Many medical schools no longer use traditional dissection to teach their students anatomy. Three dimensional models and computer simulations are replacing cadavers. Does this mean that medical students miss out? Samena Chaudhry and Shahid Mohammed argue for and against the method that they themselves have not experienced

Writing in favour of a practice that I have never experienced may sound a little hypocritical, but there are two sides to every argument. It is always worth considering an alternative way of learning. The important question being is, "Might we have learnt more another way?"

My experience of anatomy included handling waxy plastic limbs and clever looking 3D models that you could take apart like a jigsaw puzzle. We watched the formation of inguinal canals using paper origami and worked through chapters of worksheets with the help of anatomy demonstrators. For those interested, a visit to see pro sections could also be arranged. All this was meant to give us a basic grounding in anatomy as well as to give some clinical relevance to what we were learning.

Our anatomy exam, which formed a small part of the main exam in each system, was designed in such a way that we could choose physiology questions over anatomy ones to gain most marks (even As). It was not until the third year that the sheer importance of this anatomy struck me. I felt unconfident with the lobes of the lung, the specific locations of the popliteal and foot pulses, and I barely knew the major branches of the aorta.

Our surgeons were horrified when they discovered that we could hardly name major nerves or vessels, let alone where they actually ran to and from. They resorted to assuming that we knew nothing and used theatre white boards and backs of x ray folders in a desperate attempt to orientate students in the more crucial areas of anatomy.

Traditionally, most students in the United Kingdom have studied topographical anatomy in considerable detail, basing their work on the dissection of cadavers. However, this method of teaching anatomy is expected to decrease over the next decade. As computer simulation and models take over, we have little choice but to go for the cheaper and more efficient option. Dissection will soon be seen as outmoded and oldfashioned.

However, dissection can give students a clear three dimensional picture of anatomy. Using books and computers require a considerable amount of imaginative effort to visualise the actual appearance of the structures. Through dissection, students can discover the anatomy for themselves directly from the cadavers which helps them to remember it.¹ You can appreciate anatomical variation by seeing the differences between cadavers. In addition, the manual dexterity acquired while dissecting may prove useful in many different specialties.

The dissection room also provides an early exposure to the reality of death. We need to develop sufficient detachment to deal with tragedy and realise that death for everyone is inevitable.

The way we look at patients with an awareness and understanding of what is going on, our thoughts of what might be happening under a person's skin, the way we examine patients and study radiographs, all have their foundations in the subject of anatomy. Therefore, a real time, 3D, correctly scaled, appreciation is essential. I believe that the best way of doing this is by studying the human cadaver, alongside radiographs, models, bones, and each other. It may be that widespread unhappiness in the low level of anatomical knowledge in today's students may well swing the pendulum back towards dissection.

At Birmingham, dissection has a place only in the special study module setting where students spend up to 18 hours on a particular region. The view that teaching everyone dissection may not be the best thing for today's students is based on three main reasons. Firstly, past experience has shown that only a few students (those actually doing the procedure) from the group will benefit from dissection. Secondly, the time in the undergraduate preclinical course devoted to learning anatomy is not enough for students to dissect usefully or properly. Thirdly, there are concerns about eye and respiratory tract irritation from formaldehyde and phenol use in the dissecting room.

Despite these concerns, I would argue that dissection is a necessary component of the undergraduate course.

Perhaps, a centuries old method of teaching anatomy should not be abandoned until the alternative is clearly shown to be more effective. Until that time, based on my own preclinical experience, I remain unconvinced.