Mayo Med School Info

[delchrys]

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i am wondering how many out there are aware that the following occurs within the halls of the mayo medical school, and what your thoughts are on the subject:

medical students partner up with another med student, whoever is available, for the years that precede their rotations. they then procede to learn/practice ALL physical examinations on each other. yes, that includes prostate, milking the ol' pecker, pelvic exams (bimanual, woohoo), and the rest of the sordid list. most med schools hire people to serve as subjects for these exams. mayo has students do this on each other.

so, what do you think? would it influence your application decision, one way or the other?

 

[i77ac]

you must be kidding.

 

[delchrys]

you must be kidding.

nope. my gf interviewed there back when she was interviewing (she's graduating from a top school not to be named so as to avoid identifying her and leading to people attributing my jackassedness to her in any way, lol), and i met her during her second-last year of med school. i was so freakin shocked that i emailed one of the deans at mayo, and had to re-email her after a month of no reply, and then after the second email waited like another week or so before i got a response from her confirming that this is indeed the policy of mayo's med school. i'll paste in an excerpt of her email...notice how she doesn't include any mention at all of pelvic or prostate, but she throws out the testicular and breast exams as red herrings to throw off the focus of the inquiry. and in the end, while breast and testicular exams are not PRACTICED on each other, they are TESTED by demonstrating proficiency on each other, so what's the freakin difference?

please note, this is a direct copy/paste of her email reply to my inquiry.

"Our students first exposure to structured teaching of the physical exam occurs in Intro to the Patient in our first year. At the beginning of the course, class members pair up - your choice. You are with your partner through out the course. Your partner and you practice the exam on each other and your partner serves as your patient for evaluation. The teaching of the female breast exam and testicular exam is done on a hired standardized patient. You can practice this exam on your partner and you do demonstrate you competency with either exam on your partner and some point in the class depending on the sex of your partner. Some people partner with the same sex, others with members of the opposite sex.



Some faculty have expressed that they do not feel that is it appropriate for you to practice the exam on your colleagues while others feel it is very appropriate. I do not know if there is an opt-out policy, however, I am checking with faculty to find out the answer. I do recall discussion that a student inquired to one of the faculty about the issue of pairing up with classmates at some point and I think that the faculty member handled it extremely well. The essence of his argument was that many students will become physician colleagues and therefore must be able to maintain a professional attitude regardless of the circumstances.



I hope this is a helpful response to your inquiry.



Best regards,

Barbara L. Porter

Assistant Dean for Student Affairs"

my problem with all of this is that it takes a VERY vulnerable class of people (med students desperate to get into a "good" school and desperate to succeed) and puts them in a very shady spot. apparently, there IS no opt-out policy, since she never got back to me on that point, and i'm sure the defense would be "but we never have any student as to opt out". no kidding...what a shock, no students in a class of 40 in a cult-like school (as it has been characterized) asking to opt out. do ya think maybe they don't ask to opt out because they'd then be ostracized or at least viewed as "not part of the group"?

i just hope a student of the mayo med school tries to opt out and then faces a hard time at the hands of the faculty/administration as a result, and then calls me so i can bring a suit against them the size of jupiter to force them to change their policy. you'd think for the cost of tuition they rape students for that they'd just hire a damned standardized patient! it kills me bad enough that at DO schools everyone does OMM on each other in sports bras and/or topless, and that at nursing schools across the nation breast exams are all done on one's classmates, but the mayo med school just takes it to a whole new level of demeaning and unethical.

 

[Mumpu]

Yet again, we have the proof that "average" medical schools are better than the rigourous traditional institutions in every respect other than US News rankings.

Oh, I bet my classmates and I are better at physical exam than 99% of Mayo graduates. And we didn't have to milk any classmates either.

 

[Medikit]

Why would this be a problem?

