Alarming decline in recognition of anatomical structures amongst medical students and physicians

Ann Anat. 2019 Jan;221:48-56. doi: 10.1016/j.aanat.2018.09.004. Epub 2018 Sep 20.


Background: Insufficient anatomical training can put patients' safety at risk. The aim of this study was to assess the proficiency of medical students and physicians in identifying labeled anatomical structures. The second aim of the study was to evaluate factors that can affect this recognition.

Methods: An internet-based survey where participants had to correctly identify labeled anatomical structures on cadaveric specimens was designed.

Results: The study group included 1186 participants (58.7% females): 931 medical students and 255 medical graduates from all twelve Polish medical schools. The mean total survey score for the entire study group was 65.6%. Students gained significantly higher results than graduates (total: 67.3% vs. 59.5%, P<0.001); 331 (27.9%) participants did not pass the test (<60). There was a correlation observed between points gained in this survey and grade obtained in the gross anatomy course (P<0.001). Multivariable logistic regression found that participation in cadaver laboratory classes most strongly increases anatomical competencies (OR=5.30, 95%CI=1.20-23.40, P=0.03). Other significant factors boosting anatomical proficiency were membership in students' scientific clubs, being male, and having a high grade (≥80%) in initial gross anatomy course. The time since anatomy course completion was negatively correlated with the total survey score (OR=0.86, 95%CI=0.81-0.92, P<0.001).

Conclusions: Anatomical knowledge of Polish medical students is moderate (<70%) and it significantly decreases with time. Anatomical structure recognition can be up to 25% lower in highly trained physicians when compared to pre-clinical medical students. This trend may be reversed by replacing subject-based anatomy courses with system-based (integrated) curricula at the undergraduate level or introducing short refresher anatomical courses during postgraduate training.

Keywords: Cadaver dissection; Clinical anatomy; Gross anatomy education; Medical education; Surgical anatomy; Undergraduate education.

Publication types

  • Multicenter Study

MeSH terms

  • Anatomy / education*
  • Clinical Competence*
  • Faculty, Medical*
  • Female
  • Humans
  • Internet
  • Male
  • Poland
  • Students, Medical*
  • Surveys and Questionnaires
  • Young Adult