The exact wording and procedures vary depending on which nurse is working that day. But for a full physical, generally the nurse for my internist first records my vitals with me fully clothed and then usually does the ECG. For that she has me remove my shirt and T-shirt but my pants and everything else stay on. Once she finishes with that, she opens a drawer under the exam table and pulls out a cloth gown (still in its own plastic bag) and also a folded paper drape. As she opens the plastic bag containing the gown, she tells me to remove everything and put on the gown so that it opens and ties in the back. She then shows me the folded paper drape and tells me I can place it over my legs. Then she'll say something like "you can leave your underwear on."
I don't bother with gowns. I've always hated them and while I have worn them in the past, I generally don't wear them -- certainly not for a full physical with a doctor that I've seen several times before. Once the nurse leaves, I go ahead and strip completely, including removal of my socks and underwear. She did say to remove EVERYTHING, right? How could leaving ones underwear on be the same as removing everything? I've never understood that. Either you're removing everything, including your underwear, or you're not. And she did say I *can* leave my underwear on. That means it's optional and my choice. Anyway, now fully nude, I take a seat on the exam table and place the still folded paper drape over my lap. My doctor arrives and first goes over my medical history with me sitting on the table just like that. Once she completes a full review of my history she begins her hands-on exam. I generally don't remove the paper drape immediately, but once she gets to the point where I'm laying on the table and she's doing my abdominal exam, it generally gets pushed out of the way or removed completely. Certainly by the time I'm standing in front of her for the genital and hernia exam, it's wadded up in a little paper ball and tossed on the table.
For a full body exam by my dermo, the routine is very similar. The nurse first goes over my history, medications and any concerns first with me fully clothed. Then she gets out a gown and paper drape and tells me to remove everything and put the gown on, opening in the back. Lately she says that I *can* leave my underwear on. I do remember in the past that the nurse there would always instruct me to take my underwear off too -- that must be a change in the office policy or just a change in the way the newer nurses do things. But once again, I strip completely and just sit there with the paper drape covering me. Once my dermo comes in, with the same female nurse, I usually lift the drape out of the way and set it aside. I know that one way or another, my dermo and her nurse will soon see every inch of my skin, so I prefer to just get the uncovering over with right away.