1334
Letters
to
the Editor
PROGNOSIS FOR ANATOMY SIR,-As anatomists with experience in Britain, Canada, and Australia, we write to express our appreciation of Professor Sinclair’s1 timely reminder of the plight of anatomy in medical schools. The global decline of anatomy in the medical curriculum is paralleled by the gradual disappearance from anatomy " departments of clinically oriented " anatomists, and has been hastened by the rigid separation of traditional anatomy departments from clinical departments. An ever-decreasing number of anatomists has maintained clinical interests and too few clinicians are involved in teaching anatomy. Anatomy teaching time has been severely cut and clinicians complain ever more vehemently that clinical students do not know their anatomy. We agree with Professor Sinclair’s diagnosis. The illness is iatrogenic. Denigration of anatomy by doctors, the financial disadvantages of a career in anatomy, and the loss of status of this basic discipline have effectively cut off the medically qualified recruits. We believe that it is not too late to alter the prognosis. The surprising fact is that, despite the hostile environment, here and there, dedicated enthusiasts survive who seek to teach and advance the subject of anatomy. In the present climate of opinion, however, it is inevitable that such people are in short supply, and that it is difficult or impossible to fill vacant posts with professionals whose enthusiasms encompass research, the teaching of topographical anatomy, and an awareness of the relevance of their subject to modern medicine. Change is certainly necessary, but changes in attitudesin the entire medical profession-not only in anatomy departments. Organisational and administrative changes, in the past, have tended to be destructive rather than constructive and have resulted in medical educators in a country such as Canada having to sacrifice standards for
political
reasons.
It is the responsibility of the medical profession to put its own house in order, even at the risk of losing the
popularity
Human
Morphology,
Medical and Biological Sciences
Building, Bassett Crescent East, Southampton SO9 3TU.
D. BULMER.
DANE PARTICLES IN HOMOGENATES OF MOSQUITOES FED WITH HBsAg-POSITIVE HUMAN BLOOD
SIR,-It has been suggested that blood-sucking arthropods could play a part in disseminating type-B hepatitis
contest.
If the kind of anatomy necessary for a " safe doctor " is to be taught in medical schools, we need to preserve and encourage the good that remains and attract back into anatomy suitable medically qualified recruits. To create separate clinical anatomy departments, as Professor Sinclair suggests, whether desirable or not, seems unrealistic. " Clinical anatomists " belong rightly to anatomy departments, but with a more flexible remit than at present in traditional schools. They should be anatomists who have had clinical and research experience, and who maintain active clinical interests and contacts with clinicians. They should do at least some of their anatomy teaching in a clinical context, in the middle or later years of the medical curriculum. They would then be in a position to keep their subject matter relevant to medicine. Paraclinical salary scales might be an inducement to young doctors to enter such a career, but money is not the only problem. When the profession curbs its largely uninformed criticism of anatomy, anatomy departments may recover their morale, and, with encouragement, will more effectively provide medical students with the essential basis for reachingproper physical diagnosis based on sound anatomical principles. Department of Anatomy and Human
Biology,
University of Western Australia, Nedlands, Western Australia 6009. 1.
ANATOMY AND MEDICINE 1975 Sm,-I read my colleagues’ letters (May 3, p. 1028; May 24, p. 1186) on the problems of staffing anatomy departments, particularly in the new schools, and from my experience I fully endorse their warnings of urgency. Our shortened courses demand an intensive tutorial and prosection programme if they are to be successful; with current staff shortages it is becoming increasingly difficult to maintain such a programme in the face of increasing student numbers. Many non-anatomists are now aware of the seriousness of the situation, and of the dangerous limitations it is likely to place on our ability to teach medical students In Southampton we have the over the coming years. sympathetic understanding and help of the University, the regional health authority, and our clinical colleagues, but the problem is a national one and the help which can be given locally is limited by national constraints. It would be of some reassurance if the authorities who have the overall responsibility for undergraduate and postgraduate medical education indicated their awareness and concern. There are means by which, even at this late stage, the situation might be improved, but it is certain that no solution will appear spontaneously. Unless urgent steps are taken to initiate discussions involving all the interests which are concerned,, and unless these discussions result in an effective solution, then the point of no return will arrive as surely and as soon as Professor Coupland and Professor Beck predict.
Sinclair, D. C. Lancet, April 19, p. 875.
J. R. TAYLOR A. S. WILSON.
Fig. 1-Radioimmunological detection of HBsAg in a poolextract from mosquitoes fed with blood from HB,Ag-positive carrier (A——A). Extract became negative after neutralisation with anti-HB,
(&Dgr; - - - - A). A pool-extract from mosquitoes not fed on blood was HBsAg negative before (•——•) and after (8 - - - -.) neutralisation with anti-HB,.
