Mboyd77.
If I have understood your post correctly, please forgive me if I have not, then what you're suggesting is that you don't consider masturbation, giving or receiving, to be a sexual act as long as it happens under the umbrella of a medical fetish exam.
I assume what you are referring to when you mention "sex" is actually sexual intercourse. I have to say in my humble opinion performing an act which deliberately elicits sexual arousal should surely be construed to be a sexual act.
Please don't misunderstand, I'm not criticising in any way or suggesting this shouldn't occur during a play examination, it certainly does when I perform exams, I'm merely stating that sexual intercourse is not the only act which should be described as sex.
I have read posts where someone has written "I wouldn't want there to be sex in a play exam" I find this to be somewhat misleading where in certain cases they would enjoy some form of sexual arousal to happen, they just wouldn't wish to have intercourse or provide the "doctor with sexual gratification.
I feel a better and more accurate statement might be along the lines of "No sexual intercourse, but some form of sexual stimulation would be acceptable /expected"
I do understand that peoples understanding can be vastly diverse. I have known several guys who would insist that if they hadn't ejaculated into a vagina, regardless of whatever else they might have done they had not had sex. Go figure.