Polite Dissent

As part of our Obstetrics/Gynecology rotation, we had to finish a 10 station practical exam the final week (this was in addition to the 3-hour written exam). You had 10 minutes at each station, and received a score of 1-10. The ten scores were added together to give a final score of 10-100. The tests included ultrasound reading, patient counseling, laboratory interpretation, online medical reference searches, and several stations dedicated to physical exam skills.

I was 40 minutes into the exam and felt confident. I had been able to pinpoint the placenta on the ultrasound. Online research was a snap. Talking to the patient on the phone had been relaxed and natural. Then I came to the Pap smear practical.

This station consisted of a plastic mannequin of a female pelvis and an OB resident sitting next to it. I was supposed to pretend the resident was my patient, and talk to her, but perform the exam on the mannequin. I knew the resident well as we had been on call together several nights. It was a little awkward pretending someone I knew was my patient, but I learned to cope quickly. I explained what I was doing and answered her questions. I finished the basic exam and then moved on to the Pap smear itself.

Unfortunately, plastic mannequins have a property real people don’t: elasticity. As soon as my brush touched the mannequin, it flexed, and the instrument shot out of my hand, over the heads of several incredulous students, and bounced off the far wall. Newton’s Third Law had never been demonstrated better.

The resident was trying so hard not to laugh; tears were rolling down her cheeks. Calmly and matter-of-factly I told her, “On a real patient, that would never have happened.” I then picked up a replacement brush and finished the exam without incident.

She must have believed me, because I scored a 9 on that station, and a 93 overall.