Adolescent male patients are often too shy to volunteer concerns, self-conscious about the size of their genitals, or may be completely unaware they have an abnormality, especially if the GU exam has not been a routine part of their preventive examinations.

Male adolescent patients are not engaged in GU health as it is not emphasized or performed well at healthcare visits. Subsequently, there may be missed diagnoses of cancer, sexually transmitted infections, and structural anomalies not previously captured due to lack of prepubertal exams. Many pediatricians omit the male GU exam despite guidelines from sources including the Society for Adolescent Health and Medicine and the American Medical Association. Īdditionally, even providers specialized in adolescent care cannot agree whether male reproductive health should be addressed at all visits or just annual preventive visits. Therefore, residents do not know common GU abnormalities, stages of growth and development, or feel comfortable as an expert for male health although adolescents represent 32% of pediatric outpatient visits. As puberty begins, providers’ performance rate of the exam, and thus skill level, decreases. Resident comfort level with genital exams decreases as patient age increases. Īdolescent male genitourinary (GU) exams are an essential component of the preventive adolescent exam, but observation shows many pediatric residents do not have the knowledge, experience, or confidence to perform the exam correctly with a tendency to avoid guidelines or entirely omit the examination. Thus, less than 20% of categorically trained pediatricians feel capable of treating adolescent patients. Consequently, resident education regarding male genital health is limited, and pediatric residents do not know how to effectively perform male genital exams.

Education for male genital health is typically limited to medical students, although formalized curricula with videos, demonstrations, and hands-on simulations are still rare with varying levels of supervision. Female roles in reproductive health are often emphasized due to their direct relationship to childbearing and contraception, but male health is rarely emphasized. Adolescent medicine was introduced as a 1-month mandatory pediatric rotation in 1997, but there are no standardized processes for teaching adolescent medicine to residents despite Accreditation Council for Graduate Medical Education (ACGME) guidelines.

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