Lack of anatomy training could lead to shortage of surgeons

Computer images and models have taken over from real dissection, meaning students lack confidence

Medical students are leaving university with a "worrying" lack of anatomical knowledge, top surgeons have warned, with many never having dissected a body and some qualifying as doctors without even seeing a cadaver.

Experienced surgeons also said it was "alarming" that at least two UK medical schools, Plymouth and Exeter, now have no cadaver-based teaching whatsoever in their core curriculums. There are also concerns that a lack of confidence in anatomy is putting medical graduates off applying for postgraduate surgical training. Some warn that the problem could soon result in a national shortage of surgeons.

The Royal College of Surgeons (RCS) has drawn attention to two worrying trends. For the past two years, Britain has failed to fill all of its training places for new surgeons, not for want of applicants, but because many candidates did not meet minimum standards.

Secondly, a survey of nearly 1,000 medical graduates from 13 universities, carried out by the RCS earlier this year, found that more than half cited "poor anatomy teaching at medical school" as a reason for not pursuing a career in surgery.

Vishy Mahadevan, a professor of anatomy who teaches postgraduate surgical trainees at the RCS, told The Independent on Sunday he was "very concerned" by the current status of anatomy teaching in the university curriculum.

"Whereas anatomy was once rightly regarded as essential and of crucial importance to the study of medicine, the time allocated to its study in the present day is substantially and worryingly less than in the past," he said. "We are seeing an increasing number of qualified doctors in their early surgical training who do not feel confident in their clinical abilities, and they often attribute this to an inadequate understanding of anatomy."

It was particularly alarming that there were medical schools in the UK where internal anatomy was learnt "entirely from pictures, radiological images on computer screens and plastic models", he said.

Concerns at the top of the surgical profession over the quality and scope of anatomy teaching are not new. The amount of time students spend on the subject has been gradually reduced, and many medical schools now depend on demonstrations with pre-dissected cadavers, rather than giving students hands-on experience.

One second-year student at Plymouth University Peninsula Schools of Medicine and Dentistry told The IoS that the lack of anatomy teaching at the school was "a running joke" among medics. Another said students who were "really interested" could do a special course in autopsy, but that there was no core teaching with cadavers. While the majority of UK medical students do still have training time with cadavers, the RCS said many prestigious medical schools, including Birmingham, Edinburgh, York, and Oxford use "pro-sected" specimens, which allow students to interact with body parts, but which have already been dissected by a professional.

Professor Mahadevan said this was "not an unreasonable way to learn anatomy", but that dissection was preferable and more likely to improve the students' confidence and ability. "What is important is for all these students to go away with a fairly comprehensive understanding of three-dimensional anatomy, not just the anatomy they can pick up from colourful atlases and pictures," he said. "It is far too important a subject for them to comprehend from looking at pictures and models."

Experts said that time spent on anatomy training had increasingly given way to studies in communication and other "bedside-manner" skills. While the medical profession has largely accepted the vital importance of these aspects of a doctors' work, there are concerns that, in some universities, too little time is being spent on medical know how.

Ed Fitzgerald, a registrar in general surgery in London and a past president of the Association of Surgeons in Training, said all medical students could benefit from dissection. "A lot of students themselves want cadaveric dissection, but there are a lot of reasons why it's not being offered," he said. "One of the big factors is costs and resources. The cost of having the license, of the facilities, maintaining the labs, and the cadavers themselves, is an expensive option for medical schools.

"Anatomy is very visual subject, it's difficult to get your head around and you need the benefit of dissection …. You need a good knowledge of anatomy, and if students are perceiving this as a weak spot, they're going to be less inclined to go down a surgical career path."

There was no concern about the quality of surgeons qualifying in the UK, because of the rigour and of postgraduate surgical training, he said. But there was a case for making experience of dissection a requirement for qualifying as a doctor.

Spokespeople for the medical schools at Plymouth and Exeter were not available for comment.

