Interesting. I get most of my medical care at a teaching hospital, and pretty much every time I am examined for anything, I am told, “here is so-and-so, do you mind if he examines you?” I always say “go for it”, since I figure medical students need to learn somewhere, and a medical student may be more interesting in my routine problems and look more carefully than the senior doctor anyway. Usually, the student takes a long time, and then the doctor does exactly the same exam in 1/3 the time.
But I’ve never had a student do a rectal or cervical exam, now that I think of it.
Oh – and there’s absolutely no question that the cervical exam is more invasive and uncomfortable than the rectal exam. Not even close. Guys, you may be squeamish, but you have it easy.
Free fun fact: the reason why hospitals had high maternal mortality rates was because the medical students were practicing forceps delivery on cadavers.
Nowdays most difficult births in the USA go straight to ceasarian, but it used to be that doctors learned to use forceps to assist birth. (And that was a fairly recent invention. Before forceps, mother and child just died)
When they first started training doctors to use forceps, they used models. Practicing on actual cadavers was a high-tech medical inovation at high-tech cutting-edge medical schools. There was opposition from old-fashioned out-of-touch reactionary doctors and medical schools, who did their training on good old-fashioned wood/lleather models. And then some woo-woo alternative-medicine type started suggesting that modern medicine was causing maternal mortality by carrying germs from the cadavers they used in oby/gyn training, to their patients. You can imagine how well that idea went down.
I think you’re confusing the story of Dr. Semmelweiss ( Ignaz Semmelweis - Wikipedia ). It’s worse than that. In the European hospital he worked at, the doctors were trying to figure out what caused post-partum infections that frequently killed the mother. (Puerperal fever) He noted that the first clinic with the doctors doing deliveries had a death rate two or three times the second clinic that used midwives. He figured that the doctors, who went straight from dissecting cadavers of dead mothers to delivering babies, were carrying the disease in on their hands. Midwives, of course, did not touch the cadavers.
He suggested a through scrubbing of the hands with antiseptic would go a long way to reducing the instance of the disease. Tests actually proved him right. Of course, the good doctors of Vienna were very prominent society members; to be told their hands were “dirty” and causing disease, as if they were common working class labourers, was a gross insult, and they basically drove Dr. Semmelweis to an insane asylum.
This was before the germ theory of disease gained acceptance, so his hand-washing demands sounded more like OCD than logic.
The robotic rectum sounds impressive, but this model still leads the pack.
*"Prostate Rectal Digital Examination Simulator Trainer
$1799.00
A realistic representation of Prostate Rectal Examination. Included: the Buttocks, Anus, and Rectum, five Interchangeable Prostates, and two Perineum’s, allowing for the practice of diagnostic skills associated with Rectal Examination. Skills include: Digital Examination of Prostate, Digital Rectal Examination, and Proctoscope Insertion and use. Features: Two interchangeable Perineum’s, one normal for Prostate Examination and one with Two Pathologies (polyp and carcinoma); Five Interchangeable Prostates: Normal, Bilateral Benign, Unilateral Benign, Bilateral Carcinoma, and Unilateral Carcinoma; Palpable Sacrum; and Realistic Sphincter Tone. Carcinomas of prostates are hard to the touch for realism. When in use the prostate is hidden and cannot be seen by the trainee. Prostates can be easily and quickly changed. The Manikin includes: One Rectal-Examination Normal Perineum, one Rectal-Examination Pathology Perineum, set of five Rectal Examination Prostates, Clear Plastic Stand, and one Impact Protection soft Storage/Carry Case. Wt: 18 lbs. "*
Is there any male Doper who didn’t automatically touch his nose when he read this? Or his prostate.
Does that consent form I sign before general anesthesia include permission for people to do things like this to me while I am under? And it has been a long time, but the last time I was an inpatient in a hospital I was once the subject of rounds, where a bunch of medical students came around to see me, and one of them did an exam on me. Actually I didn’t mind - it was interesting to hear them talk about my case, and they were careful to acknowledge me and not just treat me as a specimen. They did stay out of my ass, though.
Damn. I went all afternoon, and even checked the thread a few times, and didn’t.
But then I started thinking about how I check meat doneness, and that people are taught (for better or worse to compare it to touching parts of your hand. And I wondered if the base of my thumb (“well-done”) feels like the tip of my nose, and before I knew it, boom, I was touching my nose and thinking about my prostate simultaneously with a steak on a pan.
I can’t remember if I’ve ever actually felt my own prostate. And yes, that would be the only potential experience, not that there’s anything wrong with that.
ETA: So they can tell students, but perhaps not Indian ones who will find it less helpful, that a healthy prostate feels like a well done steak.
It’s more than just the proper firmness. It’s also a good size and shape analogue as well. So perfect, in fact, that the tip of your nose has the same crevis down the center of it that your prostrate has. Go ahead, I’ll wait while you feel for it.
On your nose, this crevis is formed at the apex where two cartilages come together. On your prostrate, it’s where the urethra runs down the center of it. They really feel quite similar.
Between the time when forceps were invented, and the time when cadavars were used for obstetrics training, there was a short period of time when simulation babies and birth canals were used for obstetrics training.
How do I get to be one of these simulated patients? I’ve never seen any advertising for it. I’d be quite happy to let them practise on me if they pay well.
A few years ago, I had a routine physical and my physician introduced a young woman physician who was shadowing her for a few months (I’m unclear if such a person is called a resident or simply a new doctor). At any rate, my regular doctor first did a prostate digital exam, and then asked if her shadow could repeat it for practice. I had no objection, and did my part for better future diagnostics somewhere in these United States.
