Performing speculum examinations as an FY1

I am a current FY1 and have done a speculum examination many months ago as I felt comfortable doing so having done over 4 months of O&G during my time as a medical student and done around 5 under supervision during that and done more during 2 months of my elective in O&G too. A consultant commented that this shouldn’t really be done by an FY1 and so I’m just wondering what people’s thoughts are. I was asked to do it by a consultant surgeon for PV bleeding, I consented the patient and had a chaperone and the patient was comfortable throughout? I wouldn’t have done it had I not felt capable of but am just worrying about it

Yeah Cusco’s. No not an O&G consultant it was just the consultant on my current medical placement, who just looked shocked that I had done one as an FY1. I wouldn’t do anything I felt I wasn’t comfortable and capable of doing. Think my consultant is of the opinion that as an FY1 you’re not properly a doctor yet being only provisionally registered

I am a current FY1 and have done a speculum examination many months ago as I felt comfortable doing so having done over 4 months of O&G during my time as a medical student and done around 5 under supervision during that and done more during 2 months of my elective in O&G too. A consultant commented that this shouldn’t really be done by an FY1 and so I’m just wondering what people’s thoughts are. I was asked to do it by a consultant surgeon for PV bleeding, I consented the patient and had a chaperone and the patient was comfortable throughout? I wouldn’t have done it had I not felt capable of but am just worrying about it

So many people are discouraged from doing them when they shouldn’t be (I’ve heard A&E doctors ban their juniors from doing speculums, saying it’s “O&Gs job” even when the junior has been competent!).

You've had loads - like actually loads - of experience and the idea that every single FY2 would be more competent than you just because they are an FY2 is absolutely ridiculous. The notion that an FY1 is not a 'proper doctor', and that that translates into you not being allowed to do something as simple as a speculum exam, is also ridiculous. That consultant sounds like a real moron.


I may have said this before, but in my previous hospital the O&G SHOs were banned from doing speculums unless they had 10 observed sign offs, which was just impossible as a male. Can only imagine some terrible incident in the past!

Ironically though, I was entirely happy to do a speculum before I started that job (there was no hospital policy about other specialities SHOs or FY1s doing them), and came out feeling I should never do one again!

[I've changed my mind though now I'd do one under the right circumstances!]

Agreed. If you're confident you know what you're looking at then by all means. When it comes to intimate examinations I guess my policy is that if you feel you likely have the experience and skills to interpret what you're seeing first time (and are not just doing something which will almost 100% inevitably have to be repeated by somebody who has more experience than you do, subjecting the patient to multiple intimate and/or pretty uncomfortable exams when they could have had just one) then go for it.