My First Real Patient

Posted By: Paul   |   Humor   |   4 Comments

putting on gloves for my first real patient

Game time…

My first real patient in PA school: a woman for a pelvic exam. No, I didn’t see that coming.  Or that right after, I would go to another exam room and perform a male genital and rectal exam.  My class has been practicing our physical exam skills on one another for weeks now.  But the powers that be want us to learn these skills on real people, which I guess makes sense.  Wait – what?  I have to do what?  Zoom out for just a second …

It’s not uncommon for medical students to do full exams on each other (same and opposite genders).  Yes, that’s right: your own classmates fumbling with specula and gloved, lubricated fingers, all up in your most personal anatomy.  UC Davis School of Medicine did it that way with PA students until 2004.  Nowadays, they break us in a little more gently, having us do simple exams (abdomen, lungs, eyes, ears) on each other with shirts/bras on.   And when it comes to invasive procedures, they find someone else for us to prod.  Thanks, powers that be. Zoom back in…

So I read.  I practiced on plastic anatomic models.  I stressed.  I heard horror stories of inappropriate things that students would do or blurt out without thinking during their first pelvic, like “Oh my God, I found her cervix!  It’s just like in the book!”  I even asked my wife what a pelvic was like.  [Cue rolling eyes]  “Honey,” she told me, “You have no idea.”  Man, was she right.  Thankfully, my victim, Virginia (name changed) was very cool.  She even gave me constructive feedback about my technique that I know better than to go into here.  They’re called standardized patients, and unconfirmed rumor has it they’re paid $35 for every green medical student who touches them.  They’d have to be well compensated to get ten or fifteen sensitive exams in a night.  When it was all over, I wouldn’t say that I enjoyed myself (that would be – ew— I don’t even want to think about that), but  it was a good experience.  I was trusted to do something extremely private with a total stranger, because someday,about two years from now, I will be a clinician.  A Physician Assistant.  That’s hard to beat.  Maybe someday I’ll talk about the rectal exam that followed.   But for now, I’m just gonna let that memory fade a little bit.

-PK

4 Comments

  1. Amy Papazian September 2, 2010 at 5:09 pm - Reply

    Thoroughly enjoyed the real world view of your experiences and feelings. Thanks so much for sharing! I look forward to more soon.

  2. […] Here is a post by Paul about doing his first pelvic exam on a “patient”. Actually someone paid to allow students to learn physical exam skills. When I did this a group of women interested in women’s health had the fore site in the 1970’s to volunteer to teach us how to do a pelvic exam. They gave us feed back as we “went along”. I remember being nervous and embarrassed but needing to know how to do this, so pushing myself to listen and ask questions. Good Work Paul. […]

  3. Happy Holidays June 21, 2011 at 8:48 pm - Reply

    […] My First Real Patient […]

  4. elgallo March 3, 2012 at 5:57 am - Reply

    Ha! I cannot imagine, at the moment, what that must have been like. I also cannot imagine doing such exams on other students and then have to see them the next day. “Just wanted to tell you that you have healthy anatomy.”

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