VIEWPOINT COMMENTARY

Keeping Dissection Alive for Medical Students

James Chambers,* Daniel Emlyn-JonesWarwick Medical School, Coventry, West Midlands, United Kingdom

Traditional dissection teaching is being reduced in a number of medical schools, particu-larly in the United Kingdom. In response to this, 12 medical students from Warwick Uni-versity, UK, traveled to the Island of Grenada for an intensive extracurricular dissectioncourse at St. George’s University. This course not only benefited the host universitythrough the creation of prosections for teaching but also allowed the participants to com-pletely immerse themselves in anatomical study, by developing their dissection skills andconsolidating anatomical knowledge. We believe that similar courses could be easilyimplemented by other medical schools, thereby allowing future students to keep traditionaldissection alive. Anat Sci Educ 2:302–303, 2009. © 2009 American Association of Anatomists.

Key words: undergraduate medical education; curriculum; teaching of anatomy;dissection anatomy; educational methodology

Since the time of Hippocrates, human dissection has been animportant part of medical research and education. However,more recently, the role of traditional dissection in medicaleducation has been a subject of debate and its value calledinto question. Some argue that alternative teaching methodssuch as the study of prosections and plastinated specimens,living anatomy, surface anatomy, radiological images, andbody painting make better use of student time (Nnodim,1990; McLachlan, 2004; Patten, 2007; McMenamin, 2008).Others hold that traditional dissection gives students advan-tages over those who have not dissected, for example psy-chological and emotional training (Arraez-Aybar et al.,2008; Korf et al., 2008; Patel and Moxham, 2008; Slingsby,2008).

The fact remains that due to the financial and time con-straints placed on the modern medical curriculum, as well asthe emergence of new methods for teaching anatomy, the tra-ditional dissection of cadavers is being reduced in manyschools. Indeed, several medical schools in the United King-dom have phased out dissection altogether (Howe et al.,2004). This is in contrast to the United States, where allmedical schools have active dissection programs.

Here, we describe a novel format for dissection by medicalstudents: a five-week extracurricular summer dissection

course. This course took place between July and August 2008at St. George’s Medical School on the Caribbean Island ofGrenada. Twelve first-year students from Warwick MedicalSchool, UK, who demonstrated sufficient knowledge in a onehundred question ‘‘spot test’’ of cadaver images, were selectedto attend the course.

Although dissection has been phased out of several medi-cal school curricula in the United Kingdom (Howe et al.,2004), students from Warwick Medical School were still ableto perform dissections in 2008. However, this was limited toa maximum of two hours per week and necessitated travel-ling by coach to the Leicester University Anatomy Laboratoryto access dissection facilities.

In contrast, at St. George’s Medical School in Grenada, theselected Warwick students had unrestricted access to the anat-omy laboratory for five weeks. They were given the opportu-nity to manage their own workload, although most adopted anine-to-five routine. On the previous dissection course at theLeicester University Anatomy Laboratory, only one cadaverwas available for ten students, whereas at St. George’s MedicalSchool in Grenada, one or two students had the opportunity towork on a single cadaver at a time.

Students performed a variety of dissections at St. George’sMedical School. Some were planned prosections to be usedfor teaching purposes at the medical school. These includedthe abdomen, back, upper limb, and lower limb. Studentsalso had the opportunity to pursue their own anatomicalinterests. One student performed a dissection of the coronaryarteries, another dissected the sympathetic chain, and anotherthe hand.

From this hands-on practice, students felt that increasedanatomical knowledge was gained, as well as a three-dimen-sional feel for the spatial relationships and textures ofdifferent structures.

*Correspondence to: Mr. James Chambers, Warwick Medical School,Gibbet Hill Road, Coventry, West Midlands, CV4 7AL, UnitedKingdom. E-mail: j.w.a.chambers@warwick.ac.uk

Received 24 June 2009; Revised 25 July 2009; Accepted 27 July2009.

Published online 9 September 2009 in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ase.104

© 2009 American Association of Anatomists

Anat Sci Educ 2:302–303 (2009) NOVEMBER/DECEMBER 2009 Anatomical Sciences Education

By dissecting different cadavers, an appreciation of ana-tomical variation was gained, as well as the effects of diseaseon the anatomy and the impacts of different fixation techni-ques on tissues. Development of fine dissection skills was amajor outcome of this course, and each student developedhis/her own individual preference in dissection technique.Such technical development as a result of prolonged dissec-tion may be important for those considering surgery as acareer.

Admittedly, students found fine dissection to be a labori-ous and, at times, a frustrating process, but the rewardsmade this effort worthwhile. Many felt that spending pro-longed time working on a cadaver allowed them to build arelationship with it. From anatomical clues, hypotheses couldbe constructed as to what sort of life the person led and thedisease processes which resulted in death. In some cases, itwas possible to work backward from a known cause of deathand search for anatomical clues using an explorative learningapproach (Philip et al., 2008). The experience of prolongeddissection allowed students to reflect upon issues of death,dying, and body donation, and also caused them to confronttheir own mortality. Such reflective practice is one of thepearls of traditional dissection in medical education(Lachman and Pawlina, 2006).

An extracurricular course such as this would be particu-larly attractive to students with a special interest in anatomyand to those considering surgery or radiology as a careerpath. Although not all of the students who undertook thecourse were initially interested in surgery as a career, by theend of the course all had seriously considered it.

Similar courses could easily be developed into a summerexchange format, whereby students are given the opportunityto perform fine dissection, to gain a taste of life at anotheruniversity in the developing world, and to meet and talk withnew colleagues. The host university would also gain prosec-tors, preparing specimens for the following semester’s teach-ing. Such an extracurricular course would provide a viableoption for undergraduate dissection in medical schools wheredissection has been phased out of the main curriculum. Bymaking dissection extracurricular and available during thelong vacation, ample time would also be available to performthe task slowly and carefully, which surely is what everycadaver gift truly deserves (Shapiro, 2007).

ACKNOWLEDGMENTS

The authors are grateful to Marios Loukas, M.D., Ph.D., forhis kind hospitality throughout their stay in Grenada, andPeter Abrahams, MBBS, FRCS (Ed), FRCR, DO (Hons) fororganizing the dissection course. They also thank all of thestudents who attended the course for making it such awonderful experience.

NOTES ON CONTRIBUTORS

JAMES CHAMBERS, B.Sc. (Hons), is a second-year medicalstudent at Warwick Medical School, Coventry, United King-dom.

DANIEL EMLYN-JONES, B.Sc. (Hons), Ph.D., is a sec-ond-year medical student at Warwick Medical School, Coven-try, United Kingdom.

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