Letters
to
the Editor
PROGNOSIS FOR ANATOMY SIR,-As anatomists with experience in Britain, Canada, and Australia, we write to express our appreciation of Professor Sinclair’s1 timely reminder of the plight of anatomy in medical schools. The global decline of anatomy in the medical curriculum is paralleled by the gradual disappearance from anatomy " departments of clinically oriented " anatomists, and has been hastened by the rigid separation of traditional anatomy departments from clinical departments. An ever-decreasing number of anatomists has maintained clinical interests and too few clinicians are involved in teaching anatomy. Anatomy teaching time has been severely cut and clinicians complain ever more vehemently that clinical students do not know their anatomy. We agree with Professor Sinclair’s diagnosis. The illness is iatrogenic. Denigration of anatomy by doctors, the financial disadvantages of a career in anatomy, and the loss of status of this basic discipline have effectively cut off the medically qualified recruits. We believe that it is not too late to alter the prognosis. The surprising fact is that, despite the hostile environment, here and there, dedicated enthusiasts survive who seek to teach and advance the subject of anatomy. In the present climate of opinion, however, it is inevitable that such people are in short supply, and that it is difficult or impossible to fill vacant posts with professionals whose enthusiasms encompass research, the teaching of topographical anatomy, and an awareness of the relevance of their subject to modern medicine. Change is certainly necessary, but changes in attitudesin the entire medical profession-not only in anatomy departments. Organisational and administrative changes, in the past, have tended to be destructive rather than constructive and have resulted in medical educators in a country such as Canada having to sacrifice standards for
political
reasons.
It is the responsibility of the medical profession to put its own house in order, even at the risk of losing the
popularity
Human
Morphology,
Medical and Biological Sciences
Building, Bassett Crescent East, Southampton SO9 3TU.
D. BULMER.
DANE PARTICLES IN HOMOGENATES OF MOSQUITOES FED WITH HBsAg-POSITIVE HUMAN BLOOD
SIR,-It has been suggested that blood-sucking arthropods could play a part in disseminating type-B hepatitis
contest.
If the kind of anatomy necessary for a " safe doctor " is to be taught in medical schools, we need to preserve and encourage the good that remains and attract back into anatomy suitable medically qualified recruits. To create separate clinical anatomy departments, as Professor Sinclair suggests, whether desirable or not, seems unrealistic. " Clinical anatomists " belong rightly to anatomy departments, but with a more flexible remit than at present in traditional schools. They should be anatomists who have had clinical and research experience, and who maintain active clinical interests and contacts with clinicians. They should do at least some of their anatomy teaching in a clinical context, in the middle or later years of the medical curriculum. They would then be in a position to keep their subject matter relevant to medicine. Paraclinical salary scales might be an inducement to young doctors to enter such a career, but money is not the only problem. When the profession curbs its largely uninformed criticism of anatomy, anatomy departments may recover their morale, and, with encouragement, will more effectively provide medical students with the essential basis for reachingproper physical diagnosis based on sound anatomical principles. Department of Anatomy and Human
Biology,
University of Western Australia, Nedlands, Western Australia 6009. 1.
ANATOMY AND MEDICINE 1975 Sm,-I read my colleagues’ letters (May 3, p. 1028; May 24, p. 1186) on the problems of staffing anatomy departments, particularly in the new schools, and from my experience I fully endorse their warnings of urgency. Our shortened courses demand an intensive tutorial and prosection programme if they are to be successful; with current staff shortages it is becoming increasingly difficult to maintain such a programme in the face of increasing student numbers. Many non-anatomists are now aware of the seriousness of the situation, and of the dangerous limitations it is likely to place on our ability to teach medical students In Southampton we have the over the coming years. sympathetic understanding and help of the University, the regional health authority, and our clinical colleagues, but the problem is a national one and the help which can be given locally is limited by national constraints. It would be of some reassurance if the authorities who have the overall responsibility for undergraduate and postgraduate medical education indicated their awareness and concern. There are means by which, even at this late stage, the situation might be improved, but it is certain that no solution will appear spontaneously. Unless urgent steps are taken to initiate discussions involving all the interests which are concerned,, and unless these discussions result in an effective solution, then the point of no return will arrive as surely and as soon as Professor Coupland and Professor Beck predict.
Sinclair, D. C. Lancet, April 19, p. 875.
J. R. TAYLOR A. S. WILSON.
Fig. 1-Radioimmunological detection of HBsAg in a poolextract from mosquitoes fed with blood from HB,Ag-positive carrier (A——A). Extract became negative after neutralisation with anti-HB,
(&Dgr; - - - - A). A pool-extract from mosquitoes not fed on blood was HBsAg negative before (•——•) and after (8 - - - -.) neutralisation with anti-HB,.
