It Happened To Me: I Teach Pelvic Exams to Med Students (On Myself)

Sure it’s strange having a job that entails having about 75 strangers a year inspecting your girly bits, but hey, somebody’s got to do it and I happen to do it well.

Oct 17, 2012 at 9:00am | Leave a comment

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Sure it’s strange having a job that entails having about 75 strangers a year inspecting your girly bits, but, hey, somebody’s got to do it and I happen to do it well.

If you asked me what I do for a living, I’d tell you I’m a librarian. I even have the master’s degree and glasses to prove it. So, most of the time I spend my days doing normal librarian stuff. However, a few times a year, I clock in at the local Med School and drop trou in the name of science. 

For the past six years, I’ve been a standardized patient, or SP. This job is most easily described as being a fake patient, but it’s much more than that. And no, it’s not “just like that one episode of Seinfeld where Kramer pretended to have gonorrhea” (said everyone ever when I tell them what I do). As an SP, I’m a trained professional who teaches med students how to perform standard physical exams. I show them how to use an otoscope (that thing they stick in your ear) or do an abdominal exam and then they practice on me. These days though I specialize in teaching two exams: the breast and pelvic.

So how does one become a professional vagina?

Well, one thing the Seinfeld episode got right is that most SPs are actors or at least have some theatrical ties. I started SPing (types fine, sounds bad) to supplement my dinner theater gig. As it turned out, I was a natural educator, which I can only assume is thanks a childhood of “playing teacher” with my dolls and sibling hostages. 

I loved the work and my students had great things to say about me. For a year I just taught the general exams, but then, motivated by a combination of altruism, curiosity and the promise of a fat paycheck, I asked to train for the genital exams. 

Regardless of what exam an SP teaches, the procedure is more or less the same. We receive thorough training and practice the exam on each other. The girly exams are no different, meaning that I, a librarian, have actually performed these exams –- although I did nervously drop the first speculum and those suckers just pop right apart and bounce all over the place. Not cool.

In addition, we all receive exams from one of the med school’s doctors to make sure there’s nothing odd going on, which is how I got the most awesome exam of my life. The doctor not only diagnosed my childhood asthma during the breast exam (turns out my ribs are more pronounced), she also informed me of my nifty retroflexed cervix. No doctor IRL has mentioned either before or since!

Armed with a clean bill of health, extensive training and a road map to my cervix, I was ready to roll.

Now, at the med school where I work, the students learn the male genital, breast and pelvic exams over the course of three hours. It makes for a memorable morning. (Incidentally one year, either through administrative oversight or sheer cheekiness, this all took place on Valentine’s Day.)

Students are grouped into fours and visit a different mock exam room and instructor for each of the three exams, so I either teach the breast or the pelvic. (I actually prefer the pelvic because it’s faster and gives me more time to read in between sessions, thanks for asking.)

The students are often completely bewildered and nervous when they enter the room, so I try to get a few laughs out of them early on. (Did you know those spiffy Lucite speculums make awesome duck puppets?)

The source of the nerves is manifold. Every year, I have at least one student who has never seen a set of boobs or a vagina in person, at least not on a living body. Sometimes the women are sketched out about getting in another girl’s business; sometimes the men are worried they’ll get turned on. Universally, they are terrified that they are going to hurt me.

I always tell them, and this is the honest truth, that I’ve never been hurt in a teaching session. (Yes, my vagina is not always ready for a night on the town after a day of teaching, but nothing ibuprofen can’t fix.)

The session then runs like this: I walk through the entire exam, demonstrating with posters and my little plastic models (I call the boob one my “breast friend”), and answering any questions along the way. Then the students take turns performing the exam on me.

Mostly, it’s not anywhere as weird as you’d imagine. There’s something about an exam room that normalizes the whole experience. (Although, I’ll never get used to Gmail trying to sell me products like these every time I get correspondence about the exam.)

After the initial shock of the situation, I’m just another body and it’s just another exam. I take time to help them locate my retroflexed cervix (the key is aiming the speculum toward the floor) and discuss proper speculum usage. We talk about ways to phrase things, like saying gel instead of lube and heel rests instead of stirrups.

I remind them to say, “Everything appears normal,” instead of, “Everything looks great.” (Not the best for these exams.) I suggest that rather than asking a reticent patient to spread her legs, they ask her to relax her knees into your hands.

Basically, I give them the opportunity to do all the awkward stuff in a safe environment, like the foreign student who kindly explained he was to “rape” me when he was trying to say “drape” or the gay nurse who loudly exclaimed, “That’s where babies come from!” to his bewildered female classmates upon locating my cervix. I guarantee you neither of them will repeat these mistakes.

In the course of getting to know people, if I mention my side job, the inevitable response is, “Why?” Well, sometimes they wait for the punch line, then, realizing I’m being serious, and then ask why.

Did you know that before my job existed, med students often learned how to do pelvic exams on pre-op unconscious patients who were frequently never told of their contribution to education? Yup. Pretty creepy, huh?  

Even now sometimes medical professionals never get a trial run before performing these exams. (How would you like to be their first patient?) I’m sure you’re aware that many women fail to get regular exams because of anxiety or previous bad experiences.

By doing my job, I am helping to create better doctors. These doctor’s patients will then have a better experience, encouraging a proactive relationship between the two. Inevitably the students are surprised at how easy it actually was.

Usually a few people each year comment that they never thought they’d be interested in OB/GYN, but now think they might be. I always get a huge round of thank yous. My mom thinks I’m some kind of superhero. Basically, it’s the most gratifying job I’ve ever had -– and probably the only job I’ll ever have that pays $120 an hour.

However, I find it very unfortunate that the profession is not taken too seriously. I’ve had more than one male doctor IRL crack tasteless jokes when I mention teaching. (I’d tell them the students do the exam better, which is almost always the truth, but think twice about upsetting the guy with the speculum.) 

I’ve had people compare it to prostitution, or who think it’s disgusting, or say all the teachers must be some kind of fetishists.

For years, I didn’t tell anyone what I did. But you know what? The naysayers and wannabe comedians can suck it. I’m proud, my husband’s proud and my family’s proud. I’ve learned more about my body and grown to love my body more thanks to the experience. How many jobs can you say that about?

Besides, I’ve always been the kind of girl who takes one for the team. So, for all the ladies, this one’s for you.