Teaching of anatomy in the new millennium.

Somerset Maugham is well known for his literary skills as a best-selling author. But many may not know that he studied medicine and qualified as a surgeon at St Thomas’s Hospital, London. It is no wonder that in his book “Of Human Bondage”, Maugham wrote of a lecturer advising first-year medical students that, “You will have to learn many tedious things which you will forget the moment you have passed your final examination, but in anatomy it is better to have learned and lost than never to have learned at all”. Anatomy has arguably the longest history as a discipline in formalised medical education. Human anatomy is not just the study of structure or morphology but the human anatomist is likened to “a geographer of the human body”. Regarded as an integral component of the medical curriculum, a sound knowledge in human anatomy prepares the medical undergraduate for his future training in the clinical disciplines. However, the teaching of anatomy in the new millennium is facing significant changes. Paalman bemoans the “erosion of medical school gross anatomy”, once considered the cornerstone in the first year medical curriculum, to a 4–5 week course “with little cadaver time” in some medical schools. Cadaveric dissection has been a regular feature in anatomy teaching since the Renaissance. In fact, dissection evolved into part of the culture in medical education. But is cadaveric dissection necessary for the learning of gross anatomy? Even within the anatomist community, there are differing viewpoints as to whether the new methods of teaching anatomy are better than the traditional use of cadaveric dissection. In a survey of 112 professional anatomists, Patel and Moxham found that the order of preference for teaching methods (in descending order) was cadaveric dissection by students, prosection, living and radiological anatomy, computer-aided learning (CAL), didactic lectures alone, and the use of models. With the advent of technology, there has been an explosion of computer-based anatomy material which are made available. CAL such as online interactive programmes are useful tools in enhancing learning in the dissection laboratory. However, CAL can never “fully replace the intellectual, educational and emotional experience afforded to medical students by cadaver dissection and even prosection”. Bay B H, Ling E A