 

[Mumpu]

Would you want your classmate to do a pelvic on you? That's like "playing doctor" for real. 😛

 

[agp4]

I'm a first year at Mayo right now. We haven't done any of the physical stuff and I'm not thrilled at the prospect, but I figure that I have to learn somewhere. Plus, from what I've been told, you can opt out of anything you're uncomfortable with. No one is going to make you do anything you don't want, and this is all stuff that you'll get at a normal physical (i.e. nothing invasive). Seriously, we all have to fez up eventually and stop feeling weird about some of the exams we will be forced to do as doctors. I'm chalking this up to the systemic desensitization that goes through med school. As for the more private exams, there are hired people that are trained in teaching med students how to do those exams on them (not other classmates). So far, I love it here at Mayo and I'd encourage anyone thinking about applying to not let this deter them.

Yet again, we have the proof that "average" medical schools are better than the rigourous traditional institutions in every respect other than US News rankings.

Oh, I bet my classmates and I are better at physical exam than 99% of Mayo graduates. And we didn't have to milk any classmates either.

As for Mumpu, I don't care what med school you're at - in my mind, we're all future doctors and thus future colleagues. Lose the chip on your shoulder - as med students, we all know better than to believe the US News rankings. If you're staking your ego on rankings still, I pity you.

 

[mpp]

No testicular or breast exams on students unless they feel comfortable in doing it...many don't and it is perfectly fine. Even if it were mandatory not sure what a lawsuit might be about.

Pelvic, testicular, breast, and prostate exams are all taught by paid professional patients.

Oh, and by the way, Mayo Medical School is one of the most inexpensive medical schools in the country and, by far, the cheapest private school. The majority of students pay less than $10,000 per year.

 

[trouta]

Third year Mayo Med Student.

This is all bull 👎 . Whomever started this forum is full of crap 😡 .

It is true that as part of the physical exam class you have a partner that you practice your exam on. However, YOU choose that partner at the start of the class, thus your partner can be whatever sex you are more comfortable with. If you want to examine someone of the opposite sex that is fine, but if you are more comfortable with someone of the same sex that is fine as well.

The exam that you do on one another is the basic exam (eyes, ears, mouth, nose, lungs, heart, abd, pulses etc.) NOTHING MORE...

As for the more intimate parts of the exam (breasts, scrotal, testicular etc.) those are all performed on paid models who come to the school and are examined by many students. These exams are NOT done on your partner unless you specifically decide to practice that exam more OUTSIDE of the context of the class.

Pelvics, prostate exams and the like are NOT part of this course. Thus we do not "milk eachothers prostates" or do any of the other stuff that the original poster suggested we might. When it comes time to learn those exams, that is done either on paid models or as part of your clinical rotations.

So, to the first year student who posted here... dont worry about baring parts of yourself you would rather not share.

To the rest of you, dont believe everything you read on this site. If you want more info about particular concerns regarding this class at Mayo feel free to PM me or mpp (who is also a student here).

To the original poster... either your girlfriend exaggerated things to you, or she was lied to when she interviewed. As for YOUR INTERPRETATION of Barbara Porters letter, that is all fine, but prostate and pelvic exams are not part of the first year curriculum... you dont know what you are talking about.

 

[Caesars0331]

Am I the only one that finds it odd that students would want to "practice" testicular "exams" on each other???

 

[constructor]

mayo is sketchy...

 

[leechy]

mayo is sketchy...

Yeah, totally... this "Intro to the Patient" class sounds one step away from a med student orgy.... Talk about skanky. I guess there isn't much else to do in Minnesota.

Big disclaimer: I am totally just kidding 😉 Mayo is a great school, and one of my top choices.

 

[delchrys]

that's awesome, 3rd year mayo student--i'm full of crap but then you go on to confirm what i said. sure, they let you 'choose' to do the more intimate exams on paid models. the bottom line is that they set up students to have their physical privacy invaded by others, for which there is no justification. why don't you practice putting in a central line on each other, too, so you know how that feels (the common rationale behind doing these exams on fellow students)?

screw my 'interpretation' of porter's letter--just read the letter itself, no interpretation needed.

of course, as a member of the cult yourself, three years indoctrinated now, you feel obliged to defend it. that's okay. i'm not offended by your highly agitated state. it comes with the territory; just ask david koresh...

