How Often is Digital Rectal Examination Performed? Is it Still Taught to Medical Students?

Digital rectal examination is an essential skill. However, it is not clear how often it is performed by AUA (American Urological Association) members or if it is still taught in medical school.

Two web based surveys were administered to AUA members (practicing urologists and residents/fellows) and medical student members of the AUA. The surveys inquired how often digital rectal examination was performed, when and how it was taught, and how the AUA could promote it.

There were 331 responses from AUA members and 160 responses from medical students. Most (64%) AUA members performed digital rectal examination on at least 50% of male patients. When respondents were subdivided according to the median age of 36 years, AUA members older than 36 years performed significantly more routine digital rectal examinations while those 36 years old or younger relied significantly more on prostate specific antigen screening (p <0.001). While few medical schools had a mandatory urology rotation, 89% of students reported that digital rectal examination was a required component of their medical school education and it was taught during the second year. While 81% of medical students were aware of the AUA Medical Student Curriculum only 43% of them were aware that the AUA has videos instructing students on digital rectal examination. Finally, AUA members and students provided insight as to how the AUA could promote digital rectal examination.

This study underscores the importance and general attitude of AUA members and students toward the digital rectal examination. In the future the AUA could further develop clinical guidelines, content and educational videos with particular emphasis on augmenting medical student education on digital rectal examination.