“Ma’am… Can you lift your breast please?”

Abstract

I got to the cardiac auscultation station of my clinical examination—a station I was relatively comfortable with—and read the instructions while waiting for the buzzer to sound. When it finally rang, I opened the door and my heart sank: the patient-actor was a woman. For the previous few weeks, my classmates and I had spent our evenings perfecting our physical examination techniques for the examination. During one of those late night practice sessions, we realised we were not confident on how to perform the cardiac examination on a female patient. Where do you put your hand when you are feeling for thrills? What do you do with the patient’s bra? If the patient’s breast is in the way, do you move it gently aside, or do you ask the patient to do so? We had a lot of questions that most clinical textbooks do not cover. Finally, we gave …