 

[constructor]

yeah, i'm not sure the letter's really that open to interpretation... it clearly says what it says. i'm certainly buying bush's case for wmd's in iraq more than i'm buying the mayo student's interpretation of the letter. i think it's good that they don't force everyone to participate, but the idea itself makes me wonder if they're living in the middle ages.

 

[lorelei]

why don't you practice putting in a central line on each other, too, so you know how that feels (the common rationale behind doing these exams on fellow students)?

Probably because putting in a central line carries a non-negligible risk. (1 in 100 adverse results? I can't remember but I was surprised how large it was.) Don't students practice starting IVs on each other? Or maybe the person who told me that was trying to scare me (I have a slight fear of needles). Anyway, I wouldn't have a problem with letting a trusted friend practice safe procedures on me. And I probably will practice with friends once the time comes. (My boyfriend jokingly offered to let me bring "cute" friends home to practice on him.) I can see how it would make a lot of people uncomfortable, though.

 

[Mumpu]

Sorry about the chip, I was at the end of a long night. 🙁

I learned my DREs and such on real patients. They needed an exam and I did it. No harm, no unnecessary violation of body cavities.

 

[stinkycheese]

Probably because putting in a central line carries a non-negligible risk. (1 in 100 adverse results? I can't remember but I was surprised how large it was.) Don't students practice starting IVs on each other? Or maybe the person who told me that was trying to scare me (I have a slight fear of needles). Anyway, I wouldn't have a problem with letting a trusted friend practice safe procedures on me. And I probably will practice with friends once the time comes. (My boyfriend jokingly offered to let me bring "cute" friends home to practice on him.) I can see how it would make a lot of people uncomfortable, though.

Although it may be true that some schools have you learn IV placement on fellow students, I would not let an inexperienced person put an IV in me (nor would I want to practice on a classmate) because there is quite a risk involved with blown veins, permanent nerve damage, etc. I learned to draw blood on my colleagues and they on me, but that is less risky than the placement of a catheter. I think practicing anything on classmates should be voluntary (on your own time only), and standardized patients should be utilized for everything possible, including non-invasive procedures. What if a fellow student has abnormally high blood pressure, a heart problem, or something else they don't want others to know about? Or what happens when abnormal results are found on someone who thinks they are healthy? Who is in charge of informing the student? Telling the course director or staff physician about it constitutes a violation of the student's rights, since he/she has a right to not have their school involved in their medical care/problems. It's a messy situation.

Practicing on someone outside of a standardized or patient-doctor relationship is not the best idea in my opinion, and I think the decision to practice on classmates should be wholly voluntary and uninfluenced by the school. With HIPAA and other new regulatory measures, I believe student-student learning of techniques will quickly become an antiquated practice.

 

[45408]

While it would be more than a bit awkward doing a prostate check on a friend/partner, I think it would almost be sexually tense to do a breast/pelvic exam on a girl I knew from class (I'm a guy). In no way would I be bothered to do the same on a standardized patient, but if it was someone I already knew outside of that type of environment, it would be awfully strange for me.

 

[MDT]

delchrys - you seem to have a personal vindetta against Mayo Medical School. No one is forcing you to apply or attend there if you don't agree with the policies or culture of the school. What is the point of cutting down the students that do go there?

I'm a Mayo 1st year, and from what I understand breast and testicular exam are a part of the Intro to Patient class, but NOT pelvic or prostrate. I'm sure the 3 mayo third year students who posted their experiences know what they are talking about. Now, do I want to exam the testicles of my male classmates, not particullarly! So, I'm sure I'll partner up with a fellow female student. I have no problem with learning/practicing the breast exam with another female student.

