Medical students’ cadaver conundrum

For more than a year, anatomy students at Australia’s most prestigious medical schools have been forced to dust off their textbooks and access anatomy classes virtually.

Associate professor Quentin Fogg, head of clinical anatomy at Melbourne University, in the campus surgical theatre. Picture: Aaron Francis

Australian universities are facing a cadaver conundrum.

For more than a year, anatomy students at Australia’s most prestigious medical schools have been forced to dust off their textbooks and access anatomy classes virtually. But it’s a poor substitute for the real thing, according to leading professors in the field, who fear restricted access to cadavers in a real-life practical setting could have lasting consequences for surgical training in Australia.

Since March 2020, disruptions to anatomical training have forced educators to rethink the teaching of “wet anatomy” across the country, as lab closures and restrictions prevent students from accessing cadavers. And for Quentin Fogg, head of clinical anatomy at Melbourne University, the challenge has become even more pronounced this year.

“The main problem we are facing with ongoing restrictions now is somewhat intangible and more pressing,” said Professor Fogg, who has conducted Zoom anatomy classes since April last year.

“Having no access to cadavers is hard to quantify because there is really no metric for how students will respond in a lab setting when … presented with a body and asked to begin dissection.”

Professor Fogg says experts in the cadaver caper call this “the hidden curriculum”.

“Handling cadavers is something you constantly need to revisit and relearn, no matter if you’re a first-year anatomy student or someone who’s had professional experience as a doctor for more than four years after medical school,” he explained.

Cadavers are the cornerstone of anatomy, said Professor Fogg, and restricted access could see a damaging gap in surgical training emerge across the country.

In May 2020, 18 of the country’s top anatomy professors published a research report discussing disruptions to surgical training during the pandemic. Their chief concern, the report concluded, was “the loss of integrated ‘hands-on’ experiences”.

Michelle Lazarus, director of Monash University’s Centre for Human Anatomy and co-author of the report, said students and educators had done well to draw on new technologies and shift to online learning, but she worries a crucial part of the surgical experience remains missing.

“Spatial awareness, tolerance towards cadavers and the use of instruments in dissection are all skills that need to be honed in a lab setting,” Professor Lazarus tells The Australian. “We are dealing with clever students who can, of course, learn from textbooks and engage with the virtual technology effectively, but in a live practical you can see how different structures are connected and how they vary in different human bodies … this is very difficult to pick up in a virtual class.”

Alan Brichta, who runs Newcastle University’s gross anatomy program, said the entire field remains in “a fluid and uncertain state” because of the pandemic.

“Touching, feeling and dissecting cadavers is our bread and butter,” said Professor Brichta, who cancelled another round of lab practicals in June. “Students are missing out on what it’s like when you’re first confronted with a cadaver, and when we (educators) have to deal with squeamishness and students passing out.”

But University of Sydney head of anatomy Kevin Keay says it’s not all doom and gloom.

“We’re seeing a major revolution in anatomical teaching technologies that actually predates the pandemic, which is able to augment reality in truly remarkable ways.”

Last week, Sydney University received its first delivery of Sectra terminals, a technology allowing students to simulate a real-life surgical scenario.