The pelvic exam as bellwether for patient‐led care in the curriculum

Abstract

Sarah Towles' article, ‘Poorly relaxed women’, offers a compelling analysis of pelvic exam learning materials for medical students. In doing so, it highlights an overdue opportunity we have as educators to address the hidden curriculum of lip-service paid to patient-centred care (PCC) that we find in our formal curriculum. It could be argued that the pelvic exam, considered an ‘exceptional procedure for both patients and students’, might serve as a bellwether for authentic PCC and cultural competence across the curriculum. In other words, if absent or poorly described in the pelvic exam procedure, then what are the chances of finding truly patient-centred content in less challenging procedures? Conversely, well-developed patient-centred training materials for the pelvic exam might signal a greater likelihood of other sensitive and appropriate training that respects a wide range of patient vulnerabilities. An exceptionally high-quality patient-centric approach to the pelvic exam may indicate an overarching and pervasive patient-centred philosophy, not merely careful instructions pasted into difficult procedures.