The arguement for learning on other students does have some merit. We will someday have patients from our community, church, social circles, etc. and we will have to be comfortable performing examinations on people we know.

 

[agp4]

Its a relief to hear that there's no weird stuff. I can handle the basic exam - I was just a little iffy on the idea of having to do a breast exam on a classmate (I'm a guy). Its nice to know that I don't have to do that. Phew!

I think this pretty much makes the whole issue not nearly as concerning, and I hope it lays the matter to rest. And if the idea of the physical still makes you uncomfortable, I'm sure that if you felt strongly enough about it, you'd be able to find an alternative. From my point of view, the first few physical exams are going to be awkward no matter what. I might as well start with a sympathetic classmate before I move up to real patients.

As for delchrys, I'm sorry that you've received such a negative opinion of our school. I've never heard Mayo Med School referred to as a "cult" and I certainly haven't participated in any weird rituals or cult-like activities in Rochester. I'll admit that there is a strong sense of tradition here, but most of that is based on the benevolent works of Drs. Will and Charlie Mayo, and their practice of compassionate medicine. As for the size of our class, I think that is one of Mayo's strongest attribute - like I said before, the administration so far has been very receptive towards our ideas, and our class seems to be getting very close. I know that I'm only a first year, but if you have any other specific concerns with Mayo's medical school, feel free to PM me and I can try my best to answer them. I'm sure the third years that have posted wouldn't mind fielding questions either, but I don't want to volunteer for them. They have enough work to do! 🙂

 

[45408]

I have no problem with learning/practicing the breast exam with another female student.

Nobody was really disputing that one.......it's just that it'd be harder (for me at least, but I doubt this only applies to myself) to focus on what you're supposed to be learning as opposed to "OMG, I'm touching Sarah's boobs!

"

If it was someone I'd never met before, or only seen in passing, it'd be a different story.

 

[delchrys]

i want to get something straight--i'm not actually casting any doubt on the mayo 3rd year's statements. i believe him. i just have a problem with any med school that requires its students to be physically intimate in ANY way with fellow students. you are in med school to learn how to DO procedures, not how to be on the receiving end. period.

my issue with it is this: sure, i could choose to not go to mayo if i was uncomfortable with it, but then i'm forced to cross off a quality school simply because of their unusual practice in this regard.

my point is that there are a lot of young, sexually-inexperienced folks who enter med school (and i'm not making a negative or hostile characterization here, just a genuine observation), and for them all this examination practice is a good way to get them past the nervousness, although i still strongly reject the assertion that doing these exams on each other instead of models is wrong. the problem is the non-standard, older med student who is in a relationship. as an example, if my partner was entering mayo this year, i'd be highly uncomfortable with the idea of a guy doing physical exams on her. it's one thing if it's a stranger she'll not see again, totally another if they will be working together a lot. that's the same reason a lot of pregnant doctors deliver at hospitals they don't work at. i don't think a person should get physically intimate with someone who is neither their one-night-stand nor their long-term partner, and while an exam in a hospital by a doc is not an intimate thing, practicing this stuff over and over on your partner surely gets to be that. as the 1st year mayo said, "our class is getting much closer". bonding is great, but there is a line, and i think the physical exam practice crosses it.

to most aspiring med students 'practice exams on each other' and 'go to a less prestigious med school' is not a choice; the former is the choice they'll make every time. i'm not sure how many premed students would NOT sleep with the dean of their med school of choice if they knew it would get them in (male or female). not saying premed students are bad or morally weak; i'm saying that a program that takes advantage of that is corrupt and it is an indefensible position to take that there is some benefit granted to the students that outweighs the weirdness of it and the invasion of privacy and personal space it creates.

