School pupil allowed to observe intimate examination
Helen Barratt London
A hospital trust has been forced to apologise after it emerged that a 15 year old work experience student was present during an intimate examination without the patient’s consent. The female patient who has not been named lodged a complaint after noticing the girl during the procedure at North Manchester General Hospital.
The trust refused to go into details, but emphasised that the girl, who was wearing a white coat, had taken no part in the patient’s treatment or care. However, the trust confirmed that she had been shadowing Roger Williams, a consultant general surgeon at the hospital, who is thought to have allowed the girl to attend checks in several other cases. Thousands of school pupils undertake work experience placements in hospitals each year as it is now an almost essential prerequisite for applying for a place at medical school. However, the policies dictating what they can and cannot do are normally very restrictive.
A spokesperson for the trust said, “We have already acknowledged that [our] policy for work experience students was not followed in this case. The staff involved have been warned against this in future and all staff have been reminded as to the policy and the need for obtaining consent before allowing work experience students into patient areas.”
The consultant has already offered his apologies to the patient involved and Philip Randall, medical director of the trust added, “I would like, on behalf of the trust, to offer our sincere apologies to all patients affected by this breach of procedure. The trust has identified some other patients who may have been observed by the student without consent and we are contacting them to offer the trust’s apologies.”
The incident has sparked criticism from several patient groups.
A spokesperson for the Association of Community Health Councils in England and Wales said, “This is clearly an issue of concern. People are not in hospital to be a spectacle for school pupils.”
studentBMJ 2001;09:357-398 October ISSN 0966-6494
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Responses published this month
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Articles
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Responses
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NEWS
School pupil allowed to observe intimate examination
Helen Barrat (October 2001)
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Ben Clayton
(September 22, 2001)
Read this response
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NEWS
School pupil allowed to observe intimate examination
Helen Barrat (October 2001)
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James Raymond Oliphant
(October 01, 2001)
Read this response
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NEWS
School pupil allowed to observe intimate examination
Helen Barrat (October 2001)
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Ben Clayton
(September 22, 2001)
POSITION AND AFFILIATION EMAIL
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As a prospective medical student (yes another one of those irritating people who insist on probing and questioning all manner of medically related personnel) I too have been faced with the prospect of finding work experience. I managed to get a week with a consultant anaesthetist at the local DGH, an experience I relished and found thoroughly fascinating (those of us with a limited exposure to medicine get fascinated easily). I find it incredible that the events described in this article can have been allowed to happen and now fear that this may seriously jeopardise the chances of myself and others gaining the valuable experiences which I was lucky enough to achieve.
Whilst I have to agree with the statement that "People are not in hospital to be a spectacle for school pupils", these same people will often very willingly allow pupils such as myself to be involved in some stages of their treatment. All the patients I met were wonderfully helpful and many even engaged me in conversation (a rarity, I can assure you!).
As a very active member of St John Ambulance I am also often fortunate enough to treat a range of acute conditions, yet confidentiality in such situations is still protected. Regardless of medical prowess, anyone treating anyone where intimate examination or treatment is involved is required to be chaperoned... and that includes doctors.
I know that when I undertook my work experience, I was required to sign confidentiality agreements and so forth, but these hardly compensate any patient who has to suffer observation by oiks like me! It is un-dignifying and no doubt embarrassing enough that patients have to undergo such treatment but to have to worry whether you are being watched by an 'outsider' is an unnecessary extra burden.
I only hope that this incident will not have serious repercussions for other prospective medics in the future.
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NEWS
School pupil allowed to observe intimate examination
Helen Barrat (October 2001)
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James Raymond Oliphant
(October 01, 2001)
intercalated medical student, University of Aberdeen u02jro@abdn.ac.uk
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After reading last month’s news story about a school pupil being allowed to observe an intimate examination (1) (1)my mind wandered back to a time before medical school when things seemed altogether simpler. I too did work experience in hospital as a school pupil and I was also allowed to be present during intimate examinations. The patients were toldf that a few students would be observing the procedure, but they were not told that we were only 17 year old school pupils. While at the time the opportunity to stand in on a few exploratory endoscopies seemed like my life’s ambition realised, I can now look back and see exactly how wrong this practice is.
The story of the 15year old not only brings up many issues concerning informed consent and patient confidentiality, it also raises questions of the ethics of exposing a child to such procedures. A spokesperson for the hospital was quick to offer a public apology to all the patients concerned, but neglected to mention any words for the parents of the children involved.
While work experience should be encouraged, patient contact should be kept very basic. School pupils seeing patients who have given informed consent must be supervised at all times in order not only to protect both the pupil and patient, but also the hospital from any litigation that may ensue.
As students we also have a responsibility on the wards to be as honest as we can with patients, with the common aim of becoming as transparent as we can within the realms of practicality. Commonsense must prevail. Unfortunately, it is the only attribute that a doctor requires which is not on the curriculum.
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