being in a swimsuit at the beach. If you don't see the difference...

For one, the word examine.
 
I really don't. Its a human body. I guess I'll just have to accept that I don't understand.

And that's fine. I don't understand many things about different people, I just accept it anyway.


I do want to add, I hope that med school students take this professionally. One problem I had in nursing school about it, is classmates would giggle and act stupid when it came to assessing a bare chested individual. Makes me feel like we're back in middle school.
 
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For another perspective on the issue of examining fellow classmates...

It’s intriguing to me that so many people are more concerned with the possibility of finding their classmates too attractive than they are with how people will perceive their shirtless bodies. Me, I’m about 40 lbs overweight. Working on it and have lost 20/60 lbs so far, but socially all that really matters is that you don’t look fit to other people, no matter what the underlying reason for the extra baggage is (PCOS in my case, so say my doctors) or how far you’ve come. So during our first PE workshop, I really had to muster up some guts to get on the table.

Displaying a chubby body in clothes is hard enough without having to lift up your shirt and assume the lateral decubitus position, jelly rolls abounding. But I did it anyway. After all, we should be viewing our classmates as patients in the workshop setting, assessing exactly what we are supposed to be assessing about them rather than evaluating their bodies for attractiveness.

I’m in a happy relationship with a very attractive person but still found myself feeling insecure that the other people around, save for one other girl struggling with obesity in our group, were fit and happy to show off their figures. What I reminded myself of is that this is all about medicine. I volunteered so my peers would have a less-than-perfect body to palpate, because fitness is way over-represented in medicine, and physicians who balk at the sight of body fat are not exercising their greatest capabilities for empathy. Hopefully having a few chubby but brave people in our group will help the others see the human body as a medical object that holds a real person inside rather than a sexual object that is simply being showcased in a medical setting.

Also, not everyone is heterosexual, so the assumption of same-sex practice being more comfortable for everyone is kind of outdated. Just something to think about. In my opinion, the person’s gender shouldn’t matter. This is a practice patient, and we should treat them all with equal respect, as we should treat our future patients. Unfortunately, though, doctors are not immune from the biases and toxic attitudes that permeate our society, and I’ve heard many a physician talk crap and make assumptions about patients who have overweight bodies. Let’s all try to leave that in the dusty, gray medical past rife with stereotyping and middle school social politics. We are millennials who are becoming physicians: empathetic, creative, and in search of meaning. I hope we all keep that alive instead of focusing on how attractive or unattractive we find people’s bodies in the context of professional education.
The persons gender should matter, because we do not set laws to accomodate the 5% minority. Its like all these ACLU battles where a team of females is forced to shower with the transgender girl. Comeon now.

Also, what the others mean, i think, is the innate attraction they feel for their peers (as opposed to a judgemental view as your post suggests)
 
The persons gender should matter, because we do not set laws to accomodate the 5% minority. Its like all these ACLU battles where a team of females is forced to shower with the transgender girl. Comeon now.

I think any rule that is flexible enough to allow for known variations in human backgrounds and behaviors is a good one. Catering to the majority just because they constitute the majority may be fair according to one standard, but it risks excluding or failing to acknowledge the existence of people outside the norm. I don't want to go on a long tirade about the systematic oppression of sociologic minorities, but I think it's relevant here. A greater percentage of our society now knows these people exist and are valuable and equal human beings. I think our policies should align with that knowledge and should seek to specifically cater to no particular population if possible.

For example, perhaps course directors could give students a survey at the beginning of the term that asks if they have a gender preference for physical examination partners, based on potential worries about attraction, religious beliefs or even discrimination. If given the choice, I would probably prefer opposite-sex workshop partners because I am in a same-sex relationship (assuming we should be able to opt out of examining certain people, which I disagree with). But if you believe no one should be coerced into such situations, why is it fairer for me to be in a suboptimal position when the majority gets their preference? Fairness is listening to every individual person about their needs and trying to accommodate everyone, or no one, so the outcome is equal.

The main point I was making with this, though, on the demographics front, is that it shouldn't matter because we are all going to have young, old, male, female, cis, trans, gay, straight, and even asexual patients one day. We should be able to compartmentalize our personal and our professional lives to the extent that we view all peers as patients, view all patients as equally worthy of our respect and attention, and conduct ourselves accordingly in workshops. It primes us for professional relationships in the future with colleagues and patients.

Also, what the others mean, i think, is the innate attraction they feel for their peers (as opposed to a judgemental view as your post suggests)

Right, I do understand that is a major worry in this thread, and I expressed amusement at that because it made me realize that people fret over such different things. I do, however, think that for every extreme (attraction) there is an opposite extreme (disgust), and when we are viewing people's bodies as sex objects, we have according reactions to them. Finding someone attractive is a judgment. Finding someone unattractive is a judgment--just a more traditionally negative one. My point was attraction should have no place in our mindsets regarding this process. Maybe just something to be acknowledged and sucked up because it should be the least of our worries as future medical professionals.
 
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MD students, at least you don't have to learn OMM. We had an entire test over how to diagnose sacral dysfunction. There was a lot of palpating of uncomfortable places and a lot of quoting Finding Nemo ("He touched the butt").
 
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Didn't realize this thread was so old. Btw, for all the DO's out there, what's an ischioanal fossa release? :eyebrow:

This is definitely an instance where being a DO helps (for the love of Christ anyone who starts DO vs MD will die). OMM, as much as I dislike it, has made my classmates and me pretty damn comfortable doing PEs. Once you do an ischioanal fossa release, nothing else really seems that personal.
 
For everyone mentioning attraction, what are you going to do when you have an attractive patient?


You have to shut it off. Co workers and patients should be off limits. I don't even think of them in that way. Attraction isn't solely visual, it's also situational.
 
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MD students, at least you don't have to learn OMM. We had an entire test over how to diagnose sacral dysfunction. There was a lot of palpating of uncomfortable places and a lot of quoting Finding Nemo ("He touched the butt").
Hold up. We have to do rectals on each other in med school?
Hold up. We have to do rectals on each other in med school?
Interesting. Never had that done on me before.

At MEPS they did make like 20 of us bend over and grab our butt cheeks and spread them and the doctor went down the line looking up our buttholes but I never did know what that was for. Nothing went in though lol.

@Matthew9Thirtyfive any idea what that is to check for?
 
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