Letter to the Editor Anatomy: Too Much Too Soon at Medical School To the Editor, Clinical Anatomy: I was pleased to read the interesting article ‘‘Are We Teaching Sufficient Anatomy at Medical School?’’ by Fitzger- ald et al. (2008) in Clinical Anatomy which highlighted doctors’ self-awareness of their limited knowledge of anatomy. The argument is that this followed changes to medical university curricula across the United Kingdom and this article raised a number of key questions. As a recent medical graduate in 2003 and former dem- onstrator of anatomy in 2006, I am well aware of current time given to medical students to learn anatomy. The authors states that 44% of students felt that they had insufficient teaching and implied that more teaching was needed. My personal experience is that medical students in the early years do not necessarily grasp the relevance of the subject. It is extremely daunting to be told to learn: the names of muscles, nerves and bones, their attachments and course, innervation and blood supply, etc. This is a huge volume of work and I believe that some take to the subject very easily whereas others do not. I would argue that the current amount of teaching is sufficient but the mode and structure of delivery needs to change. Anatomy cannot be afforded the same time as before for two simple reasons. First is the advent of a more holistic curriculum. Greater emphasis is now placed upon communi- cation skills and patient interaction than ever before so that key interpersonal skills can be developed in the formative years of one’s career. Second, medicine has moved on a tremendous amount in the last 40 years. We now know more about the body than ever before, more about treat- ments, drugs and all manner of things. A 5-year medical course cannot cover everything in that time and some sac- rifices need to be made. It is unfortunate for anatomy but these are the realities that need to be faced. I suspect that all subject areas wish they were afforded more time at medical school. A more structured approach would be to pare down the information given in the first 2 years of medical school, and then supplement it to a reasonable level during appropriate clinical attachments. This would rein- force a student’s knowledge for anatomy at a stage where it can be seen to be most relevant. Furthermore, education does not end once medical school is over but continues till the end of our careers. Although educational budgets are being cut, it is paramount that the profession realizes that investment in education will bear long-term benefits. To that end, junior doctors wishing to enter specialities that have a greater require- ment for anatomical knowledge such as surgery and radiol- ogy should be given additional anatomy training by senior clinicians. Unless changes are made, junior doctors of now and tomorrow will always think their anatomy is insufficient. A consensus of change needs to be sought on how to reverse this trend. Shelain Patel* Department of Orthopaedics and Trauma University College Hospital London, United Kingdom REFERENCE Fitzgerald JE, White MJ, Tang SW, Maxwell-Armstrong CA, James DK. 2008. Are we teaching sufficient anatomy at medical school? The opinions of newly qualified doctors. Clin Anat 21:718–724. *Correspondence to: Shelain Patel, Department of Orthopaedics and Trauma, University College Hospital, London, United King- dom. E-mail: [email protected] Received 16 September 2008; Accepted 23 September 2008 Published online 20 November 2008 in Wiley InterScience (www. interscience.wiley.com). DOI 10.1002/ca.20731 V V C 2008 Wiley-Liss, Inc. Clinical Anatomy 22:287 (2009)

Anatomy: Too much too soon at medical school

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Letter to the Editor

Anatomy: Too Much Too Soon at Medical School

To the Editor, Clinical Anatomy:

I was pleased to read the interesting article ‘‘Are WeTeaching Sufficient Anatomy at Medical School?’’ by Fitzger-ald et al. (2008) in Clinical Anatomy which highlighted doc-tors’ self-awareness of their limited knowledge of anatomy.The argument is that this followed changes to medical uni-versity curricula across the United Kingdom and this articleraised a number of key questions.

As a recent medical graduate in 2003 and former dem-onstrator of anatomy in 2006, I am well aware of currenttime given to medical students to learn anatomy. Theauthors states that 44% of students felt that they hadinsufficient teaching and implied that more teaching wasneeded. My personal experience is that medical students inthe early years do not necessarily grasp the relevance ofthe subject. It is extremely daunting to be told to learn: thenames of muscles, nerves and bones, their attachmentsand course, innervation and blood supply, etc. This is ahuge volume of work and I believe that some take to thesubject very easily whereas others do not. I would arguethat the current amount of teaching is sufficient but themode and structure of delivery needs to change.

Anatomy cannot be afforded the same time as before fortwo simple reasons. First is the advent of a more holisticcurriculum. Greater emphasis is now placed upon communi-cation skills and patient interaction than ever before so thatkey interpersonal skills can be developed in the formativeyears of one’s career. Second, medicine has moved on atremendous amount in the last 40 years. We now knowmore about the body than ever before, more about treat-ments, drugs and all manner of things. A 5-year medicalcourse cannot cover everything in that time and some sac-rifices need to be made. It is unfortunate for anatomy butthese are the realities that need to be faced. I suspect that

all subject areas wish they were afforded more time atmedical school. A more structured approach would be topare down the information given in the first 2 years of med-ical school, and then supplement it to a reasonable levelduring appropriate clinical attachments. This would rein-force a student’s knowledge for anatomy at a stage whereit can be seen to be most relevant.

Furthermore, education does not end once medicalschool is over but continues till the end of our careers.Although educational budgets are being cut, it is paramountthat the profession realizes that investment in educationwill bear long-term benefits. To that end, junior doctorswishing to enter specialities that have a greater require-ment for anatomical knowledge such as surgery and radiol-ogy should be given additional anatomy training by seniorclinicians.

Unless changes are made, junior doctors of now andtomorrow will always think their anatomy is insufficient. Aconsensus of change needs to be sought on how to reversethis trend.

Shelain Patel*Department of Orthopaedics and Trauma

University College HospitalLondon, United Kingdom

REFERENCE

Fitzgerald JE, White MJ, Tang SW, Maxwell-Armstrong CA, JamesDK. 2008. Are we teaching sufficient anatomy at medical school?The opinions of newly qualified doctors. Clin Anat 21:718–724.

*Correspondence to: Shelain Patel, Department of Orthopaedicsand Trauma, University College Hospital, London, United King-dom. E-mail: [email protected]

Received 16 September 2008; Accepted 23 September 2008

Published online 20 November 2008 in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ca.20731

VVC 2008 Wiley-Liss, Inc.

Clinical Anatomy 22:287 (2009)