Wednesday, April 15, 2015

Pelvic exam

Today was one of my final clinical skills experiences - learning how to do a pelvic exam!

Being a woman, I can tell you there is not much worse in this world than a poorly done pelvic exam, so I was anxious to learn how to do this exam FAST and WELL - I didn't want to inflict any more discomfort on our practice patients than I had to!

There's 2 parts to the pelvic exam - the first part involves the speculum, which sort of spread the vaginal canal so the doctor can look at and/or get a cell sample of the cervix. I was able to locate the cervix on the 2nd try on my first patient, and on the first try on my 2nd patient - I felt super accomplished!

The second part of the exam is called "the bimanual exam", and essentially involves inserting your fingers into the patient's vagina, and then using your other hand to press down on the patient's abdomen and sort of "smush" all the soft tissue together, so you can feel the outline of the uterus and the ovaries. This is much trickier, although I was able to at least palpate one ovary. It feels sort of like a little marble!

My mentor for this session was an ER doc I've worked with before, and this time I especially appreciated her style, both as a doctor and as a teacher. She was efficient but not cold, and got the job done quickly - something both myself and the patient appreciated. I asked her how many pelvic exams she does as an ER doc, and she said that if she wanted to, she could do 10 or more a day - lots of pregnant patients and people coming in for STD checks at the ER.

To me, that's really cool. I wasn't interested in OB/GYN because I don't think I would want to do this sort of thing all the time, but its definitely an interesting procedure, and one that I could feel comfortable doing as an ER doc.

Just 2 more clinical skills experiences this year - phlebotomy, and our Gateway exam!!!!

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