My experience as a tutor in cadaver courses about minimally invasive procedures in plastic and aesthetic surgery convinced me that, if anatomy is directly connected with practical clinical and technical aspects, is easily learned and enter in the physicians' baggage of knowledge. If anatomy is practical, it becomes an "instrument" used daily by doctor. I'm agree with dr. Ternyik that anatomy has to be integrated with clinics. Unfortunately now in Italy anatomy is a big exam to pass before starting to study the clinics.

Medical bodies of knowlege, like anatomy, physiology and pathology, should be very early connected will the practical skills of clinical reasoning or medical problem-solving. It is not a matter of quantity or a complete list of 'organs', but about interactive functions of the living human body, i.e. integrative medicine.

Such medical skills can only be learned via social interaction, virtual or real, and by seeing patients from the very beginning.

My experience as a tutor in cadaver courses about minimally invasive procedures in plastic and aesthetic surgery convinced me that, if anatomy is directly connected with practical clinical and technical aspects, is easily learned and enter in the physicians' baggage of knowledge. If anatomy is practical, it becomes an "instrument" used daily by doctor. I'm agree with dr. Ternyik that anatomy has to be integrated with clinics. Unfortunately now in Italy anatomy is a big exam to pass before starting to study the clinics.

I agree with the other responses. Personally, the anatomy component is simple and easy to learn with adequate effort. Also, Anatomy is not a modular topic, it needs to be integrated into functional systems. I think what may be useful is the context of what principles are most beneficial to the cohort being taught.

https://physiology.org/doi/full/10.1152/advan.90139.2008

I reference this article whenever I revise a lecture or series of slides. Granted, I teach undergraduate anatomy & physiology so I may be even more conservative given the overall lack of academic experience my students have. As such, I reinforce 4 major principles for every system we cover.

1. Complementarity, 2. Gradients, 3. Interdependence, 4.Homeostasis and negative feedback.

An issue that I think is a problem is that there is NOT ENOUGH anatomy taught at the UNDERGRADUATE level. I am speaking here about lecture classes and animal dissection laboratories, of course - human cadavers can wait until medical school.

The reason is because it appears that only a basic, 101 level knowledge of anatomy and physiology is required (or even desirable) for admission to medical school.

Having spoken with many 'pre-med' students from several US colleges and asking about the anatomy and physiology classes they have taken, a typical reply is that they have taken one course and are expected "to learn that in medical school." Said students instead labor, inexplicably, through higher level physics and calculus courses, seemingly as a demonstration of their academic rigor. With the exception of the rare specialty, knowledge derived in these physics and math classes will almost certainly never be needed in their medical careers, and will most likely be forgotten within a year, anyway.

The result is that students sit in their white coats in 300 person medical school lecture halls studying the anatomy they should have taken as undergraduates. Considering the astronomical cost of medical school, this eventuality is unacceptable, both in terms of costs for the students and for society down the line.

The other effect this has is that in many colleges it is difficult to find mid-to-higher level anatomy courses even being offered at the undergraduate and even graduate level, since this is a 'medical school thing'. This results in biology students not having the option of taking such anatomy courses. Teaching positions in undergraduate anatomy and physiology are likewise diminished.

You ask us how much normal human anatomy it is right teaching to medical students. As far as systematic anatomy is concerned, I think the strictly necessary to understand physiology, special pathologies and clinical reasoning. For these purposes microscopic anatomy is very effective and it is also preparatory to the study of pathological anatomy. For those who want to become radiologists or surgeons, topographic anatomy is very important. Good educational objectives are to know how to correlate radiological, topographic and clinical anatomy, especially with regard to thorax, abdomen, kidney and urinary tract, female genital apparatus, endocrine glands.

Here you can find suggestions about the best teaching practices

Article Best Teaching Practices in Anatomy Education: A critical review

My contribution to the discussion, based on a career in anatomy teaching...

