Medical Students’ Dual Role: Both Patient and Educator
A recent investigation in the United States and subsequent surveys among medical students and physicians in the Netherlands have brought to light a concerning practice: medical students performing internal exams – including vaginal and rectal examinations – on patients without explicit consent. This practice, sometimes referred to as “the learning touch,” raises ethical questions about patient autonomy and the training of future healthcare professionals. Understanding these issues is crucial for maintaining trust and upholding standards of care in medical education.
The issue gained prominence in the U.S. In 2025 following research from Yale University, which revealed the practice of non-consensual internal exams for educational purposes was more widespread than previously thought. In response, a national guideline was implemented in the United States to address the issue.
Argos, a Dutch investigative journalism program, conducted a survey of Dutch medical students and doctors regarding their training experiences. The survey specifically asked about instances where an internal exam was performed solely for learning purposes, and whether participants were certain consent had been obtained. More than 30 of the 151 respondents reported having either personally experienced or performed such an exam without being sure if consent was given. 10 out of 128 respondents confirmed they knew for certain that consent was not obtained.
While the survey numbers are relatively small and not fully representative, the results suggest the practice occurs in the Netherlands as well. Most students reported isolated incidents, but one respondent estimated having witnessed this occur fifteen times.
Prior to the Argos survey, concerns had already been raised. One medical student, Ayla, experienced a similar situation during her clinical rotations. This prompted her to distribute her own questionnaire to 150 fellow students. Eleven of them reported performing a rectal or vaginal exam without consent during their gynecology rotations.
The practice involves a student performing an internal examination during a medical procedure while the patient is under anesthesia, without the patient’s knowledge or explicit consent. These findings underscore the require for clear communication and adherence to ethical guidelines in medical training to protect patient rights and ensure appropriate medical education.
