Medical Student Evaluation: Fill & Download for Free

One evening, many years ago, some medical students showed up to be “on call” in my psychiatric emergency room. I believe I was moonlighting as the attending, although I may have been on regular call as the fourth-year resident (we could moonlight if we were licensed, which I was). I was also fairly pregnant.One of the students, a young man, perhaps my age or within a year or two either way, decided he was not going to do any of the tasks that he was supposed to do as a student. He spent the whole evening on the phone instead. He told me he was getting married soon and had a lot to do.No cell phones in common use back then - so he sat in the doctors’ room using my desk phone.I took the other students with me and they did what they had to do. We had a good time - I always made it fun and the psychiatric emergency room is always entertaining.At the end of their “shift,” after this guy had done nothing, he told me again that he was getting married and could not be bothered to waste his time with psychiatry.I asked him if his bride to be was also a medical student.He looked at my big pregnant belly and said arrogantly, “Oh no, I would NEVER marry a doctor. Ugh.”That was the thing that made me shudder.The best part?I had to fill out his evaluation. And I got to fail him. With good reason, of course. He did not meet a single clinical objective for the shift. “Talking on the phone with girlfriend” is not even on that list. In all my years of teaching medical students that is the only one I ever failed. I’m only sorry it was just for one measly night in the ER and not for the entire rotation.

I’ll address this from the standpoint of not just prostate exams, but the teaching of all such intimate exams with elements of potential awkwardness or embarrassment—prostate, pelvic, colorectal, and breast exams.I didn’t go to med school and can’t speak from experience, but I mentored premeds, took them on group visits to med schools, attended conferences on premedical advising, and fed my premed seminar students plenty of readings and videos on physician training and practice.Medical students typically start in the second year or so with soft plastic models called simulators—like the one below for gynecological exams—on which they practice such procedures as I listed above. These have interchangeable parts that can be inserted to simulate such conditions as enlarged prostate, prostate cancer, ovarian tumors, uterine fibroids, and so forth. From today’s googling, it appears that some or many of these now have interfaces with computers that give feedback or guidance for improving the student’s technique, as in the third and fourth photos below.From there they progress (year 3?) to persons trained and paid ($35–50/hr from some info I saw today) to serve as model standardized (simulated) patients (SPs). These may just present to the student simulating some health complaint so the student can practice conversational interviewing techniques, taking a history, etc., and progress to actual breast, pelvic, or rectal exams. These actors coach the med students on their technique for things like ovarian and prostate palpation. “[Standardized patients] are also useful to train students to learn professional conduct in potentially embarrassing situations such as pelvic or breast exams.”[1][1][1][1] The standardized patients are trained in how to evaluate the student’s technique, often by a checklist, and give them useful oral feedback during the procedure.After that is when they begin going on rounds, observing and practicing on real patients in teaching hospitals or other clinical settings. I don’t think you’d want to start out a totally inexperienced medical student probing the vagina or rectum of a real patient.See the Comments section where I’ve added photos of medical students being trained on live simulated patients and information on how to become an SP (my sub-comment under Océanne Bridget Peek’s comment).Such models or simulators are used also in veterinary school. At least the simulators won’t kick you!Footnotes[1] Simulated patient - Wikipedia[1] Simulated patient - Wikipedia[1] Simulated patient - Wikipedia[1] Simulated patient - Wikipedia

I would nominate those surgeon tryout tests that Kurashiki Hospital in Japan conducted. There was a video of young medical students taking the test that went crazy viral sometime in 2015 or so.The hospital had given the aspiring candidates three tests to complete within a stipulated time - fold three tiny origami cranes, reassemble a tiny insect from small and fragile pieces, and create miniature pieces of sushi from single grains of rice.“In daily clinical practice, physicians constantly confront difficult challenges. We would like to evaluate the capability of medical students to stay calm and make correct judgments even under these circumstances,” Dr. Toshio Fukuoka, the hospital’s HR director, said in a statement. “We planned this tryout to reveal the potential and uniqueness of the students which ordinary written exams and interviews could not show,” he added.Here’s the full video…Nope, nothing to beat this, I guess.