Who cares about anatomy?

[relapse]

As an IMG currently studying in India, I wanted to inquire to the U.S. medical students how it is they study anatomy. I've heard various accounts of "prosected" cadavers being presented to 6 week modular programs that stress rote memorization to get through the entire body. Other students have told me they have read NMS clinical anatomy and Thieme Anatomy Books 1 and 2.

Anatomy here is not emphasized that much pre clinically and not at all after your pre-clinical years and in the wards. I get lost very easily tracing where it is the pathophysiologic basis of disease starts in the body while roaming around in the wards.

The system here, much different than back home, doesn't require a broad or even detailed understanding of anatomy but I wanted to know how important having a thorough understanding of anatomy was in terms of:

1. USMLE
2. Residency
3. Becoming a competent doctor

[MexicanDr]

Originally Posted by relapse

I wanted to know how important having a thorough understanding of anatomy was in terms of:

1. USMLE
2. Residency
3. Becoming a competent doctor

ARE YOU FREAGGIN SERIOUS??

[MexicanDr]

delete

[MexicanDr]

delete

[c4e]

From what I've heard from various MD faculty, anatomy isn't stressed so much for USMLEs as much as it used to be, and is why prosections are used in some medical schools. But it doesn't mean that it should be ignored. If you plan to specialize in surgery, you better know your anatomy damned well if you want to be anywhere in that field. Path also has plenty of involvement with anatomy.

In my opinion, prosection is the bare minimum to make any sense of human anatomy. Dissection is the golden standard. Rote memorization and studying out of texts give a lot less payback and takes longer to truly understand, unless you can build your own accurate 3-dimensional model of the human body from a limited number of 2-D figures.

[nontradfogie]

I agree with c4e. Dissection is the gold standard.

I can't stand gross lab and dissection but I will have to admit that actually doing the dissection imprints it 3-dimensionally in my brain. Plus, if your school does it right they'll include relevant clinical correlations (ie clinical diagnoses or procedures that depend on anatomical relationships), what our school calls "In the clinic" boxes, that are tested too. Also radiography is big too. We also do embryology parallel with gross, which actually helps me alot. Knowing the progression of development helps me remember why things end up where they are.

There are obviously different specialties in medicine that require more or less anatomy knowledge, but I can't imagine going through the generalist portion of your training that a decent understanding of anatomy wouldn't make you a better doctor.

As far as USMLE, etc I don't think that is such a big issue. Buy a BRS book and read along during your anatomy course.

I find gross the hardest to study for but have to admit that along with physio it's the most "doctory" of the M1 courses. I like that I know it after each block, but it's torture learning it.

[nontradfogie]

Oh yeah, if you're looking for good resource materials there are a number of virtual anatomy programs online like http://www.visiblebody.com/

Also Rohen's Color Atlas is a nice book with actual photographs of beautiful "netterized" dissections.

But as was said, you get more mileage out these materials if you've actually done the dissection.

[relapse]

we do dissection here, but since we do it first year, it seems that by the time were finished with cutting, we have cut through a good number of minor nerves, branches of arteries, and some muscles

[Haemulon]

It seems to me that having a decent understanding of the anatomy of the human body is pretty important for anyone wishing to diagnose, treat, and communicate about the pathology that occurs in it.

[RiceOwl04]

As a radiology resident, I can say that anatomy is crucial to me. While I don't remember the details of the dissections I did as an MS1, that is where I built the basis of my anatomical knowledge which I employ daily.

[Forthegood]

The details can be forgotten and revisited as needed.

The 3D representation of the body's major structures in my head are priceless.

[psipsina]

Anatomy is crucial to being able to think through disease process and presentations. Why does a tension pneumothorax affect blood pressure? What type of pancreatic lesion could be treated endogastrically? Should you give a patient presenting with positive battle sign an NG tube, why not? This are three questions I've had thrown at me in the past 24 hours as a third year student that I wouldn't have been able to answer without my gross anatomy dissection experience first year.

[MossPoh]

You can tell the different types of learning standards just by the perceptions of dissection. I've never had problem with visualizing things in 3d. I can have a picture (2 is ideal) and rotate that image in nearly every plane possible. My real anatomy learning was done with the prosected body and a book. I used all the other cadavers to see the variations and what it looked like on a poor dissection since we used those poor dissections for practicals.

Is it important? Of course. It is just a building block. As a surgeon told me the other day, it becomes much more important when you're the one cutting into the person. (Referring to the mnemonic NAVeL)

[Dral]

It's always baffled me that anyone interested in Medicine wouldn't be inherently interested in Anatomy. Personal opinion of course.

