So today was my first day in obstetrics and gynecology and I really think I'm going to like this rotation. It was pretty apparent to the rest of my group too that this is definitely an area I'm passionate about. We talked about a lot of the things that I care about today: recto-vaginal fistulas, female genital mutilation and proper female pelvic exams. However, we had one lecture today that got under my skin. I tried to be as diplomatic as possible to this male gynecologist that had been practicing for 40 years but these things definitely irked me. He said that if a woman hasn't had sex she doesn't need a pelvic exam (and he meant sex with a man). He flat out said that nuns, celibate woman and lesbian women did not need to get pap smears. This upsets me on numerous levels - the major reason being that a woman needs her vagina "opened up" by a penis so that she can get adequate medical care. I know this is because HPV is sexually transmitted and the major cause of cervical cancer but still what if women share sex toys? And what if there's a huge uterine tumour that can be seen on pelvic exam? Or a sexually transmitted infection that can be seen in a pelvic? And when I asked about a lesbian's right to a proper pelvic the man looked at me like he hadn't even contemplated this idea.
The other thing that he said today was that HIV is not a notifiable disease. For those of you that don't know HIV has been a notifiable disease in Canada since 2000. This means doctors have to disclose if they've had a patient with this disease, their age and gender but not their name. This is a very important part of public health and doctors, regardless of number of years of practice, should know this.
So yeah, obstetrics and gynecology might be my path seeing as how I get this passionate about some of the issues in this specialty on the very first day.
Monday, May 15, 2006
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