 

[tofurious]

the problem is the non-standard, older med student who is in a relationship. as an example, if my partner was entering mayo this year, i'd be highly uncomfortable with the idea of a guy doing physical exams on her. it's one thing if it's a stranger she'll not see again, totally another if they will be working together a lot. that's the same reason a lot of pregnant doctors deliver at hospitals they don't work at. i don't think a person should get physically intimate with someone who is neither their one-night-stand nor their long-term partner, and while an exam in a hospital by a doc is not an intimate thing, practicing this stuff over and over on your partner surely gets to be that.

What are you talking about? Doing a physical exam is "get[ting] physically intimate"? Every time you examine someone's grandfather or grandmother you are getting PHYSICALLY INTIMATE with them? Does "over and over" include examining your regular patients on a monthly or yearly basis?

If you are indeed a non-traditional applicant, your maturity has obviously yet to catch up to your chronological age.

 

[45408]

What are you talking about? Doing a physical exam is "get[ting] physically intimate"? Every time you examine someone's grandfather or grandmother you are getting PHYSICALLY INTIMATE with them? Does "over and over" include examining your regular patients on a monthly or yearly basis?

If you are indeed a non-traditional applicant, your maturity has obviously yet to catch up to your chronological age.

You're missing the point. Most of a doctor's patients are not in any other way tied to their doctor - my dad is a landscaper and in turn works for a few doctors he's also visited, but other than that, that's the extent of the relationship. Think of it as you being a doctor and having friends and family come in to see you. Wouldn't THAT be a little weird?

 

[delchrys]

since you are having trouble understanding what i'm saying, i'll use a very simple example. give your mother a pelvic, and then have her check out your nuts.

if you don't balk at that, then do the same for any sisters you might have.

if you would be okay giving your mom a bimanual and letting her check your testes, then you are abnormal, and maturity has not a damned thing to do with it. AND, if you are normal, and see the reason for discomfort with these examples, then i ask you this--why is the exam totally weird in that one context but then "totally acceptable and non-intimate" in every single other context?

 

[tofurious]

Most of a doctor's patients are not in any other way tied to their doctor - my dad is a landscaper and in turn works for a few doctors he's also visited, but other than that, that's the extent of the relationship. Think of it as you being a doctor and having friends and family come in to see you. Wouldn't THAT be a little weird?

Talk to some real doctors and see how many of their "acquaintances" are their patients. It's not weird. It's called professionalism.

And delcrys' example of givng his mother a bimanual exam just puts him right up there along with some of SDN's (in)famous fools. I wish I knew your name so I could pass it along to all the admissions folks.

 

[agp4]

For the love of pete, stop posting on this thread before it gets any more ridiculous!

 

[Mumpu]

Err no. It is generally a Bad Idea to take care of anyone you know personally. You have a huge bias when your patient is a friend or a family member. In fact, this is specifically advised against in the physician's code of ethics.

 

[delchrys]

tofurious, you crack me up...you continue to attack my points sideways while ignoring the actual POINTS. if the system at mayo is so freakin great, why are the they only med school in the country that uses it, and why does the assistant dean of student affairs candidly admit that the faculty have had heated debates about whether it is a good or bad thing?

either you are simply too dense to understand what is being said or you are being deliberately blind to the obvious. either way, enjoy your schooling, but spend your time learning medicine instead of wasting it in a forum like this proving what an illogical, irrational, one-dimensional person you can be.

 

[45408]

Talk to some real doctors and see how many of their "acquaintances" are their patients. It's not weird. It's called professionalism.

And delcrys' example of givng his mother a bimanual exam just puts him right up there along with some of SDN's (in)famous fools. I wish I knew your name so I could pass it along to all the admissions folks.

Actually, my aunt decided not to take care of my preemie sister in the NICU because of the relationship.

 

[mpp]

Err no. It is generally a Bad Idea to take care of anyone you know personally. You have a huge bias when your patient is a friend or a family member. In fact, this is specifically advised against in the physician's code of ethics.

