Women: a poll regarding male gynecologists and male medical students

In My Humble Opinion
41

Well, I answered based on my experiences when I was pregnant with both my kids…I had a midwife and a Dr. and was always willing to allow the “trainees” to observe my exams and even births.

No GYNOs/med students as a rule, mainly apprentice midwives and almost all female, but it would not have mattered to me either way (med students/midwives OR their sex).

I recall one time, late in my pg. with my first, the Dr. was checking me for dilation (I was at 6 cm by 6 wks before the birth…same with my 2nd) and he asked me, “Is it ok if I bring them and let them check this out?” (making it very clear it was entirely up to me and he was asking a lot).

I said, “Sure, why not? I’m OPEN to anything!” :smiley:

So they filed in, took turns feeling me up (most apologizing as they did so :p).

But hey, I felt flattered; apparently, I had a “great cervix” and he wanted to use it as an example of what that felt like on a live patient. ( He actually said that, “Hey, I want you all to come see what a great cervix looks like!”…not that they “saw” or “looked”, of course:p)

And there were 3 apprentice midwives at my first home birth and 6 at my second. They were not only very helpful to have around (always eager to lend support or fetch me another glass of juice or something) BUT I knew I was helping THEM out, since they have to get a certain number of births under their belt (or, more accurately, under someone else’s ;)) before they can graduate.

And again, I would have been more than happy to allow male students use me for practice (as long as the actual providers I knew and trusted and I remained present and in control).

42

I don’t get why people have a gender preference re: gynecologists. I’m not there to see a man or a woman. I’m there to see a doctor. And I know that to a doctor, I am just one of many bodies they’ve seen, and I probably do not make much of an impression on them one way or another. I just care that they are good.

I’m not crazy about medical students, because there is something more uncomfortable when it is “two against one” in an exam room. But my decision to decline their participation in an exam would be based on the demeanor of the student, not the student’s gender.

43

I don’t think I’d even have the choice to say “hey, I’m a patient, not an exhibit” if the doc happened to have a “student”. In Spain that could mean either a whole passel of students (at a university hospital) or a single already-degreed-doctor doing rotations during his specialty training (in any other medical center). If you get someone who’s on rotations, that means you may get the joy of being examined twice; more likely, the student will be the one performing the examination and the specialist may give pointers.

I had a bad experience with a male gyne once, but I blame it on his being an ass and not on his being male, so I have no problem with getting a male.

ETA: I remembered, I once had the opposite case, in that the student blushed to his roots and asked the doctor to let him skip my exam. He was an old classmate of mine’s.

44

I have a preference because I’ve found that as a general rule, female docs (and PAs and NPs) tend to be a little gentler and empathetic. I’ve had a couple of bad experiences with females, and also with males. The gentlest person to examine me was a male PA, as it happens. But if I know nothing more about a doctor than his/her sex, I’m probably going to choose a female, because of my experiences. I also think that women are less likely to dismiss things like cramps. I don’t know how many male doctors told me that cramps were all in my head, before studies came out that showed that cramps are an actual physical problem. Female doctors never said or implied that.

45

I had a pelvic exam–albeit not a Pap–for the first time from a very old male doctor…I had just had surgery on my backside (for a pilonidal cyst) and he had zero zero sympathy for me when he asked me to “slide down further! Open your legs wider!”

And I tried to explain that I had JUST had surgery on the very spot on my ass that he was trying to get me to “slide down” on…and he wasn’t hearing it. He quite clearly wanted to get it over with and get me out of his exam room. Regardless of my feelings on the matter, or the pain he was causing me.

I hated that old man. Thinking about him now, I still hate him.

I’ve gone to Planned Parenthood for my Paps since then, for years, and they have lovely kind sympathetic Nurse Practitioners who have never made me feel anything but comfortable and relaxed. And they’ve done so many Paps that half the time I don’t even feel the “Giant Q-Tip.”

'm not saying I would never consent to a man doing my Pap, but I would greatly prefer a woman. She has the same plumbing. It just makes me feel easier and more relaxed.

As for a med student observing? Um, no. There are plenty of vaginas elsewhere. I find the whole thing annoying/distressing enough as it is. I don’t want spectators.

46

I don’t have a preference, but I understand having one. It’s not about not wanting a man to see your bits because you think he will have sexy thoughts about you–I think everyone realizes that is not likely–but that there are few positions more exposed, more vulnerable than being in the stirrups. You are positioned with everything that is most delicate on display. It’s not that you feel any sort of specific threat, you just feel generally threatened. Many women are more comfortable around other women in general, and given that, it’s reasonable to want only women around you in that vulnerable state.

