pelvic exams

[aggiecatholic05]

so i am taking my first ob/gyn class. thats part of my degree plan and i knew that going in so no complaints. i have to do 10 pelvic exams to get credit otherwise its an incomplete. these have always been done on manequins and models, this is something i find silly but dont object to.

what i do object to is the new teacher we have. she has outlandish views like ‘hospitals are evil’ and ‘women who have c-sections will never love their children’. shes a midwife and quite the hippie type. she is working to bring in standardized patients so that we can preform the full vaginalanal exam on real people at least 2 times. this is something that i find immoral.

why? because it is chiropractic school. preforming these exams on patients is not in our scope of practice. in real life if i did this to a patient i could be sued, lose my liscense and maybe be jailed.

now i know that for actual medical and research reasons there is nothing wrong with a man examining a woman or learning how to do it. however it seems very odd to make us do this in school(which apparently the school is liscensed to do in teaching us) when we have no ability/reason to need it.

not wanting to have to deal with any womans reproductive issues is the main reason i did not go into medical school(abortion and contraception being at the top, but this was a part).

so since it was not a part of the circilum when i started school, and since it is seemingly not a legimate reason(out of scope) is it ethical to do these exams on healthy women who do not need them? i am thinking no and wanting to object to be allowed to do them all on models.

thoughts? insights?

 

[Joannm]

so i am taking my first ob/gyn class. thats part of my degree plan and i knew that going in so no complaints. i have to do 10 pelvic exams to get credit otherwise its an incomplete. these have always been done on manequins and models, this is something i find silly but dont object to.

not wanting to have to deal with any womans reproductive issues is the main reason i did not go into medical school(abortion and contraception being at the top, but this was a part).

so since it was not a part of the circilum when i started school, and since it is seemingly not a legimate reason(out of scope) is it ethical to do these exams on healthy women who do not need them? i am thinking no and wanting to object to be allowed to do them all on models.

thoughts? insights?

It is ethical to do pelvic exams on healthy women. I am healthy and get one every year. As far as having to do them as part of the program you are in, why don’t you talk to the director and express your concerns.

 

[newbetx]

It is ethical to do pelvic exams on healthy women. I am healthy and get one every year. As far as having to do them as part of the program you are in, why don’t you talk to the director and express your concerns.

First I’d ask the teacher for an alternate assignment. If you get nowhere, escallate. Or, drop the class. What’s next? Surgery?

 

[Randy_Carson]

so i am taking my first ob/gyn class. thats part of my degree plan and i knew that going in so no complaints. i have to do 10 pelvic exams to get credit otherwise its an incomplete. these have always been done on manequins and models, this is something i find silly but dont object to.

what i do object to is the new teacher we have. she has outlandish views like ‘hospitals are evil’ and ‘women who have c-sections will never love their children’. shes a midwife and quite the hippie type. she is working to bring in standardized patients so that we can preform the full vaginalanal exam on real people at least 2 times. this is something that i find immoral.

why? because it is chiropractic school. preforming these exams on patients is not in our scope of practice. in real life if i did this to a patient i could be sued, lose my liscense and maybe be jailed.

now i know that for actual medical and research reasons there is nothing wrong with a man examining a woman or learning how to do it. however it seems very odd to make us do this in school(which apparently the school is liscensed to do in teaching us) when we have no ability/reason to need it.

not wanting to have to deal with any womans reproductive issues is the main reason i did not go into medical school(abortion and contraception being at the top, but this was a part).

so since it was not a part of the circilum when i started school, and since it is seemingly not a legimate reason(out of scope) is it ethical to do these exams on healthy women who do not need them? i am thinking no and wanting to object to be allowed to do them all on models.

thoughts? insights?

Talk to your dean. Perhaps you can can an exemption if you explain your position as thoughtfully as you have done here.

