Medical Students Anatomy Knowledge

NewsBot · May 7, 2006

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This is an interesting spat in Australia. First some senior medical professionals said:
Medical students fail basic anatomy

TEACHING of basic anatomy in Australia's medical schools is so inadequate that students are increasingly unable to locate important body parts - and in some cases even confuse one vital organ with another.
Senior doctors claim teaching hours for anatomy have been slashed by 80per cent in some medical schools to make way for "touchy-feely" subjects such as "cultural sensitivity", communication and ethics. The time devoted to other basic sciences - including biochemistry, physiology and pathology - has also been reduced.

Several senior consultants have told The Weekend Australian they have been "horrified" to encounter final-year medical students who do not know where the prostate gland is, or what a healthy liver feels like.

When asked by a cardiac surgeon during a live operation to identify a part of the heart that he was pointing to, one group of final-year students thought it was the patient's liver.

A coalition of senior doctors appealed this week to the federal Government to step in, claiming public safety was at stake and that national benchmarks for teaching the basic medical sciences were urgently needed.
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The heads of Australia's medical schools fiercely contest the criticisms, saying there has been an "explosion" of medical knowledge that doctors need to know, in fields such as genetics and new drugs, and that other areas have to be cut to accommodate the newer topics. They also strenuously deny that they are turning out inadequately trained doctors.

But many students are also unhappy about core science training. One group of students wrote anonymously to two noted academics last year, saying they were "sick of being asked, 'Didn't you study anatomy?"' by consultants amazed by the gaps in their knowledge.

"How can we learn if we are not taught the basics?" they wrote. ...
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Full story from the Australian

Now the medical students are upset at the claims:

Medical students defend skill level
Medical students are angry over claims today that some graduating doctors are not educated well enough in anatomy.

They say that while the teaching of anatomy can be improved, those going through the current medical courses will still graduate as competent doctors.

Australian Medical Students' Association president, Teresa Cosgriff, says students are worried that these claims will cause people to lose their trust in young doctors.

"We don't want to see that sort of put down of the future generation of doctors, because it could affect the relationship we share with our patients," she said.

"In the end we are very skilled doctors and bright students, we'll cope with the system, and we'll treat our patients well."
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From the ABC

Admin2 · Jan 25, 2008

Dynamic Chiropractic are reporting:
MDs, Med Students Still Deficient in Musculoskeletal Knowledge

The fact that allopathic physicians and medical students lack adequate knowledge of the musculoskeletal system is not news to chiropractors.

The most recent study to examine this educational gap shows that, while medical students continue to feel unprepared to deal with musculoskeletal complaints, they rate learning about such conditions to be of high importance.3 Charles S. Day, MD, and colleagues at Harvard Medical School conducted a survey of 449 medical students during the 2005-2006 academic year. The researchers wanted to determine the importance students placed on musculoskeletal education in terms of their future medical careers, as well as their clinical confidence in performing musculoskeletal exams. In addition, students were given a competency exam to assess their cognitive understanding of musculoskeletal medicine....
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Full story

Admin2 · Jan 25, 2008

Admin2 said: ↑

The most recent study to examine this educational gap shows that
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Musculoskeletal Medicine: An Assessment of the Attitudes and Knowledge of Medical Students at Harvard Medical School.
Academic Medicine. 82(5):452-457, May 2007.
Day, Charles S; Yeh, Albert C.; Franko, Orrin; Ramirez, Miguel; Krupat, Edward:

Purpose: To assess medical students' knowledge and clinical confidence in musculoskeletal medicine as well as their attitudes toward the education they receive in this specialty.

Method: A cross-sectional survey of students in all four years of Harvard Medical School was conducted during the 2005-2006 academic year. Participants were asked to fill out a 30-question survey and a nationally validated basic competency exam in musculoskeletal medicine.

Results: The response rate was 74% (449/608). Medical students rated musculoskeletal education to be of major importance (3.8/5) but rated the amount of curriculum time spent on musculoskeletal medicine as poor (2.1/5). Third-year students felt a low to adequate level of confidence in performing a musculoskeletal physical examination (2.7/5) and failed to demonstrate cognitive mastery in musculoskeletal medicine (passing rate on competency exam: 7%), whereas fourth-year students reported a similar level of confidence (2.7/5) and exhibited a higher passing rate (26%). Increasing exposure to the subject by taking clinical electives resulted in greater clinical confidence and enhanced performance on the exam (P < .001). Students' feedback suggested that musculoskeletal education can be better integrated into the preclinical curriculum, more time should be spent in the field, and more focus should be placed on common clinical conditions.

Conclusions: These findings, which are consistent with those from other schools, suggest that medical students do not feel adequately prepared in musculoskeletal medicine and lack both clinical confidence and cognitive mastery in the field. Implementing a four-year integrated musculoskeletal curriculum is one way that medical schools can address this concern.
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NewsBot · Jul 18, 2015

The spine surgeons not doing too well on lower limb anatomy:

Foot Drop Assessment of Spine Surgeons's Understanding of L5 Radiculopathy vs Peroneal Neuropathy.
Maulucci CM, Madineni R, Ghobrial GM, Hannon M, Riew KD, Harrop JS.
Neurosurgery. 2015 Aug;62 Suppl 1, CLINICAL NEUROSURGERY:197.

INTRODUCTION:
The spine surgeon often encounters patients with a foot drop. It is the task of spine physicians to be able to determine the etiology and responsible pathological process based upon history, physical examination, electrophysiological testing, and radiographic studies. A detailed knowledge of the musculoskeletal anatomy of the lower extremity and of the peripheral nervous system is beneficial to interpret the aforementioned findings in order to arrive at an accurate diagnosis. Specifically, the spine surgeon needs to be able to identify whether a "foot drop" is the result of a central, radicular, or neuropathic etiology. Peroneal neuropathy must be differentiated from L5 radiculopathy, because the treatment strategies for each of the pathologies differ.
METHODS:
An Internet-based survey consisting of 9 questions was distributed to 6231 members of Arbeitsgemeinschaft für Osteosynthesefragen (AO) Spine network. The survey asked for demographic information including practice setting, years in practice, geographic location, and type of training. It also consisted of 5 questions regarding musculoskeletal anatomy, neuroanatomy, and neurophysiology of the L5 nerve root and the peroneal nerve.
RESULTS:
A total of 645 responses were received. Of these, 464 (72%) had all 9 questions answered and were considered as complete. Final analysis of results was based only on the 464 complete surveys. Fourteen respondents (3%) answered all anatomy questions correctly. Two hundred twenty-nine surgeons from academic institutions answered 51% of the questions correctly. Two hundred thirty-five surgeons from all other practice settings answered 44% of the questions correctly (P = .142). There was no difference in the ability of surgeons from different geographic regions to answer the questions correctly.
CONCLUSION:
There may be a lack of knowledge among spine surgeons of the lumbosacral plexus and lower extremity anatomy. Medical education dedicated to the musculoskeletal system and neuroanatomy may be necessary so that gaps in knowledge may be minimized.
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