US teaching hospitals are allowing medical students to perform pelvic exams on unconscious, unconsenting women? [Edited by MNHQ]

So sorry, that came across not how I meant it, it was supposed to be reassuring for women.

I hope that you find a logical and acceptable explanation for what happened to you, which is different to your fears. For example it may have have been conductive jelly for the diathermy pad that was on your thighs and/or rectal pain relief (which wasnt used so much in my days hence not suggesting it). If you had needed to be turned on your side rapidly. we used to put a hand under and over the thighs to kind of flip patients. I suppose that could cause bruising.

Thank you. I'm going to write to PALS.

@Washedwithrain I just dont believe that women undergoing any procedure other than a gynae one were examined vaginally whilst unconscious.

What a luxury for you. How dare you dismiss people's experiences like that.

Johnny I too had serious issues with my twin pregnancy as a result of traumatic gynae procedures / exams previously, and had a similar experience of it being dismissed by consultants. I ended up with an emcs and no labour which was probably for the best.

I was once given a video of one of my laparoscopies (think it was the 4th one). I was quite amazed to see my uterus moving out of the way seemingly of its own accord. I couldn’t understand it. There were no instruments visible that moved it. I can only assume they insert an instrument vaginally in order to do that. They consent you for every possible adverse outcome. They tell you to expect vaginal bleeding but don’t tell you why. They explain how the procedure is done but don’t mention this aspect.

I find this really awful, and it’s nothihg compared to nonconsensual exams.

That BBC article was awful - a student being told that the best way to learn recital exams is on anaesthetised patients as “they’ll never know”

There are no words for how horrific this is. I understand that HCPs have to become desensitised to things to an extent, but the flip side of that is the danger of treating patients without dignity.

Another reason pants can be removed is to allow painkillers to be inserted into the rectum - a very common and good method of analgesia.

Just going back to that Cosmo article, and thinking about practice years ago, the reason everyone had to remove pants (men and women) was that we used to use a large diathermy pad which was placed either around the thigh or more usually under a buttock as it needed good contact with skin. We didnt remove gowns unless absolutely necessary for the procedure and patients were just gently lifted to place the pad underneath them, the buttock wasnt even visible and the gown was untucked from underneath the patient, but not raised. I just dont believe that women undergoing any procedure other than a gynae one were examined vaginally whilst unconscious.

That isnt making excuses for a system whereby women undergoing gynae procedure were maybe were examined without consent by the way.

God this thread is sickening. Where it's still legal on the US surely the woman doctors and men doctors who aren't sexual predators would stop this?

Fwend truly awful.

Oh Lordy, predictive text fail! A teaching hospital. I haven't been at the gin, honest!

*woken up with

When I was a student in a hospital I did a placement in theatres. To my absolute horror there were student paramedics 'practicing' placing tracheal tubes into unconscious, unconsenting patients. It was brutal. Those people would have whoever up with sore, bruised airways, when they went in for gallbladder surgery. When I challenged this practice I was told that patients consent by attending a texting hospital

also wanting to vomit at the thought.

fwend

Sock, thanks for answering. I did feel you were dismissive by putting phrases like interfered with without consent in quotes. However, as you can maybe guess, this is a sore topic for me as I was myself subjected to a non consensual vaginal exam as a tween (awake).

It's affected the whole rest of my life and made me feel frankly suicidal when recently faced with the prospect of a highly medicalised twin birth with lots of people watching, stirrups etc. For me, the effects of that are ongoing and this is exactly the same as the state of the Met Police in the 90s - it shows a systematically, criminally discriminatory institution.

I mean, imagine if we now found out that say certain police forces had a policy of carrying out mass miscarriages of justice, deliberately and systematically, against ethnic minorities. I think if a scandal like that broke, the perpetrators would be brought to book even now, and no amount of "oh everyone was at it" would cut it.

What can you do about it? Nothing, I guess, beyond being aware. Being careful that you don't sound dismissive either when representing your profession online or in person to patients. The consultant who "looked after" me in my recent pregnancy quite clearly didn't believe me and so failed to put in place any measures to help. You could not be that person. And you could be aware that senior people you work with may have been trained to see women as meat and therefore their decisions and opinions may be suspect.

@SinkGirl - couple of reasons - 1) if you're lying on the knots on the operating table, they can cause pressure sores; 2) if the knots are tied then the gown can get twisted all sorts of ways when moved onto the table, and lying on bunched up fabric can again cause pressure sores or even restrict blood flow in the neck; 3) to allow proper placement of ECG monitoring and for us to listen to the chest if we need to.