 

[aggiecatholic05]

It is ethical to do pelvic exams on healthy women. I am healthy and get one every year. As far as having to do them as part of the program you are in, why don’t you talk to the director and express your concerns.

perhaps i worded it wrong. those healthy women have to get an exam from an obgyn to be sure they are clean and ‘normal’ for us to learn on prior. so i couldnt even consider that i might help them as a justification for what we’d be doing.

part of this is also a c.y.a. thing. there are cases of chiropractic students being charged with practicing medicine without a liscense for giving friends and family advice(God bless them the AMA just doesnt care for us) so that is a small part of my worry.

but mainly it just seems inapproiate. i am very good at being professional with my work, but even with that this just doesnt sit right with me.

i intend tocomplain up the c.o.c., i was just hoping to get a concrete reason as to why i objected.

thank you for the (name removed by moderator)ut though

 

[aggiecatholic05]

First I’d ask the teacher for an alternate assignment. If you get nowhere, escallate. Or, drop the class. What’s next? Surgery?

if i drop the class i just have to retake it. cant graduate without it, and cant get liscensed with out graduating.

and in oregon we can do minor surgey(stuff like stiches). i think its foolish, thats not our forte. we adjust and do nutrition, pt and things like that, but its a wild world when you look at what we can and cant do in some places(limited prescription power in TX) and what some people want our scope to include(nothing to everything)

 

[Jeanne_dArc]

First I’d ask the teacher for an alternate assignment. If you get nowhere, escallate. Or, drop the class. What’s next? Surgery?

Hey, there could be a perfectly good reason to understand this. Why assume you know more than your teacher or the program of study? (Ok, I do agree their can be seemingly “pointless” classes, but I always find in the end I learn something, having a positive attitude that I will gain something can play a big role. While you may not perform pelvic exams in your career there may be an important reason for you to understand the process, etc. I’m graduating this semester with Bachelors of Science in Science Education (ages 8-15) I’ve learned more about science/ embryology/ human reproducation than I will ever teach my students. Some of it I could probably be sued if I taught them, or at least I would be morally reprehensible. However because of what I learned, I have such a deeper level of understanding of science, etc, that I will be a better teacher.

Anyway, that’s just my two cents.

 

[VociMike]

Seems to me that once you agreed to a course of study that included (for whatever reason) one or more ob/gyn classes, then you at least agreed to this as a possibility. Sure, try and talk your way out of the requirement if you want, but beyond that I wouldn’t make a big deal about it.

 

[vera_dicere]

I’m a nurse, and while when I was studying we did watch a video on the process, but in my country only nurses with specialised training are allowed to do a pelvic - because of the damage you can do if you don’t know what you’re doing.

I saw plenty done on clinical practices and assisted doctors both as a chaperon and as someone giving them the instruments. And a lot of these pelvics were done on healthy women .

Honestly, I think you sound a little prudish. Dont’ look at it as something “intimate”, rather a skill you can add to your porfolio. Even if you never actually do one in your practice, its still good to do - if anything it teaches you that what you see drawn in a text book don’t look anything like what exists in reality. Its also a good way to see the muscles and what not.

As for being sued - obvioulsy you know what your scope of practice is, but your lecturers are pretty clued in even if they dont’ act like it- chances are they will know what they can and cannot teach. I mean, nurses are taught how coronary bypasses are performed but we’re never allowed to do them!

 

[Jolly_Joe]

It does make sense that they teach you, because a fair number of places do allow chiropractors to do such things.

soto-usa.com/SOTLiterature/ScopeofPractice/ScopeofPracticeLamm.pdf

Is an article that shows the results of a survey from 1999.

As things are going in the US, I think even if you are where it isn’t allowed in your scope of practice today, there is an excellent chance it will be before long, certainly in your practice lifetime.

 

[aggiecatholic05]

joe the article was a little dated, but very interesting. thanks.

yes it is true that the scope may expand to that( there are people pushing for us to have prescription rights), or it may shrink(in some state we can only adjust the spine-no extremities, no soft tissue stuff, etc).

my point wasnt so much against learning it. i am ok with videos and practicing on models. it was more of:

‘is it ethical/reasonable to put patients through an unnecessary exam by unskilled students with no supervision when most likely 99% of them will not be able to do it in practice upon graduation, and possibly never will’

and by the way when we do assesments on standardized patients for other classes like physical exam, orthopedics, or for entrance and exit exams to the clinic we are alone. there is no teacher present or watching. it is done by several cameras then graded by a panel afterwards. apparently this is how they would occur if it happened, and as was noted earlier this procedure is not without its risks.

 

[The_Stig]

I’m just not at all sure why the OP thinks this act is immoral in the first place?

