Letters
Volume 190 - Issue 6

Peer physical examination: time to revisit?

Author:  John E Marley

Med J Aust 2009; 190 (6): 342-343. || doi: 10.5694/j.1326-5377.2009.tb02436.x
Published online: 16 March 2009
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To the Editor: The article by Outram and Nair on peer physical examination1 misses the point that consent by medical students for physical examination by their peers can never be freely given. It always contains elements of coercion.

Ethics committees usually do not allow medical students to enter clinical trials run by staff, who at some point may be their assessors, because there may be subtle duress to participate. Even if consent for peer physical examination is sought by staff who will be neither assessors nor tutors of these students, non-consenting students are immediately apparent to their colleagues, creating peer pressure to participate. The emotionally vulnerable are the most likely to accede to this and the most likely to be distressed.

It is unsafe to rely on all staff seeking consent and behaving appropriately at all times. In one Australian medical school, students were told that they all had to “bring their swimmers” to wear so that they could be examined by other students. The statement that peer physical examination “has high acceptability”1 is not supported by the cited literature, and it is not clear to whom it is highly acceptable.

There are good arguments for learning physical examination skills on the healthy. If young bodies are needed for this, universities are full of students from other faculties, and medical schools are not so poor they cannot pay the small amounts of money valued by these students for their participation.

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