Examining the medical student body: Peer physical exams and genital, rectal, or breast exams

Background: Some medical schools have replaced all student practice peer physical examinations in the curriculum with examinations of standardized patients (SPs). Purpose: To assess attitudes of medical students toward practicing physical examinations with classmates, including genital, rectal, or female breast components. Methods: Survey administered to all 235 Year-4 students at University of Minnesota Medical School (69% response rate). Results: Ninety-five percent believed that limited peer practice exams are valuable. Six percent of students were uncomfortable with these exams: This was strongly associated with having had an uncomfortable experience. Conclusions: Although most students value practicing limited exams with classmates, a small, consistent number of students are very uncomfortable with these. Explicit guidelines for faculty and classmate behavior may minimize their discomfort, but alternatives to peer exam, such as SP exams, need to be provided this small group. There is no role for peer genital, rectal, or female breast exams in the curriculum.