No./Title: COM128/Consent for Exams Under Anesthesia	Resp. Office: Medical Education Approval Body: CUME	Effective Date: 3/21/22
Category: COM/UME	Last Review: N/A	Next Review: 3/21/25
Contact: Michael Whitt, Ph.D. Assoc. Dean for Medical Education	🕿 901-448-4634	🖂 mwhitt@uthsc.edu
Related Policy: N/A

POLICY

It is the policy of the University of Tennessee Health Science Center (UTHSC) College of Medicine (COM) to set guidelines relating to patient consent for examination procedures involving anesthesia.

RATIONALE

Many surgical procedures require an examination under anesthesia, including sensitive activities such as pelvic exams. It is the provider’s responsibility to obtain consent for these procedures and to respect patient autonomy when working with learners.

PROCEDURE

1. The listed attending will ensure that adequate consent is obtained for an exam under anesthesia. Such procedures include examination of the external genitalia, vaginal speculum exam, internal vaginal exam, and rectal exam.
2. Learners in the operating room should only perform an exam under anesthesia for teaching purposes when it is explicitly consented to, related to the planned procedure, performed by a learner who is recognized by the patient as part of their care team, and done under direct supervision by the educator.
3. Learners are defined as those in a learning role; educators are defined as those who are in the teaching role. The American College of Obstetrics and Gynecology (ACOG) considers the line between learners and teachers in medicine to be fluid and nonlinear.
4. Learners may decline to participate in such an examination, without repercussion, if consent is not documented or is unclear.
5. This policy is formulated to support the ethical considerations noted in ACOG Committee Opinion Number 500, Professional Responsibilities in Obstetric-Gynecologic Medical Education and Training, Obstetrics and Gynecology (reaffirmed 2020), and the APGO Statement on Teaching Pelvic Exams to Medical Students (March 2019).

APPROVAL HISTORY

Effective: 3/21/22

Revised: N/A