Medicine is about maintaining the balance between life and death processes in the human body, while keeping the mental attitude of the person towards the healing process positive. In this pursuit, a good grasp of body's macro and micro anatomy (and their connection to pain) is essential.

Learning anatomy is a life long affair for the physician, as with technology, new discoveries of cells and their function continuously appear. There is also a lot of anatomical deviation from the accepted norm that a physician needs to be aware of, in order to diagnose and perform medical procedures correctly.

This is reflected at our anatomy department - we are teaching not only regular students and residents, but also clinicians who feel the need/ or have the desire to up-grade their understanding on the subject.

I suppose the answer given by the teachers are very useful, but maybe you may find a student-point-of-view useful too.

It is both important and challeging to reach the right balance between:

- a study which is related to clinical cases and physicians practice

- a general and detailed comprehension of the subject (necessary to face the various cases that a student will meet in the future);

It is fundamental to preserve the Quality, it may be useful to reduce the Quantity by dividing the programs in more separated exams rather than an only "big" one.

Good question! By reading answers by you professional scholars, I have acquire a lot. However, in China, the ones newly enrolled as clinical medical students into medical colleges or universities just graduated from high school. It is indeed a hard task to learn even the basic knowledge such as anatomy. They feel confused to follow a class involving much knowledge about diseases and clinical practice. I am devoting myself to investigate how to solve this problem. I will be grateful if you give me advice!

Dear Junhua,

Yes. Medicine is not like other sciences. We are dealing with human life and we seek ways to preserve (and better) it. It is therefore crucial that a physician has a good grasp of theory and keeps his/her intellectual curiosity about throughout his/her professional life.

The amount of anatomical and clinical data to acquire is often overwhelming, especially to students, who (as you say, are coming fresh out of high school and) are not used to the increased study load and the advanced reasoning required.

I would argue that graduates have it worse, since they try to establish themselves on the job market, and/or have started a family.

Pressed for time, it is somewhat easy to decide to "prioritize" (i.e. cut down on the reading), throw the towel and ask - why do I need so much anatomy?

Well, without it, I am afraid, there could be no clinical practice. Like it or not, anatomy is the foundation of medicine.

If some people cannot (or, do not want to) cut it, then, perhaps they are not suitable to become physicians, or are not going to be good ones professionally-speaking.

Besides, with time, people forget technical knowledge. There is nothing wrong in recognizing the fact and do something about it.

For students entering medical studies - I am currently lobbying for a one or two pre-med university years. Hopefully, they would bring much needed maturity and critical thinking, develop associative skills and provide theoretical basis.

In such a system, those who are not successful in final (i.e. med university entry) exams can always be directed to other healthcare specialties (e.g. nursing, laboratory sciences).

It would be good for students, for medical universities, for the management of the healthcare system.

As to what to do in order to change outcomes, my advice is: investigate the issue scientifically, analyse the results, write articles, and raise awareness at policy-making level. Otherwise, things will go on as before.

Valeria Tananska

Dear Valeria,

I am much obliged for your kind reply and great advice. Under such a situation, I agree that this issue is really supposed to be researched in depth.

In the meantime, I am striving for a proper teaching method to solve the matter-how zero-base students accept naturally and master the massive knowledge of basic medicine - to arouse their initiative and enthusiasm, and to be helpful in their future career by integrating clinic medicine, perfectly and correctly.

I sincerely hope we could communicate more in the future.

It's intuitive. The better doctors know anatomy, the better they treat. But it is possible not to assume, and precisely to learn so it or not so. To do this, you need to conduct a special study. Accurately quantify how academic performance in certain disciplines when studying at the University (not only in anatomy) affects the quality of work of practitioners (or other professionals). We conducted large-scale similar studies. In addition to academic performance in various disciplines, we took into account the psychological characteristics of the individual, such as motivation, genetics and socially determined writing qualities. The results of this study were very good. On their basis several dissertations on psychology were defended. Research was carried out in the intellectual system Eidos, which I developed and the development of which is engaged.