Monday, March 09, 2009

Wrecked Rectum

This article about the purpose of the rectal exam is amazingly helpful; the inevitable jokes are of course excruciating. Seeing as how such intimate examinations are so critical, I'm wondering how well I'm going to cope with this. I've only been doing exams that involve exposure at the chest and abdomen; I've seen nothing yet.

I have not been focusing too much on that and I'm wondering how much my reservations about physical contact are keeping me back. Will I be the type of practitioner who will examine physically only if I think it's necessary rather than if it might be helpful?

One of my OSCE stations last year was a disaster: I was so distracted by the examiner's questions while I was examining that I pressed too hard and hurt the poor volunteer. This is the gravest sin when doing a physical examination: as a student, you are allowed not to know the correct answers but you are never allowed to cause discomfort to the patients. Even though not much clinical teaching is happening in this year of study, it is evident that I need to practise if I want to be competent later. Yet, I haven't been doing this, using lack of clinical teaching as a justification for my avoidance of "unnecessary" physical contact.

Have your personal reservations ever held you back in your chosen profession?

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