There is no such specific statement in the AMA's physician's code of ethics. In fact, there is a specific statement in regard's to medical students performing procedures on each other. (link):

(1) In the context of learning basic clinical skills, medical students must be asked specifically to consent to procedures being performed by fellow students. The stringency of standards for ensuring the explicit and non-coerced informed consent increases as the invasiveness and intimacy of the procedure increase. (2) Instructors should explain to students how the procedures will be performed, making certain that students are not placed in situations that violate their privacy or sense of propriety. The confidentiality, consequences, and appropriate management of a diagnostic finding should also be discussed. (3) Students should be given the choice of whether to participate prior to entering the classroom and there should be no requirement that the students provide a reason for their unwillingness to participate. (4) Students should not be penalized for refusal to participate. Thus instructors must refrain from evaluating students? overall performance in terms of their willingness to volunteer as "patients." (IV, V) Issued June 2000 based on the report "Medical Students Performing Procedures on Fellow Students," adopted December 1999.

 

[Mumpu]

Medical students are not physicians, although what you say still can significantly influence someone's illness and outcome (the infamous "oh, that lump is nothing, it'll go away on its own"). I distinctly recall reading a large section about treating relatives.

 

[tofurious]

Medical students are not physicians

Oh the future of medicine looks so gloomy if you guys are it... and again, this is the pre-med forum. I would not want to take care of any of my FAMILY "INTIMATELY" in the NICU or MICU either, given the mortality is about 50%. When your colleagues or friends need your services, I guess they'll find out how much of a colleague and friend you are by refusing service to anyone and everyone you know.

As a side note, seeing the "Denver CO" reminds me of a graduate of UColorado who recently loaded a patient up on 10L of fluid and only to give him 10 mg of Lasix afterwards to correct that. I guess that shows that size of the class certainly correlates well with competency.

 

[trouta]

tofurious, you crack me up...you continue to attack my points sideways while ignoring the actual POINTS. if the system at mayo is so freakin great, why are the they only med school in the country that uses it, and why does the assistant dean of student affairs candidly admit that the faculty have had heated debates about whether it is a good or bad thing?

either you are simply too dense to understand what is being said or you are being deliberately blind to the obvious. either way, enjoy your schooling, but spend your time learning medicine instead of wasting it in a forum like this proving what an illogical, irrational, one-dimensional person you can be.

I think you would be surprised at how many medical schools base their physical exam class around practicing on fellow students. Most schools I interviewed at had a similar system to that in place at Mayo (you should ask specifically about this as you begin to interview). The thing about it is a situation is only sexual if you make it sexual. As you will see as your medical school career advances, it is both possible and easy to examine another person in a totally professional way.

P.S. I think you misunderstood my original post... no student here at Mayo has to do a breast or testicular exam on anyone BUT a paid model unless they so choose.

I hope this clears things up. Mayo is a really great school that cares for and looks after its students. Students are always given an out of any situation they may find uncomfortable. I hope your understanding of what our physical exam course is like will not dissuade you from considering our school.

 

[Mumpu]

What about the size of class? UCHSC has the same-sized classes as every other medical school in the US except Mayo because they can never find more than 20 people who want to live in Rochester, MN.

Also, 10 L of IVF is not inappropriate if we are talking about a burn patient, severe DKA/HOKA, or goal-directed therapy (nice patient presentation, chief). If you are giving someone fluids, why would you diurese them at the same time (or at any time for that matter -- kidneys take care of excess fluid on their own)? What sort of morbidity did the patient have?

I don't refuse looking at people but I won't diagnose them or provide treatment. If I see something worrisome, I tell them to go see a doctor. If I don't see anything worrisome, I still tell them to see a doctor if they are concerned. There is decent research showing that physicians tend to substitute incorrect benign diagnoses for correct badness when dealing with friends and relatives. I can tell you from recent personal experience that some degree of denial is extremely difficult to overcome no matter how obviously gloomy the situation is.