Rian_sub

[RainSun]

I am looking to become an orthopedic physician assistant. But I was told during rotations I would have to perform male GU exams and deal with other exams and treatments dealing with the male anatomy. I am not comfortable doing that and feel it isn’t a necessary skill for the field of work I want to get into. Is there a way to opt out of doing those tests during rotations? 

[DiggySRNA]

No. Given the fact you will be rotating through primary care/internal medicine/urgent care/emergency medicine you will definitely be performing those assessment/skills. So no you cannot avoid inspecting the male genital area.

Edited June 20, 2023 by Diggy

[RainSun]

Ok, thank you. If I make a request to a preceptor to try and avoid cases dealing with the male genital area, will they try to accommodate that? Is there any allowance to minimize having to do exams on private areas for religious reasons, again considering they will not be a necessary skill for the type of work I hope to do?

[SedRate]

Unless you're clinic only and have patients who are mostly clothed, if you end up in orthopedic surgery you WILL see and work around male genitalia in the operating room. Part of the PA's duties can be shaving, scrubbing, prepping and draping the nude patient.

Consider upper extremity orthopedics/hand surgery. 

[RainSun]

Thank you for your suggestion and information sedrate, I will. But I would have to get through rotations first. During rotations, if I make a request to a preceptor to try and avoid cases dealing with the male genital area, will they try to accommodate that? Is there any allowance to minimize having to do exams on private areas for religious reasons, again considering they will not be a necessary skill for the type of work I hope to do? Thank you

[UGoLong]

I doubt you can get through a PA program without performing this skill. While you may have religious concerns, think about how you could miss a serious condition in a patient or be exposed to the genitalia during an emergency.

Perhaps you should speak with a religious advisor about this.

[SedRate]

On 6/20/2023 at 7:39 PM, RainSun said:

Thank you for your suggestion and information sedrate, I will. But I would have to get through rotations first. During rotations, if I make a request to a preceptor to try and avoid cases dealing with the male genital area, will they try to accommodate that? Is there any allowance to minimize having to do exams on private areas for religious reasons, again considering they will not be a necessary skill for the type of work I hope to do? Thank you

I'm not sure about the accomodations. You should speak with advisors. 

Please note it is ill-advised to avoid part of your training including physical exams such as genitourinary exams on pediatric, adolescent, adult, and geriatric female and male patients based on work you "hope to do." PAs are trained to be general practitioners and your exams including PANCE will reflect that. It is one thing to learn by reading and listening and another to actually perform it. Further, I often hear of students saying they want to work in a certain field and then end up changing their focus once they start didactic and clinical training. So it's best to maintain the mindset you should learn and experience all aspects of medicine. 

Edited July 3, 2023 by SedRate

[rev ronin]

This is a relevant concern for a minority of PAs, PA Students, and pre-PAs. The problem is made worse because those PAs who believe they are answerable to a higher power for their conduct are necessarily more ethical than those who don't have a belief in a higher power who 1) has opinions on how human beings should be treated, and 2) will know how that PA has performed.

In my case, I was relatively uncomfortable with (read: afraid of) the idea of doing female pelvic exams: Even though I had been married for almost 15 years prior to PA school, I had precisely zero medical/nonsexual experience with mature female pelvic anatomy. Yes, I had changed diapers, but that's not even in the same category. EMTs don't undress patients to that level except in cases of trauma, and aren't authorized to do anything to the area except in case of field delivery.

I received two pieces of relevant advice. An OB/GYN I knew said: "Well, there's 'yours' and 'not yours', and you don't mix them up." My advisor noted that as soon as I was called to address female pelvic anatomy in a clinical context, I would be relieved by how entirely nonsexual women's health medicine was. He was right.

Now, I don't have any personal religious beliefs that forbid me from rendering preventative women's health care, and working in family medicine, I did a modest number of paps and pelvic exams--probably somewhere between 50 and 100. So, unlike OP, I knew that what I was uncomfortable with was going to be part of my scope of practice.  What I found is that there are a number of women who seek out male practitioners to do their paps, and when asked, one of them told me "Women know how hard you can tug; men are far more gentle." which I know to be my goal: I'm not a fan of invasive exams, and so I try to make mine as minimally uncomfortable as possible.  For example, I will never start a female patient undressed.  We meet, talk, and agree what will happen, and I leave the room until she is undressed and situated for whatever exam we're doing, and then I leave again after the exam is over, so she is fully dressed again before we discuss what I saw. Horribly inefficient? I could care less. It's how I would want my wife or daughter treated by a male medical professional, should the need arise.

Since I've been doing occupational and eating disorders medicine for the past two years, I haven't done any paps in perhaps three because the year prior I was mostly doing pain management and sleep. Thus, I gravitated towards a specialty where I didn't need to perform that skill.

I hope that helps.