When Tush Comes to Shove: In MUTA Programs, Regular Joes Rent Out Their Bodies to Train Tomorrow’s Doctors

Rubber Glove-2

(Photo credit: Amanda Cohen.)

Mike Figueroa showed me his wooden penis in a Starbucks on the southeast corner of Washington Square Park. He removed it from a Dopp kit he carried in a round-backed plastic backpack. The backpack had a sticker on it that read, “I’m Just Me.”

Mike, who is 44, wore a yarmulke clipped into his short black hair and a T-shirt bearing the logo of Suite 703, a website that offers “The Best Gay Sex Porn,” featuring performers like Girth Brooks. “At first I was worried I wouldn’t get one,” he said of the wooden penis. “I was just going to bring one of my own dildos.”

We sat at a table. Another man was there with us. This man was Howard [last name omitted], 58, trim, blue-eyed and long-faced. Howard showed me his wooden penis too. He removed it from a Ziploc bag that he carried in a worn canvas tote and noted that it was more “well-seasoned” than Mike’s, which appeared to be true. At least, the wood was a deeper shade of blond.

The wooden units, the men explained, are educational tools, used to train medical and nursing students in how to handle a condom properly. The condom demo is just one part of an in-depth 90-minute training session that the men conduct with some regularity (about 40 times a year, Howard estimated), including on the evening of our meeting. For this training, each man also had with him: a hospital gown, personal lubricant and fingernail clippers. These are the tools of their trade—these, and their bodies.

Known as male urogenital teaching associates (or MUTAs), men like Mike and Howard play a unique role in the education of many aspiring medical practitioners. They, in association with professors, teach students how to conduct the male pelvic examination, which includes the visual and physical inspection of body parts typically unseen in the classroom, including the penis, testicles and rectum.

Meeting with groups of four to five students at a time, usually in a warm room, which helps relax the genitalia, a MUTA explains the proper examination technique for each body part. The students then put this instruction into practice by conducting the exams on the MUTA himself. The training culminates with the oft-dreaded prostate exam (hence the personal lubricant and fingernail clippers, when necessary).

“In the past, they did it with corpses, or people who were anaesthetized or sedated and didn’t know what was happening,” Howard said. Today, there are also Human Patient Simulators, which are high-tech lifelike mannequins that can breathe, pee, respond to medicines and do pretty much everything except be human.

MUTAs, however, are lucid and alive—essentially acting as teacher and patient. The MUTA also provides real-time feedback on the student’s technique and interactive skills.

“I always tell them, ‘Look, today you’re a little bit freaked out because you’re new at this,’” said Richard [last name also omitted], a 43-year-old screenwriter and film director who began moonlighting as a MUTA earlier this year. “In every other situation in life, the patient is going to be freaking out. So the main thing is, you have to remember to make them feel as comfortable as possible.”

Like Mike and Howard, Richard is affiliated with the MUTA program at the New Jersey Medical School, which is run by Isle Polonko. Ms. Polonko has directed the MUTA and Gynecologic Teaching Associate (GTA) programs there since 2005.

“We are a patient-empowerment model,” Ms. Polonko said. “In the past, patients have been afraid to talk to their doctors. We want every single student to become a doctor who can do a safe, comfortable pelvic exam. And on the other side, we want to develop doctors who can bring their patients into an equal partnership in this relationship.”

Richard, who is not a doctor or a nurse, speculates that this emphasis on the patient’s comfort and the medical practitioner’s bedside manner has increased during the digital age, as doctors and hospitals have become as Yelp-able as restaurants. As a result, he expects the demand for patient-interaction education, such as MUTA programs, to increase.

“Being a doctor is being a business now,” he said, “and particularly in a city like New York, where you have a choice. If you have a bad experience at a hospital, you’re not going to go to that hospital again.”

