Help wanted. Hours flexible, pay good. Those with a morbid fear of doctors need not apply.

For years, some medical schools have relied on so-called professional patients to help train medical students in skills and bedside manner.

Many surrogate patients are working professionals, students or retirees looking to make extra money while making a difference. They provide the kind of feedback you can't get from a plastic model.

Most are healthy but are given a script to follow in portraying a certain illness — say, rheumatoid arthritis, asthma or congestive heart failure. The student is expected to make a diagnosis and create a treatment plan based on the patient's "illness."

Nova Southeastern University in Fort Lauderdale, Fla., is one school looking for more "patients." Most are recruited by word of mouth, said Dr. Martha Echols, assistant dean of medical education at NSU's College of Osteopathic Medicine.

"People who are out of work might like it. It's not steady work, but it pays well," Echols said.

NSU and the University of Miami rely on a team of about 50 professional patients.

Most medical schools pay $15 to $25 per hour, said Dr. Alex Mechaber, senior associate dean for undergraduate medical education at University of Miami's Miller School of Medicine, with the higher pay going to the patients who teach the more sensitive male and female genital and breast exams.

These patients are specially trained, and the exams are more invasive, Mechaber said.

At the University of Miami, women who teach the breast and pelvic exam are paid $40, and men who teach the genital and rectal exam make $30, said Annie Maurer, manager of UM's clinical skills medical education program.

Nova pays professional patients, also known as standardized patients, $20 an hour to teach general exams; those doing the male or female exam are paid $35.

As a professional patient, journalist Martha Sternberg gets the female exam five times in a day once a week during UM's fall semester. Michael Mitchell, a hospital secretary, may get the male exam up to 12 times a session.

In the 1970s, medical schools around the country relied on prostitutes as subjects in those exams, Mechaber said.

But today's professional patient is trained to give feedback and guidance.

"There is nothing like the professional patient guiding you," said Dr. Steven Chavoustie, an OB-GYN in North Miami who trained Sternberg and others in how to teach the female and male exams.

"It's an intimidating experience," Chavoustie said. "This takes away a lot of the anxiety. … These professional patients have really changed the way we learn."

As trained instructors, professional patients teach students how to perform the exam properly as well as how to put patients at ease.

When training a group of five to 12 students how to conduct "a kinder, gentler prostate exam," a sense of humor helps, Mitchell said.

Once in the exam room, nervous students start giggling. Occasionally, one will faint.

The training helps build confidence in students who have never worked on a real patient, said UM medical student Steve Engel, 23.

"They explain everything and walk you through each step," Engel said of the trained patients. "It is such an intimate exam. It's not like taking blood pressure. … They … know a lot more than we do. We are lucky to have them."

Sternberg, a professional patient for seven years, also uses humor.

When she first meets the students, she tells them, "I am Martha, I'm a professional patient, and I'm dilated to meet you."

That makes them laugh, and everyone feels a little less awkward, she said.

Once on the table, she gives feedback, teaching them how to complete a breast and pelvic exam without causing pain. Not every student, however, gets the message.

"As a pool, we have been pinched, scratched, made to bleed and gone home crying," Sternberg said.

Why do most do it?

"It's nice extra income for a worthy cause. And it makes for better doctors and better nurse practitioners," Mitchell said.