[engineeredout]

Originally Posted by Dral

It's always baffled me that anyone interested in Medicine wouldn't be inherently interested in Anatomy. Personal opinion of course.

Well theres a difference between being interested in anatomy as a subject and anatomy as a class. Sometimes in order to do well on exams it feels like you're memorizing random facts instead of the actual anatomy. Ex: "The inferior ethmoid sinus drains into the middle nasal meatus" etc...

All in all I didn't mind anatomy; it certainly wasn't as horrific as everyone made it out to be. Dissection was definitely a great experience and does help me to visualize certain structures/cavities a lot better than an atlas.

[greatnt249]

Originally Posted by Dral

It's always baffled me that anyone interested in Medicine wouldn't be inherently interested in Anatomy. Personal opinion of course.

Anatomy only answers so many questions in medicine; (patho)physiology is where my interests lie.

[thepoopologist]

I care about Megan Fox's anatomy

[MossPoh]

Originally Posted by Dral

It's always baffled me that anyone interested in Medicine wouldn't be inherently interested in Anatomy. Personal opinion of course.

Just because one loves playing, listening to and writing music, doesn't mean one has to be in love with the architecture, structure, and function behind the instruments. It is good to know and to develop a solid base to work from, but not required to love and be good at what you do.

I love how the body is put together but it goes much further for me than knowing the name of a part. I suck at remembering names. I didn't enjoy anatomy but it wasn't because of the subject matter, it was because there wasn't much thinking involved. It was just repetition and more repetition with a little repetition.

[KeyzerSoze]

Originally Posted by MossPoh

Just because one loves playing, listening to and writing music, doesn't mean one has to be in love with the architecture, structure, and function behind the instruments. It is good to know and to develop a solid base to work from, but not required to love and be good at what you do.

I love how the body is put together but it goes much further for me than knowing the name of a part. I suck at remembering names. I didn't enjoy anatomy but it wasn't because of the subject matter, it was because there wasn't much thinking involved. It was just repetition and more repetition with a little repetition.

Ah, finally a voice of sanity in this thread.

[Dral]

By interested, I don't mean you have to eat, breathe, live anatomy. It just surprises me how much people complain about it.

It just seems so fundamental to medicine. So many greats in the past have contributed to medicine by studying anatomy. People put their butts on the line to get cadavers to learn about this stuff. And we sit here and complain because 'teacher makes us memorize'. *roll eyes*

Anyway, again, just personal opinion. I can understand that people don't like rote memorization..especially if you're not interested in the subject matter. Too bad, since I think anatomy is so amazing (although if you took me back into the gross lab and quizzed without giving me a review, I'd probably fare horribly, lol)

[Simmy]

Anatomy was my favourite subject the first year. We had labs w/dissections and lectures twice a week for the whole year. How you can even think that you can become a doctor without having a somewhat detailed overview over everything in the body is redicolus imo..

I did not find anatomy easy at all, but I knew it was essential and thats why I enjoyed it because I knew knowing more about it will make me a better doctor.

[dienekes88]

Originally Posted by relapse

As an IMG currently studying in India, I wanted to inquire to the U.S. medical students how it is they study anatomy. I've heard various accounts of "prosected" cadavers being presented to 6 week modular programs that stress rote memorization to get through the entire body. Other students have told me they have read NMS clinical anatomy and Thieme Anatomy Books 1 and 2.

Who have you been talking to?

Read it? My classmates and I memorized it... then proceeded to forget most of it.

[Deferoxamine]

Originally Posted by thepoopologist

I care about Megan Fox's anatomy

Who doesn't?

[Music MD]

Practically speaking, physicians are mechanics for the world's most complex machine. How would you expect to be able to fix something without knowing its components?

[Knicks]

Originally Posted by Simmy

Anatomy was my favourite subject the first year. We had labs w/dissections and lectures twice a week for the whole year. How you can even think that you can become a doctor without having a somewhat detailed overview over everything in the body is redicolus imo..

I did not find anatomy easy at all, but I knew it was essential and thats why I enjoyed it because I knew knowing more about it will make me a better doctor.

Originally Posted by Music MD

Practically speaking, physicians are mechanics for the world's most complex machine. How would you expect to be able to fix something without knowing its components?

[unsung]

Originally Posted by Dral

It's always baffled me that anyone interested in Medicine wouldn't be inherently interested in Anatomy. Personal opinion of course.

