To expect medical students to know the basics?

[JuneWalker]

About this time of year for several years I have acted as a "guinea pig" for medical students working on their practical skills.

Its quite an experience (for both parties) when they insert a speculum in a real patient for the first time. In the past although there have been one or two minor issues the nurse who was there 100% of the time always intervened in time.

This year there was 1 nurse for every 2 patients and Mr NHS manageer - IT DOESN'T WORK!!!

Female students have always been fine but some of the men were hopeless. I had a very sensitive part crushed by a thumb, I had one lad (looked about 12) trying to remove the speculum with the blades open and one who didn't seem to know where to put at all.

I did my 15 students but complained at the end. Got totally blanked by the doctor in charge.

Surely when they are doing something like this for the first time there should be 100% supervision???

The only good point was that this year we didn't use the dreaded stirrups and just put our feet on the examination couch. Much better.

oh jesus wrong thgread !!!!!

Sorry, but IMO this dissing of the OP is to me a good example of the kind of attitude we're talking about - telling a patient she didn't experience what she says she experienced because 'it can't have happened'. She was there. We weren't (presumably). As a starting point, how about believing her? There'll be plenty of other witnesses if that's not what occurred. If she didn't know the roles of some of the people who were there, the explanation she got may not have been much good.

BicycleBelle - most of the NHS managers in the hospital where I work are not clinically trained

I had my 1st baby 5 weeks ago.

I consented to have a student midwife present - she was on her 1st placement and had never been present at a water birth (which I was planning on having).

Each time the midwife got her to check the babies heart with the doppler or check my blood pressure she took ages to do it then forgot to record it. That meant it had to be repeated over and over

Then after 17 hours of labour when I was finally at the stage where my DS was ready to be born she was clanging about with the tools to cut the cord etc. Except she wasn't very subtle about getting them ready and set down this tray of scissors and other scary looking tools right beside me! I freaked out and thought she was going to cut me open The midwife told her off for scaring me.

I can look back now and laugh about it, but at the time I was scared witless.

Oh, and another funny one:

My DH is a doctor and he told me that during his final practical exams at uni the students were using dummies to practice their examinations.

One of the examinations was on the 'patients' eyes. My DH said that one of his fellow students picked up the whole head off the dummy to get a better look!

Suffice to say, this person didn't get a good mark, as tearing the heads off patients in RL isn't a good idea!

When I was a m/w student (about 5 years ago) I saw 2 med students practice VEs on a patient who was unconcious in theatre. Made me feel sick but after asking some questions I found the woman had consented to this.

IME the med students only do speculums and VEs on actual patients but guess this may vary between med schools.

rofl @ pulling the dummy's head off!

Let's nominate June Walker for a Pride of Britain award and watch the slebs spit their champagne out as Ant or Dec hand over her award

I have no idea whether the OP is a troll or not - I don't have that spidey sense that others seem to have. But I do want to make a couple of points:

People have volunteered for medical students' practical exams for a long time. Generally, the student will have to take a history and symptoms and illustrate their diagnostic ability from those (and any test results). But what the OP is saying is that what she was involved with was a session for students to practice a particular procedure. wuglet's link is worth reading.

I do recall the fuss about vaginal examinations being carried out on unconsented anaesthetised patients in theatre. I'm rather surprised that VEs are still done on anaesthetised women, even by consent, because that's not very realistic.

TakeLovingChances: 1: no excuse for that; 2: .

Not read whole thread but RUBBISH, this is not something that medical students practice on a real person 15x in a row!!

They need more dummies like the ones here!

Read the web pages on Gynaecological teaching associates. The London Teaching Hospitals are buying in what some of us offer for free.

archive.student.bmj.com/issues/04/12/life/468.php

What was said by the OP was that in the course of a day typically 15 students would have been given the opportunity to insert the speculum and use it using on a volunteer patient. What is strange is moving away from a system that worked to one that worked less well.

BTW The student didn't literally crush my "little man" with a mis-placed thumb. But it sure felt like it at the time.

Don't they have plasic dummies to practice on you. Took me 2 years to pluck up courage to have a smear! You are so brave and should have everything done to ensure your comfort!

As a doctor who clearly used to be a medical student (although it feels like ages ago now) I think it is pretty amazing of you to do this to help students learn. It is VERY different to practicing on a plastic model! As a female student I managed to get a reasonable amount of practice at intimate examinations but male medical students often aren't so lucky as understandably lots of women don't want to have unneccessary embarrasing exams from a bloke. If it wasn't for people like you then they would be let loose on the general public as doctors with no experience.

YANBU to say that there should be 1:1 supervision - not least as you should ALWAYS have a chaperone performing intimate exams whether a student or a doctor.

YABU to say the students should know what they are doing though - they are learning afterall and some of them will never have done this before. And will also be very nervous and anxious about getting it wrong / hurting you when you have volunteered for this. That always makes people struggle.

Not read rest of thread though - sorry

When I was a student nurse I was so grateful for the patients who consented to me practicing my clinical skills on them. All was under very close supervision of course.

I have also stood in for med students exams as a "patient" for gyn problems, they only took my history and asked about sypmtoms before discussing with the examinor what they had diagnosed was the problem and methods of treatment. There was no physical contact at all.

On a side note though I have consented to having a VE by med students whilst under a GA for a laparoscopy. They need to learn somewhere and I wasnt gonna feel it so I thought what the hell. After years of treatment for infertility my dignity was long gone anyway. Would do it again too.