Even when men get a rectal exam, they get to keep their fronts covered. In the stirrups it is all out there, and you are very, very naked.

47

I voted “I don’t care,” but I can think of one doctor – not a gynecologist – who had a student with him every single time I visited him, and I was going there about every six weeks for the best part of a year. It did get a little exasperating, to have yet another stranger standing there silently in the corner. For a gynecologist, whom I see once a year if all is well? Whatever.

48

I tend to prefer female doctors just because I find them easier to talk to for some reason but I’ve had male doctors as well. I would let a student of either gender observe and participate in the exam. I’m a doctor (just finished my intern year!) and know that there’s no other way for them to learn than to do lots of exams. I first learned to do all the genital exams on standardized patients. My med school felt that it was inappropriate for students to practice these things on each other. But that was one exam on one person. You have to practice to get good at it. And you have to see many different people to get an idea of what is normal and abnormal.

For those people who said that they don’t want anyone but the doctor in the room be aware that some docs won’t do a pelvic without a “chaperone” in the room. When I worked with those docs as a student they found it very convenient to have me there because it meant that they didn’t have to take one of the nurses away from her job. So they didn’t give the patients the option of having me step out.

Speaker for the Dead I don’t remember what year you are so you may already know this but a lot of it is how the request is made. If it’s presented as a big deal like, I know this is a big favor but would you mind… patients are more likely to refuse. If it’s normalized like, this is a routine part of our practice but you have the right to refuse… patients are more likely to consent.

49

I am only comfortable with females in the room during this sort of procedure. I would have refused you, sorry. Don’t take it personally. I have PTSD. I’m not sure if you’re aware, but anxiety of any sort during vaginal penetration ups the pain factor by about a bajillion. I have never had a pelvic exam that wasn’t painful. I understand you need to learn your shit, but I really don’t want to make this experience worse for me than it already is.

50

I have a whole bunch of doctors in my family and I know how it all works with the teaching, but I don’t want any medical students in the room, thanks.

In terms of the doctor, I go more on demeanor than gender. Brusque, doesn’t have the ability to listen and smells of God Complex? No thanks. This means I usually end up with earnest young women that remind me of my little sister (also a doctor) and my preference trends towards that these days, but my last doctor was a middle-aged guy. I also google-stalk people to find out where they did their residency and fellowship and then ask my sibs what they think.

51

This. I was getting an exam from a female gynie at what I forgot was a teaching hospital. She brought in a female student and asked if I minded if she observed. My response was “I really don’t think this is a spectator sport.” but let her stay because she was female. I don’t think I would have been comfortable if she were male. The gynie reminded me that it was a teaching hospital and I should expect this sort of thing.

Which brings me to a non-gynie related time - I was having my gall bladder removed at George Washington University Hospital in DC and had medical students traipsing through my room 24/7. It was extremely annoying when someone who looked like they should be home in bed with their teddy bear wanted to examine my incision at 3:00 a.m. That said, the surgeon was great.

52

Which brings up an interesting point - are there any non-teaching hospitals left? I know there are dozens of hospitals here in Chicago, but I can’t think of a one that I or someone I know hasn’t done Clinicals at. Where do you go if you absolutely don’t want to be disturbed by students during your stay?

53

This is my experience, too – every exam has been painful and I don’t want yet another person seeing me in that state, regardless of who they are or what their gender is. In fact, when I had my very first pelvic exam at 18, I was so anxious I had vaginismus and couldn’t complete the exam. My (female) doctor asked if I would feel more comfortable if my mother were in the room with me, and I said no. My problem wasn’t feeling uncomfortable with this particular doctor, it was with being examined by anyone, period, and adding more people to that list (even my mom) wasn’t the solution.

Even now that’s my attitude. I’m lucky I found a NP who is very sensitive and understanding, but exams are still painful. Rationally, I know that it would actually do a student good to see that exams can sometimes be like this and what some ways of dealing with physical/emotional discomfort are. But the thought of anyone else watching me silently and passively while I’m exposed and in pain like that would make me feel, frankly, really freaked out.

54

I’ve had several male OB/GYNs and several female. I prefer female, and I wouldn’t mind male students observing. For those who don’t understand it, at the risk of being overly graphic, let me explain something. And OP, pay attention. If you learn this, you could end up being a great OB/GYN.

This is my experience and not meant to generalize and speak for everyone.

The speculum is shaped in sort of the opposite way of my body. Let me put it this way. My vagina is shaped like this, pointy at the top and bottom and rounded on the sides —> (). Speculums are shaped the same way, but flipped horizontally. That puts the sharp edges in the wrong place.