MUTA programs, which are usually associated with universities, began to appear in the mid-1980s, about a decade after the emergence of female GTA programs, and closer to 20 years after the very first GTA session, according to Ms. Polonko. As such, there is a lot more history and data about—and, ultimately, demand for—GTAs.

For a fee, the MUTAs and GTAs from the New Jersey Medical School will travel to conduct trainings for schools and organizations that do not have in-house programs. Usually, Ms. Polonko said, “We can get the GTAs at universities booked first, and then I can open the door to bring the guys in.”

On the evening of my meeting with Mike and Howard, they were each scheduled to train groups of NYU nursing students. The training was part of a semester-long health assessment course, and the MUTAs were being brought in to teach the one session pertaining to the pelvic exam.

I was unable to convince Dr. Kellie Bryant, director of simulation learning and clinical assistant professor at NYU’s College of Nursing, that I should be permitted to observe this training. Perhaps I didn’t help my case by telling her I feel like a nervous dog at the vet whenever I have a physical.

It’s true: I’m afraid of doctors. This fear is called iatrophobia. Though my case is mild and, of course, self-diagnosed, it certainly impacted my ability to write this article. I did, for example, audibly gag when Richard explained how to palpate a penis. Even though “palpate” is pretty much just another word for “squeeze,” there will be no further description of this technique here.

In spite of this personal discomfort, I found myself in awe of the MUTAs for their lack of inhibition. Howard has been doing this work for more than 10 years. He attributes this longevity, in part, to his background as an actor.

“As an actor, your body’s your instrument,” he said. “I’ve never really understood—which I think is an American thing, more than a world thing—why people have such fears of their body. I’m inhibited about a lot of things, but I’m not that inhibited about my body.”

Howard, who has a wife and son, works as a MUTA primarily as a “survival job”—a way to earn extra money (typically about $300 for one 90-minute session) between acting gigs. He admits, however, that it is gratifying to see the students become more comfortable with the exam as a result of his teaching. Or as Ms. Polonko put it, “the magic that happens when a student enters the room nervous and anxiety-ridden, and when they leave the room confident—they’re different people.”

In his tenure as a MUTA, Howard estimates, he has trained 3,000 students. Though weeks may pass between trainings, some nights he works double sessions. “That means you’re getting, like, four to eight prostate exams in an hour and a half,” he said. (On one occasion, Howard received 15 exams in a double session.)

This is an especially important aspect of the job. Prostate cancer, according to the American Cancer Society, is the second most common cancer in American men, behind skin cancer. Though it is rare before the age of 40, about one in six men will be diagnosed with it in his lifetime. The key, of course, is early detection. Fortunately for anyone nervous about having this exam performed, there are men out there like Howard who make the process easier for the rest of us.

Howard has also put his experience to good use by training new MUTAs, including Mike and Richard. In February, Mike recorded his training with Howard and typed up the transcript. The document has since become the 40-page protocol for new MUTAs joining the program at the New Jersey Medical School.

Mike is also an actor, a member of the Mirror Repertory Company’s master class. Actors, Ms. Polonko said, have a unique skill set, including the ability to memorize long scripts and bring them to life with their own personalities. In general, though, MUTAs come from all walks of life. As Richard said, “Some of the guys could be extras sitting at the Cheers bar.”

Right before we left the Starbucks, I asked Mike a bumbling question about how his religion factored into his work as a MUTA. I was curious, having seen his yarmulke.

“My religious observances are what they are. But this is science, and this is about male sexuality and health, and it’s important,” he said.

I walked with Mike and Howard to the former Triangle Shirtwaist factory building, where they would soon, somehow, be naked in front of a group of probing strangers. Then Mike said something that pulled at the roots of my iatrophobia.

He said, “I think the most important thing men should understand, whether gay or straight, or sexually active or not, is their health is all they’ve got, really. And if they’re not in tune with that, or they’re afraid of that, they need to get past that and see the doctor.”

And the next day, I did make a doctor’s appointment … for a few days later.