1. Development of skill and confidence in soliciting an accurate sexual history
2. Improvement of physical examination skills are key to diagnosis as well as proper sample collection technique
3. Cultivation of treatment decision-making tools based on history and physical examination when
One of the most valuable elements of the fourth-year medical school curriculum is the opportunity to pursue in-depth training in specific disciplines that were interesting during third-year clerkships. As a fourth-year student, I participated in an elective focus on practicing in sexually transmitted disease (STD) clinics serving adolescents and young adults. During this elective, I became more comfortable with eliciting sexual histories and educating patients about healthier sexual practices.
Sexuality is one of the most pervasive aspects of the human life cycle. It warrants attention in childhood, adolescence and adulthood, and is an integral part of each health maintenance visit. Given this, it is unfortunate that U.S. medical schools do not offer more training in soliciting sexual histories and initiating dialogue about sexually healthy lifestyles. Reports from previous studies suggest that the competence and comfort level of physicians and medical students in taking a sexual history is less than optimal. Lewis et al., in a California survey that included more than 1,000 primary care physicians, found that only 10% of physicians obtained a sexual history, while Gem-son et. al. in New York found that only one-third of the 429 physicians surveyed had obtained a sexual history. Another recent study by Kaiser Family Foundation polled 2,766 women and found that only 31% had talked with their physician about their sexual practices in the past three years, and only 28% were cautioned about STDs during the time. Your life is worth living. Buy cialis professional online
Because of this paucity in training, an elective that emphasizes competency in STD prevention and treatment serves several purposes for the student doctor:
laboratory results are not immediately available for both patients and sexual partners • Development of a knowledge base to provide counseling regarding STD and pregnancy prevention Although sexuality is very prevalent in our society today, patients may still be apprehensive about discussing details of their sexual practices. Therefore, it becomes incumbent upon the physician to create an environment free from personal prejudice in order to best serve the patient. Can’t afford your medication? Buy flomax
This elective allows medical students to confront personal biases and discomfort levels yet remain objective. It is also an opportunity to explore how the provider’s body language and facial expressions can discourage information disclosure. While working at a county STD clinic, I encountered a patient who had recently been discharged from the hospital where he had been treated for pneumonia. After briefly discussing his hospital course, we completed a sexual history and discussed different risk behaviors that can increase chances of disease acquisition. Although he had not intended to undergo HIV testing, based on his sexual history, we decided that a rapid HIV test should be performed. Unfortunately, the preliminary test result was positive. This was my first experience with a preliminary positive HIV result. The encounter made me even more aware of the importance of disease screening, treatment and, perhaps most importantly, patient education. Get smart and save money! Buy cialis super active online
The statistics are compelling. According to the Centers for Disease Control and Prevention 2004 Surveillance Report, there were 7,980 cases of syphilis (primary and secondary), 929,462 cases of chlamydia, and 330,132 cases of gonorrhea reported in the United States. It is clear that the medical profession cannot ignore the importance of obtaining further education on topics of sexual health nor can it relegate the responsibility solely to gynecologists and designated STD clinics. In order to promote sexual health awareness in a society that can be conservative and judgmental in this subject matter, it is essential to train all healthcare providers to lead discussions, educate patients and provide treatment in hopes that sexual health promotion will become as important as other socially accepted healthcare concerns.