Intended for healthcare professionals

Career Focus

Moving out of the comfort zone

BMJ 2004; 329 doi: (Published 20 November 2004) Cite this as: BMJ 2004;329:s207
  1. Rhona MacDonald, Editor of Career Focus
  1. careerfocus{at} tel: +44 (0)20 7387 4499

Some of the articles in this week's issue may make you feel very uncomfortable. We are dealing with a subject that most people don't like to think about, let alone talk or read about-sexual assault.

According to 2002 statistics, about 1 in 20 women in the United Kingdom said that they had been raped, and 5% of those seen at a London based service for managing victims of sexual assault are men. Yet many people who have been sexually assaulted do not want to disclose what has happened to them and do not seek medical attention. It is therefore very likely that, no matter what your specialty, at some point in your career you may be the first point of contact for people who have been sexually assaulted. They may tell you about it as you take their medical history, or you may spot some of the telltale signs on physical examination. But would you know how to effectively and sensitively manage them, especially if there are no specialist services in your area? Forensic gynaecology may not be for everyone (p 207). but every doctor should know the basics of how to treat victims of sexual assault (p 210).

But what if it happens to you? If you do not want to read anything else in this issue, I urge you to read the harrowing account of a junior doctor's experience of being the victim of a multiple sexual assault (p 211). It is certainly not X rated, but her heart wrenching honesty about her reaction to the attack clearly shows a life changed for ever. Her experience of the medical attention she received also highlights why specialist services such as the Havens (p 210) are needed throughout the United Kingdom.

Another service, which is being introduced to UK medical schools, is raising a few eyebrows: women called gynaecological teaching associates (GTAs) help train medical students on how to perform bimanual pelvic and speculum examinations by letting them practice on the real thing—them (p 212).

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