If it would be immroral for him, it would be equally immoral for any doctor or medical student anywhere, since not all of them are going to do it in practice either.

Sounds like a non-starter to me.

 

[aggiecatholic05]

I’m just not at all sure why the OP thinks this act is immoral in the first place?

If it would be immroral for him, it would be equally immoral for any doctor or medical student anywhere, since not all of them are going to do it in practice either.

Sounds like a non-starter to me.

its not that i wont do it, but that i legally cant do it

 

[The_Stig]

Unless you move to a state that allows it, right?

I don’t think you’ve thought this all the way through.

 

[RobHom]

Unless you move to a state that allows it, right?

I don’t think you’ve thought this all the way through.

Ummm, actually, I think the OP has given it a great deal of thought and is on the right track. If the OP is attending a “Chiropractic” school…the simple fact is this, born of this simple truthful statement:

why? because it is chiropractic school. preforming these exams on patients is not in our scope of practice. in real life if i did this to a patient i could be sued, lose my liscense and maybe be jailed.

Its simple enough. An examination of that type is outside the scope of a Chiropractors practice. An examination of that nature is considered “invasive” and they are not trained or licensed for invasive techniques… also considering that the bulk of their practice is based on subluxation of the spine and other issues of that nature…intimate exams of females is not on the agenda.

Were he or she, as a Chiropractor to do such an exam, he or she would face arrest and confinement, loss of license, and in the event that it involved a minor…the words child molester and pedophile become part of the lexicon, and they get listed on sexual predator lists.

Frankly, I would have a serious “heart to heart” with the administrator of that school and ask “WHY” are we even spending time on a subject that is not germane to the field. It makes almost as much sense as studying how to “calibrate the left handed muffler bearing on an Edsel”…

 

[aggiecatholic05]

Frankly, I would have a serious “heart to heart” with the administrator of that school and ask “WHY” are we even spending time on a subject that is not germane to the field. It makes almost as much sense as studying how to “calibrate the left handed muffler bearing on an Edsel”…

well we take the ob/gyn class for the same reason as pediatrics and geriatrics. because they will be our patients and we need to know about conditions involving them. however we dont learn to do bypasses even though some of our patients may need them, or a tonsilectomy. there is no real reason to learn this exam procedure.

other than that i think you see my point.

 

[Jolly_Joe]

The part I really don’t believe is right is having the patient evaluations be unsupervised.

I would think it would be the best teaching one could get with a teacher showing and giving points in do you feel that, and do this and so on.

It seems like they just want to throw the student on people give a grade and get home.

I know medical doctors that won’t do pelvic examinations without a nurse present and yet this school is having students do it unsupervised?

I would think such a school should be shut down, but then I think that of a lot of chiropractic schools. I knew a professor who was on a national accredidation board for chiropractic schools and the stories he told of many they would not accredit were amazing.

By the way, is this school accredited and by who?

 

[aggiecatholic05]

The part I really don’t believe is right is having the patient evaluations be unsupervised.

I would think it would be the best teaching one could get with a teacher showing and giving points in do you feel that, and do this and so on.

It seems like they just want to throw the student on people give a grade and get home.

I know medical doctors that won’t do pelvic examinations without a nurse present and yet this school is having students do it unsupervised?

I would think such a school should be shut down, but then I think that of a lot of chiropractic schools. I knew a professor who was on a national accredidation board for chiropractic schools and the stories he told of many they would not accredit were amazing.

By the way, is this school accredited and by who?

to be clear joe, the school has never had pelvic exams done on real people, just models/manequins. its just that one teacher who wants it to be done, and i was describing how it would be set up. so maybe just remove the teacher, or ignore her idea to do it instead of shutting down.

and honestly i agree that most chiropractic schools probably shouldnt be accredited. there is some crazy stuff out there like:

only christians can be chiros, because God flows through your hands and heals the patient during the adjustment, all medicine is bad and chiros can cure cancer

however i go to one that is sience/evidence based, and the one in my example lost its accredation about a year ago.

yes it is accredited. by the chiro people, and by the southeastern something or other(the folks that do regular colleges, like A&M, Rice, and such), otherwise i couldnt get federal loans to pay for it and i would be going somewhere else.