Female OB/GYNs, in my experience, know to turn the damn thing a quarter turn so the sharp edges are entering my vagina at the pointy points. Get it? Male OB/GYNs don’t have any idea how this feels, so they just shove it in and the “sharp” edges of the speculum hurt a bit. It’s not a horrible, horrible pain and it just last a second, but it’s uncomfortable and screams to me: lack of empathy, lack of compassion, lack of sympathy, complete disregard for the patient’s experience.

And it seems so obvious to me. Turn the goddamn thing and you won’t hurt me. I don’t understand why many male doctors simply do not grok that they are sort of trying to fit a square peg into a round hole (forgive the imagery). Flip that speculum and now the shape of the speculum is in the same direction as my vagina. Then you can crank that sucker open and see whatever you can see. Make sense?

Now, I don’t really care much about bedside manner, although I do appreciate someone who keeps up light banter and talks to me while I’m in the stirrups. Silence is sort of uncomfortable for me. Bonus points for really great jokes.

Another tip I’d offer anyone studying this is always tell your patient what you are going to do before you actually do it. I don’t like to be surprised with a finger up my ass when I wasn’t expecting it. Male vs. female docs are about 50-50 on this. I don’t find that either gender is better or worse about this. I’m sure if you do it 50 times a day for 20 years, it’s hard to remember that, just because it’s old hat to you, doesn’t mean your patient knows your routine and the order in which you’re going to complete your exam.

Finally, don’t give me any bullshit about “this is just a pinch” or “this won’t hurt at all.” As a man, you really have no idea what hurts and what is just a pinch and comments like that are always met with much eyerolling from me. And, everyone’s pain tolerance is different. What’s “just a pinch” to someone who has given birth three times could be a virgin’s terrifyingly painful ordeal.

Let’s review:
•Turn the speculum before insertion;
•Warn your patients what you are going to do;
•And remember how vulnerable a patient feels in that position.

55

Do male medical students ever actually get up in the stirrups, with the edge of their bare ass hanging off the edge of the table?

Seriously, Speaker, if they don’t have you do that, I’d find an empty room and give it a try. It might even be a conversation started when you are giving exams.

56

This is a really good idea. Do you know why you have to keep asking us to scoot down further? Because it feels like we’re going to fall off. Do you know why we’re trying to close our legs? To brace ourselves, because** it feels like we’re going to fall off**! I have no idea how this can be addressed, because I am aware you need room to work, but a little sympathy and reassurance that you won’t let us fall if we start sliding forward off the end of the table would help.

And no, of course I’ve never actually fallen off the table. Tell it to my lizard brain, getting all kinds of “YOU’RE LAYING AT THE EDGE OF A CLIFF, IDIOT!” signals from my proprioceptors.

And Dogzilla, great call on turning the speculum!

57

I actually use that fact when I’m setting up for the exam. My usual line is “Scoot down the table until it feels like you’re almost going to fall off”.

Dogzilla, the standard teaching where I trained was to turn the speculum but not all the way to vertical because that can put the pointiest bit up against the urethra which we were told is painful. But supervising med student exams in the last year it seems that the teaching here is to insert the speculum so that the edges are vertical.

58

It’s funny to see so many women that only see female doctors. ALL of my bad exams were performed by women. In fact, I’ve only seen 1 female GYN that listened to me at all. My general experience has been that women doctors have been on the table themselves, so they think they know what you’re feeling - if you say you feel something else (like pain during the exam), obviously you don’t know what you’re talking about and it doesn’t really hurt at all, because they’ve never had that experience.

I’m sure I just had bad luck (repeatedly). Even so, I don’t have a gender preference for doctors. As for students observing… well, I’m already half-naked with a stranger poking around. Somebody may as well get something out of it :smiley:

59

My vote: I only see female gynecologists, but would accept the presence of a male student.

My GYN preference has nothing to do with sexual attraction and everything to do with equipment. I don’t care if a female GYN is a lesbian or a male GYN is gay; I want a female one, period. I’ve never owned a car or even had a license; if I were a mechanic, would you bring your car to me to repair, or would you prefer someone who has practical experience with them?

Obviously, this is a personal preference; I don’t care if other women want to see male GYNs. So, I have no objection to helping train them, subject to the usual restrictions of what might be overly intrusive.

60

I had absolutely no idea this was going to happen at my first pap test and I almost went three feet off the table. He never said a word. Who was going to tell me? My mother died when I was 7, of the nasty kind of cancer the doctor doing this very exam tells you about, so I was freaked out to begin with. And then . . . :eek: Yes, after all these years that exam still hurts like bloody hell. I end up with bite marks in my finger because I’ve been trying not to scream. Maybe I can ask for that speculum rotation trick . . . if they can understand me through my clenched teeth.