Voices
Homeless Veterans charity auction: Cook with Angela Hartnett and Neil Borthwick at Merchants Tavern
charity appealTime is running out to secure your favourite lot as our auction closes at 2pm tomorrow
Arts and Entertainment
Caroline Flack became the tenth winner of Strictly Come Dancing
tvReview: 'Absolutely phenomenal' Xtra Factor presenter wins Strictly Come Dancing final
Life and Style
A still from the 1939 film version of Margaret Mitchell's 'Gone with the Wind'
life
Arts and Entertainment
J Jefferson Farjeon at home in 1953
booksBooksellers say readers are turning away from modern thrillers and back to golden age of crime writing
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Sport
Amir Khan is engaged in a broader battle than attempting to win a fight with Floyd Mayweather
boxing Exclusive: Amir Khan reveals plans to travel to Pakistan
News
Stacey Dooley was the only woman to be nominated in last month’s Grierson awards
mediaClare Balding and Davina McCall among those overlooked for Grierson awards
Voices
Joseph Kynaston Reeves arguing with Russell Brand outside the RBS’s London offices on Friday
voicesDJ Taylor: The great tradition of St Paul and Zola reached its nadir with a worker's rant to Russell Brand
News
Twitchers see things differently, depending on their gender
scienceNew study shows that birdwatching men have a lot in common with their feathered friends...
News
i100
News
Xander van der Burgt, at the Royal Botanic Gardens, Kew
scienceA Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
Arts and Entertainment
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
film
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Finance Director

    £65000 - £80000 per annum: Recruitment Genius: Finance Director required to jo...

    Recruitment Genius: Medico-Legal Assistant

    £15000 - £25000 per annum: Recruitment Genius: This is a unique opportunity fo...

    Ashdown Group: (PHP / Python) - Global Media firm

    £50000 per annum + 26 days holiday,pension: Ashdown Group: A highly successful...

    The Jenrick Group: Quality Inspector

    £27000 per annum + pension + holidays: The Jenrick Group: A Quality Technician...

    Day In a Page

    The week Hollywood got scared and had to grow up a bit

    The week Hollywood got scared and had to grow up a bit

    Sony suffered a chorus of disapproval after it withdrew 'The Interview', but it's not too late for it to take a stand, says Joan Smith
    From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?

    Panto dames: before and after

    From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?
    Thirties murder mystery novel is surprise runaway Christmas hit

    Thirties murder mystery novel is surprise runaway Christmas hit

    Booksellers say readers are turning away from dark modern thrillers and back to the golden age of crime writing
    Anne-Marie Huby: 'Charities deserve the best,' says founder of JustGiving

    Anne-Marie Huby: 'Charities deserve the best'

    Ten million of us have used the JustGiving website to donate to good causes. Its co-founder says that being dynamic is as important as being kind
    The botanist who hunts for giant trees at Kew Gardens

    The man who hunts giants

    A Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
    The 12 ways of Christmas: Spare a thought for those who will be working to keep others safe during the festive season

    The 12 ways of Christmas

    We speak to a dozen people who will be working to keep others safe, happy and healthy over the holidays
    Birdwatching men have a lot in common with their feathered friends, new study shows

    The male exhibits strange behaviour

    A new study shows that birdwatching men have a lot in common with their feathered friends...
    Diaries of Evelyn Waugh, Virginia Woolf and Noël Coward reveal how they coped with the December blues

    Famous diaries: Christmas week in history

    Noël Coward parties into the night, Alan Clark bemoans the cost of servants, Evelyn Waugh ponders his drinking…
    From noble to narky, the fall of the open letter

    From noble to narky, the fall of the open letter

    The great tradition of St Paul and Zola reached its nadir with a hungry worker's rant to Russell Brand, says DJ Taylor
    A Christmas ghost story by Alison Moore: A prodigal daughter has a breakthrough

    A Christmas ghost story by Alison Moore

    The story was published earlier this month in 'Poor Souls' Light: Seven Curious Tales'
    Marian Keyes: The author on her pre-approved Christmas, true love's parking implications and living in the moment

    Marian Keyes

    The author on her pre-approved Christmas, true love's parking implications and living in the moment
    Bill Granger recipes: Our chef creates an Italian-inspired fish feast for Christmas Eve

    Bill Granger's Christmas Eve fish feast

    Bill's Italian friends introduced him to the Roman Catholic custom of a lavish fish supper on Christmas Eve. Here, he gives the tradition his own spin…
    Liverpool vs Arsenal: Brendan Rodgers is fighting for his reputation

    Rodgers fights for his reputation

    Liverpool manager tries to stay on his feet despite waves of criticism
    Amir Khan: 'The Taliban can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'

    Amir Khan attacks the Taliban

    'They can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'
    Michael Calvin: Sepp Blatter is my man of the year in sport. Bring on 2015, quick

    Michael Calvin's Last Word

    Sepp Blatter is my man of the year in sport. Bring on 2015, quick