A century ago, anatomy had a prominent place in medical education. The recent knowledge explosion in the cellular and molecular aspects of disease might lead the designers of medical curricula to think of anatomy as a backward relic, no longer necessary in a medical education. Thus, medical schools in the United States1 and abroad have been downsizing their anatomy departments for decades.
Educational policy in medicine directly affects the ability of future doctors to practise medicine safely. History-taking, inspection, palpation, percussion, auscultation, imaging and surgery all require knowledge of how the body is constructed at the cell, tissue and organ system levels. Looking up anatomic facts and pictures just before a procedure is no substitute for a rigorous knowledge of anatomy.
Documented iatrogenic injuries caused by inadequate anatomic knowledge include damage to the popliteal blood vessel during arthroscopy,2 damage to the cervical spinal cord during interscalene block,3 transection of the median nerve during carpal tunnel surgery4 and femoral nerve injury during abdominoperineal resection.5 The issue of deficient physician knowledge of anatomy leading to errors is part of the broader issue of medical errors causing injury and death, an extremely controversial topic.6
The expurgation of anatomy from medical curricula should be consciously avoided.
Roland N. Auer Professor Department of Pathology and Laboratory Medicine Faculty of Medicine David S. McDonald PhD Candidate Department of Neuroscience University of Calgary Calgary, Alta.
References
- 1.Cahill DR, Leonard RJ, Marks SC Jr. A comment on recent teaching of human anatomy in the United States. Surg Radiol Anat 2000;22:69-71. [DOI] [PubMed]
- 2.Parsons CJ. Popliteal artery and vein damage occuring at the time of arthroscopy. Can Med Protect Assoc Inf Lett 1994;9(1):1-3.
- 3.Benumof JL. Permanent loss of cervical spinal cord function associated with interscalene block performed under general anesthesia. Anesthesiology 2000;93(6):1541-4. [DOI] [PubMed]
- 4.Julliard FA. La chirurgie du canal carpien vue par un expert [Carpal tunnel syndrome reviewed by an expert]. Chir Main 2000;19:257-62. [DOI] [PubMed]
- 5.Norman J, McAllister E, Sweeney JF, Wangensteen S. Iatrogenic femoral nerve injury following abdominoperineal resection. Complicat Surg 1993; 11:56-61.
- 6.Leape LL. Institute of Medicine medical error figures are not exaggerated. JAMA 2000;284(1): 95-7. [DOI] [PubMed]