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Michelle
I was with a group of fourth year students, being taught by a surgical registrar. He had admitted a woman with acute cholecystitis that morning and he thought it would be interesting for us to examine her. He showed us the typical examination findings in acute cholecystitis and then told each of us (there were five students there) to examine her and elicit the findings for ourselves. The woman was pulling faces that showed me she was in pain and didn’t want to be examined, although she hadn’t said anything to the registrar. I was very unhappy about examining her, but the registrar told me that it was an excellent case with classical examination findings and I needed to learn how to examine patients even when they were in pain or distress. In the end I examined her because he was so insistent, but I tried to press really gently.
Michelle’s reaction
When the registrar had gone away, we were left on the ward. I think we were all a bit shocked at how oblivious he was to the patient's pain. I know that practicing doctors see patients in pain every day, but that doesn’t mean they should just ignore it. We went back to the lady and told her how sorry we were if we’d given her extra pain. She was really nice about it and said we had to learn, but that just made us feel even worse. We decided to submit a report through the raising concerns website – we went away and did it immediately in the students' cluster room. We all put our names on it.
Outcome
Someone from the QAEU met us the following week. She said that we were right to be concerned that the doctor was displaying unprofessional behaviour, although maybe his enthusiasm for teaching had clouded his judgment. With our permission, the lead at the Trust would be sent a copy of our report in order to discuss it with the registrar.
A couple of weeks later, the QAEU emailed again to inform us that the registrar had submitted a written reflection on the incident. The matter was considered to be closed, but would be monitored through future SEQs.