@JohnnyMcGrathSaysFuckOff what makes you think I'm not "fucking outraged?" Sorry if you felt my tone was dismissive, I was trying to reassure that it doesn't happen now and explain why certain things in theatre , which may appear inappropriate, are done. It's an alien environment to most people and I can totally understand why patients feel vulnerable, so I'm trying to explain a bit of what goes on.

Yes, it is horrible to think that some of my seniors may have been involved - and it won't just be gynaecologists, if it was med students examining, they could have gone on to specialise in anything. But I'm no more responsible for that than a junior bod at the BBC now was responsible for Savile etc, so I don't know what more I could feasibly do about something that went out of date when I was still in school?

In 2003 it was reported that some Bristol and other students in the UK were uneasy about whether sufficient consent had been obtained for pelvic or rectal exams carried out under anaesthesia:

A survey of students in one medical school suggested a quarter felt examinations they carried out on sedated or anaesthetised patients may not have involved "adequate consent".

Guidelines from the General Medical Council state that the permission of patients must be sought prior to any check or treatment.

However, the survey, carried out at the University of Bristol Medical School, suggests that this good practice is not always adhered to.

Students said they were asked to carry out rectal and vaginal examinations "inappropriately".

news.bbc.co.uk/1/hi/health/2642861.stm

Oh and on that aibu thread referenced above there was one hcp who reported being pressurised to do this in an NHS hospital in the 1990s although admittedly by a dinosaur of a consultant.

So there must still be loads of drs who trained this way.

They are criminals, to my mind.

I'd be interested in knowing exactly when this stopped, for sure. Because if it was any later than the late 70s, then there are gynae consultants working now who learned this way.

Or, to put it a different way, there are male gynaes working now who unblinkingly took part in mass, state sanctioned serious sexual assault and instrumental rape of women.

We ought to be able to find out who did this. I don't want a sexual assailant looking after me in labour.

And all that crap about ooooh it hasn't happened in simply years ... yeah that doesn't fucking fly. Instead of being so defensive and dismissive, why aren't you fucking outraged that there are presumably thousands of older women walking around who were subject to systematic multiple sexual assaults by members of your profession Sock ?

Fwend I am so sorry. I know it was a long time ago now but I have no doubt that PALS would want to hear your complaint if you feel able to do so. There should still be details of who was involved in your surgery in your notes.

When I was about 21, I was taken to A&E by ambulance for severe pelvic pain. I was pumped full of morphine which wasn’t working so I was given more and more and various other stuff until I was very out of it.

A student doctor came round and performed an internal exam without asking, without even looking at me - I don’t think he realised I was fully aware of what was going on but not able to respond.

There were no curtains drawn so the guy opposite was watching the whole thing - eventually the person doing the exam realised it was being watched and turned my bed to face the other way. I don’t know why he didn’t draw the curtains - maybe there weren’t any?

I made a complaint about 12 years later after I had an even worse experience in the same hospital, but they couldn’t find any record of me being examined at all on that day.

Fwend that is shocking and truly horrific. I'm so sorry it happened to you.

This thread is making me physically want to vomit. Peak misogyny.

If they only lift the gown out of your way, why do they have to untie the back before you lie down? I just assumed they’d be removed when you’re naked. I remember watching that BBC series Bodies (written by a gynaecologist I think?) and being appalled at the way they depicted how women were treated when under anaesthetic. Didn’t help with my later surgeries.

Fwend that's horrific.

I thought about NCing for this, but fuck it, I've got nothing to be ashamed of.

I nearly threw up reading his thread. When I was 16 (late 1990s), I had my tonsils out. I insisted on wearing my underwear (was a virgin) and when I came round, they were gone and I was sore, bruised and had a slimy, wet substance all over my thighs.

I asked what happened and was told nothing. I always assumed I was sexually assaulted under anaesthetic, but I never thought it was as part of a routine plan.

Disgusting, and appalling. In a country so keen on litigation, it seems like madness.

@kaitlinktm no women in the UK are "interfered with without consent" under anaesthesia nowadays either. Thankfully the NHS has moved on a little.

Re. Paper knickers - some trusts do provide these, some allow you to wear your own if they're pure cotton. Obviously if surgery involves that area (including non-gynae surgery e.g. hip or lower abdomen ops) they have to come off. Gowns are not usually removed, just lifted out of the way of the operative field.

A friend of mine has a part-time job to allow medical students to practice internal exams on her. She has another job where she 'acts' a victim of crime for police officers in training, which sometimes requires a rape scenario. She loves both jobs which are paid.

It's why it's important not to assume that terrible things in another country are the same here. We have plenty of problems in the uk but this isn't one of them. Sympathy to any women around the world who are still facing this.