Training in every health profession, to some degree or another, requires students to practise on one another, whether it involves learning how to do injections or measure body fat.

However, should participation be tied to grades? In a shocking case of sexual violation, female medical students were coerced to undergo transvaginal ultrasounds on one another.

Procedure was said to be voluntary on paper, but mandatory in practice

Last May, three students - Mellisa Milward, Elyse Ugalde and Ashley Rose - in the highly competitive sonography programme at Valencia College in Orlando, Florida, filed a lawsuit against several administrators at their school.

They took issue with the programme’s practice of having students in the training programme perform transvaginal (penetrative) ultrasound examinations on each other. During the test, the patient must place her legs in a stirrup while a probe covered with a condom and lubrication is placed into her vagina.

The probe sends out waves to reflect the inner body structure, which the technician then reads on an ultrasound monitor. Although the test is usually painless, according to the court: “The probe is also rather large and can be painful for some women… sometimes the technician will stimulate the patient to help insert the probe.”

Milward, Ugalde and Rose expressed their discomfort in participating, but were heavily reprimanded and penalised for doing so. “Although the transvaginal ultrasounds were purportedly voluntary,” the opinion stated, “in practice, the employees required students to perform them on each other.”

Procedure done without a ‘modicum of privacy’

Students were required to be subjected to weekly probes. According to the plaintiffs, these exams were done “without a modicum of privacy.” Students were required to undress in the bathroom and wrap themselves in only towels before re-entering the classroom.

The women also stated they were subjected to “discomfort and embarrassment each time they had to endure this forced probing of their sexual organs,” the suit read. Only one of the 12 students in that year was male.

Heavy retaliation against students’ expressed concerns

When Milward and Ugalde expressed their issues with the ultrasounds, then programme chair Barbara Ball “told them they could find another school if they did not wish to be probed,” the court stated. “When Milward complained to [the clinical and laboratory coordinator] Shaheen about the ultrasounds, Shaheen responded that she would suffer academically and professionally if she refused to participate.”

“The employees also threatened to lower the students’ grades, and [the laboratory technician] Bugnacki threatened to blacklist them at the local hospitals,” it added. Eventually Milward and Ugalde submitted to the probe, but Rose never did.

According to the court, “As punishment, the employees did not allow Rose to watch the other students perform the ultrasounds … also threatened to bar Rose from a hospital, gave Rose two failing grades, and yelled at Rose for an hour until she had a panic attack.”

Additionally, the lawsuit states that Ball had made sexually suggestive remarks to one of the two that submitted, during a probe, that she was ‘sexy’ and should have been an ‘escort girl.' Eventually, all three women quit the programme.

A standard & widespread procedure in other medical schools?

In a statement, Valencia College claimed it was standard for students in medical education programmes to practice such procedures on one another, even those as invasive as transvaginal ultrasounds. “The use of volunteers – including fellow students – for medical sonography training is a nationally accepted practice,” said Valencia’s director of public relations, Carol Traynor.

Yet, attorneys for the students say that they had been unable to find another sonography programme where students practiced this skill on one another. Valencia has stopped the practice after the lawsuit emerged.

The students' attorney, Chris Dillingham, claims the experience violated the student’s first and fourth amendments. “I’m not a doctor, but they have suffered significant psychological damage,” he said. MIMS

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