8 October 2019

Learning anatomy a grey area for students


Junior doctors are seriously lacking in their anatomical knowledge and some are unable to complete even basic clinical procedures after finishing medical school, experts say.

A survey published in Australian Journal of Education found  universities had made no noticeable changes to the way they taught and assessed anatomy, despite widespread criticism over the past decade that this education was inadequate.

The study authors surveyed 17 medical schools across Australia and New Zealand and compared the responses with the same questions from a 2008 survey.

“The level of anatomy knowledge of junior doctors has been described in modern medical systems as seriously lacking when compared to counterparts in previous decades, and as inadequate for basic clinical procedures,” the study authors said.

A majority of the universities (59%) said they provided all of their anatomy teaching in the first half of the course, with only some institutions (18%) providing anatomy education in the penultimate and final years.

The average amount of hours dedicated to anatomy across the medical degrees was 195 hours in 2018, a slight increase from 171 hours in 2008.

Dr Steven Craig, a co-author and general surgeon on the south coast of NSW, said when he completed his MBBS in 2008 he was surprised that students were able to fail every anatomy question and still pass their degree if they could succeed in answering other questions.

I’m of the impression that anatomy is a basic foundation of knowledge that everyone, regardless of the specialty they end up doing, should have as a minimum requirement before they finish medical school,” he said.

Dr Craig said the explosion of postgraduate diplomas in anatomy in recent decades proved there was a significant gap in knowledge.

The survey found the most frequently used resource for teaching anatomy in 2018 was prosected human material, with 76% of courses using it in every session and 18% reporting they used it for most sessions. And human dissection also still proved to be a popular teaching method in 82% of medical schools, similar to  that reported in 2008.

But Dr Craig said while dissection of human cadavers had its benefits for teaching anatomy, it was also very time intensive and expensive for smaller universities to run as part of the medical degree.

“Perhaps we need to see dissection as a privilege now, and not something we can expect every medical student to do these days,” he said.

“Very large-scale open operations are not very common in medicine anymore and most anatomy in practice is informed by 3D imaging, CT scans and keyhole surgery where you are operating but looking at a TV screen the whole time.

“Do we need to spend hundreds of hours dissecting human bodies? Or, should we spend more time learning what the body looks like through technology and minimally invasive approaches?”

The Australian Journal of Education, 29 September