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The Obstacles of Studying Reproductive Health

Submitted by on July 14, 2012 – 8:56 PM One Comment

In the early 1900’s, undertaking a scientific investigation was not markedly different from being a journalist operating in a totalitarian state. Agonizing measures had to be taken to circumvent established social and cultural norms, often at the cost of inhibiting the expansion of the reservoir of human knowledge. Challenging the public’s conceptions, however flawed, often led to intensely negative reactions and the subsequent threat of having one’s funding severed.

While aspects of Alfred Kinsey’s research on human sexuality remain contentious even today, his work was pivotal in establishing an important principle: the pursuit of scientific information cannot be, and should not be, subdued because of social inconvenience or embarrassment, especially when the acquisition of such knowledge is demonstrably advantageous for the society.

 

This concept is not lost on the worthy professors of our esteemed medical institutions. Since the introduction of behavioural sciences in the medical curriculum, there has been a substantial improvement in the students’ comprehension of the social impacts of the pathologies they study. However, problems still remain. Students, female ones in particular, are profoundly bashful when it comes to studying and discussing reproductive health.

 

Many medical colleges in Pakistan do not allow the students to perform dissection on a cadaver’s perineum. The idea is that this is fairly inconsequential, as the perineum may be studied adequately from other sources like textbooks or online videos. If that is the case then dissecting cadavers is, in its entirety, a pointless endeavor, since body parts like the upper limb can be studied adequately from other sources as well! It is inappropriate, in my opinion, to deny a medical student an opportunity to ameliorate his or her understanding of the human anatomy.

 

Despite the faculty’s good efforts, most students are left woefully ill-equipped for examining and counseling patients with sexual disorders or lesions involving the private regions of their bodies. Patients afflicted with such problems often ask questions that can make a poorly trained doctor feel very uneasy. These may include questions about intercourse, masturbation, explicit details of their conditions, and the social problems associated with them. Such inquiries do not signify a deliberate attempt to humiliate the young physician. Rather they are the result of the patient’s genuine, and justified, concern for his physical and social well-being. STD cases are infamous for having dire or even disastrous domestic consequences. Words spoken to such patients need to be measured carefully.

 

Students must be prepared to handle these inevitable scenarios. They need to be taught two vital lessons. First and foremost, is to urge the students to be very professional about these affairs. I’ve personally observed that female doctors are usually better at this. Secondly, the students must be taught not to express their embarrassment to the patient, either verbally or through their body language. It’s because doing so discourages the patient from sharing important details of his condition. This could significantly hamper the doctor’s ability to manage his patient and alleviate his suffering.

 

In Pakistan, sexual education is not freely provided to the general public. This is in contrast to most developed nations where sex-education courses are offered to high school students. I do not wish this discussion to be propelled into a cultural realm, as that is not quite as pertinent here. Our task, as healthcare providers, is to recognize that the general population’s ignorance concerning sexual matters manifests as an added responsibility on our part.  This burden necessitates that we better educate our medical students on how to manage patients with disorders involving the reproductive system.

 

 

About the author: Faraz Talat recently graduated from Wah Medical College, Punjab, Pakistan. He writes on the subjects of public health and prevalent social problems in Pakistan. He can be reached at:[email protected]

 

About this article: This article is competing for the JPMS International Medical Writing Contest 2012 for the theme: Medical Education

 

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  • http://twitter.com/h4hach Hassaan

    I am a graduate of Punjab Medical College Faisalabad & I don’t think your concerns are genuine… 1. Never in my entire student or internship life, Have I met a single student/intern senior or junior who is reluctant or as you say it ‘embarrassed’ to discuss with patient the pathology of private parts. We in our clinical rotations have had dozens of chances to perform DRE, illumination test for hydrocele, etc esp. in surgical units. I found patients reluctant but never fellow student or intern ashamed or shy of this.
    2. As far as counsel & consult in STDs is concerned, I didnt work in medicine or skin. & most of the STD cases come there first. Considering these diseases aren’t that big a problem here as in Developed Secular & Non-muslim countries I believe thats the reason we were never shown a case in But I’ve witnessed first hand atleast one incident where a boy had an STD & was brought in by a friend. The MO on duty took him to a separate room examined him, diagnosed him & prescribed some antibiotics & stuff and told him what was the case. Again doctor was strictly being professional. 
    So either the hospital & College where you worked had these flaws or there is something else that is JUST NOT GENERAL.