Physical examination is both taught and learned in medical school. Most schools now use non-patients (paid volunteers, and there’s an oxymoron for you) to introduce the mechanics of examination to students. As with all other things there’s a range of innate competence, and that’s the subject of a piece in Slate from yesterday:
Over the course of three days recently, I had 23 head-to-toe physicals from 23 second-year students at the Georgetown School of Medicine. I was the first person these would-be doctors had ever fully examined on their own. Some were shaking so violently when they approached me with their otoscopes—the pointed device for looking in the ear—that I feared an imminent lobotomy. Some were certain about the location of my organs, but were stymied by the mechanics of my hospital gown and drape. And a few were so polished and confident that they could be dropped midseason into Grey’s Anatomy.
It’s very well written and amusing, please give it a read. Also, she has a Q&A about the article at the bottom of this page.
It also reminded me of my ‘standard patient’ (We didn’t call them that, but I can’t remember the actual term). The one thing I do recall was the proctor in the room smiling the entire time, and his feedback was “you didn’t test his reflexes, and you don’t have to say thank you after each and every test”. I said thank you about 200 times in roughly 15 minutes. Seriously. Overly polite under stress then, I suppose.
Thanks to Mrs. Yoffe and all her Human Guinea Pig colleagues, for helping make real doctors out of medical students.