Uh... I like learning WHY things are the way they are. I like learning about anatomy if it's in conjunction with learning about function.

Unfortunately, anatomy's typically taught divorced from function, so it degenerates into memorizing a bunch of names for stuff. Which I hate doing.

Which seems to be what much of MSI is.

So, no, I have no inherent interest in anatomy. Does that make me odd? I kind of feel like an oddball sometimes, since all of y'all seem to love anatomy "inherently".

Caveat: I did enjoy head & neck more than everything else. I also enjoyed looking at radiographs. So I think my lack of enthusiasm for anatomy is at least in part due to the miserableness of digging through fascia with very little in the way of reward.

I guess I just didn't learn that much through digging through fascia. Yes, I think it's a good & necessary experience to have. Essential, in fact. But I still found myself learning more through looking at a prosection. Some will argue that dissecting helps give a 3-D conceptualization... well... yes and no. To some degree, it can help w/ some structures. But I will argue I learned very little through digging through extremities trying to uncover certain structures.

Actually I found myself really having some flash bulb anatomy moments while looking at radiographs. Things like- oh, the external iliac is a lot more anterior than the internal. Stuff that, for some reason or another, didn't really occur to me while I was looking at the body. A lot of 3-D relationships were really cloudy for me, actually, until I spent time studying radiographs... isn't that funny? I think it can be easy to get a distorted view of things during dissection since dissection is inherently messy, and it's easy to lose track of relationships... well, at least for me.

So, that is why I found the experience challenging.

[greatnt249]

Originally Posted by Music MD

Practically speaking, physicians are mechanics for the world's most complex machine. How would you expect to be able to fix something without knowing its components?

Many of us aren't aspiring to be surgeons, so in that effect, "mechanical body work" is one subset of medicine as opposed to the definition of medicine in its entirety.

I probably would have enjoyed anatomy more if it was taught in conjunction with physiology, but it wasn't. As such, it pretty much rendered anatomy to a brutal memorization-fest for me instead of being something I could intuitively figure out.

I'm more interested in fixing faulty biochemical pathways than ruptured vessels or impinged nerves, but that's just me.

[Music MD]

Originally Posted by greatnt249

Many of us aren't aspiring to be surgeons, so in that effect, "mechanical body work" is one subset of medicine as opposed to the definition of medicine in its entirety.
...
I'm more interested in fixing faulty biochemical pathways than ruptured vessels or impinged nerves, but that's just me.

Besides psychiatry, I can't think of another specialty that doesn't require at least a basic understanding of anatomy.. Would you want a doctor who had never taken anatomy doing your physical exam? I went into anatomy not knowing which side of the body the spleen was on, where the pancreas was, where a normal liver extends downward. Would you let me be your kid's pediatrician without this knowledge?

[greatnt249]

Originally Posted by Music MD

Besides psychiatry, I can't think of another specialty that doesn't require at least a basic understanding of anatomy.. Would you want a doctor who had never taken anatomy doing your physical exam? I went into anatomy not knowing which side of the body the spleen was on, where the pancreas was, where a normal liver extends downward. Would you let me be your kid's pediatrician without this knowledge?

Quite the strawman you've built there, since I never said we shouldn't have to take anatomy.

All I said was that many of our interests lie outside the realm of pure anatomy and lie more in the physiological workings of the human body.

[Music MD]

Sorry in your post you made a distinction between "mechanical medicine" and "medicine" with respect to my analogy about the importance of anatomy. I thought you were implying that anatomy wasn't very important in non-surgical specialties. My bad for any miscommunication.

[relapse]

Originally Posted by Music MD

Besides psychiatry, I can't think of another specialty that doesn't require at least a basic understanding of anatomy.. Would you want a doctor who had never taken anatomy doing your physical exam? I went into anatomy not knowing which side of the body the spleen was on, where the pancreas was, where a normal liver extends downward. Would you let me be your kid's pediatrician without this knowledge?

What about Pathology, Radiology, Sleep Medicine, Oncology

[psipsina]

Originally Posted by relapse

What about Pathology, Radiology, Sleep Medicine, Oncology

Radiology is basically 90% anatomy . . . I have no clue how anyone could read a CT cross section without a pretty deep fund of anatomy knowledge??

[smq123]

Originally Posted by relapse

What about Pathology

Autopsies, and surgical pathology (i.e. dissecting and analyzing the parts that the surgeon removed from the patient). They both require a LOT of anatomy.

Originally Posted by relapse

Radiology

I'd think this would be fairly obvious.

Originally Posted by relapse

Sleep Medicine

You should have SOME understanding of, at the very least, head and neck anatomy, since disorders of that area of the body can affect the quality of your sleep.

Originally Posted by relapse

Oncology

You should have a good spatial understanding of the body, to understand where tumors tend to grow, where they tend to spread, and what neighboring organs they can press on, which causes pain and other physiological disturbances.

Plus, when communicating with colleagues (especially surgical oncology or radiation oncology), simply saying, "Uh....the tumor is somewhere in the bowel" is not enough.

[Simmy]

Originally Posted by relapse

What about Pathology, Radiology, Sleep Medicine, Oncology

Seriously, do you know anything about medicine???

I vote troll!

[Dral]

Anatomy is just a little bit important when grossing in Path specimens. Just a tiny bit.

[KeyzerSoze]

I think that most people who aren't so enthused about "anatomy" understand that it's a fairly important area of knowledge, but are unimpressed by how it's taught in medical school.

[greatnt249]

Originally Posted by relapse

What about Pathology, Radiology, Sleep Medicine, Oncology

These specialties...they involve more than you think they do.

[relapse]

sarcasm

[greatnt249]

Originally Posted by relapse

sarcasm

What's obvious to you apparently wasn't obvious to everyone else.

[relapse]

apparently.

How is it that you guys study anatomy regarding diagnostic tests like MRI/CT/X-ray/Echo/Doppler/PET

Is it segmented based on organ systems or what?

[psipsina]

Originally Posted by relapse

apparently.

How is it that you guys study anatomy regarding diagnostic tests like MRI/CT/X-ray/Echo/Doppler/PET

Is it segmented based on organ systems or what?

My anatomy course included radiology lectures that went with whatever system we were studying. If we were doing upper extremity we'd look at all the various films. When we got into the chest and abdomen we studied CT/MRI cross sections. There were always films and cross sections on our practical exams. We then continue to go over it in clinical years. I've had 4 lectures in the past month about interpreting a chest xray alone.

[halekulani]

anatomy as a subject is awesome
learning it all in 3 months is not

[Music MD]

Try 7 weeks! Granted we're in blocks so we didn't have any other classes... Thankfully things have slowed down considerably since then, but biochemistry is not nearly as enjoyable. Something about anatomy made me really feel like I was on my way to becoming a doctor while biochemistry makes me feel like I'm in undergrad times 3.

[SocialistMD]

Originally Posted by psipsina

Anatomy is crucial to being able to think through disease process and presentations. Why does a tension pneumothorax affect blood pressure? What type of pancreatic lesion could be treated endogastrically? Should you give a patient presenting with positive battle sign an NG tube, why not? This are three questions I've had thrown at me in the past 24 hours as a third year student that I wouldn't have been able to answer without my gross anatomy dissection experience first year.

While I appreciate your support of anatomy, I'm not sure that knowing what kind of pancreatic lesion (I'm assuming you mean what location in pancreas could you endoscopically treat a pseudocyst, as you shouldn't really "treat" any pancreatic lesions endoluminally) one can treat endoluminally or that Battle's sign tells you there is a basilar skull fracture came from gross anatomy dissection. Yes, there can be a lot of clinical knowledge learned from traditional gross anatomy, but I find that most non-surgeon, non-radiologist, non-pathologist physicians function with a basic knowledge of where the organs are in relation to each other and nothing more specific than that.

Originally Posted by MossPoh

Is it important? Of course. It is just a building block. As a surgeon told me the other day, it becomes much more important when you're the one cutting into the person. (Referring to the mnemonic NAVeL)

That's why I use NAVY (Y being the crotch). It is easier than trying to remember to which leg (left or right) NAVeL applies. Nobody cares about lymphatics...

[relapse]

what type of physician are you socialist?

[docONcall]

"Who cares about anatomy?"

I think I have to.

[relapse]

Originally Posted by docONcall

"Who cares about anatomy?"

I think I have to.

There was an article in some medical journal where it stated that almost 50% of the branches of veins, arteries, nerves, and lymph channels are actually factually wrong due to variation in each body.

[Boges]

Originally Posted by relapse

There was an article in some medical journal where it stated that almost 50% of the branches of veins, arteries, nerves, and lymph channels are actually factually wrong due to variation in each body.

uh... give it up man. it seems pretty obvious you have no clue what you're talking about.

[azntxn]

i don't think it's that important to be a competent doc. I'd invest more time and brain space on path and physio. If you're worried about it that much, put up an anatomy chart in every wall in your clinic