Ep 2: Anatomy at Medical School

What is it really like to learn anatomy as a medical student? Find out in our latest podcast episode! Medicine students Karolina and Homam, and Senior Lecturer in Anatomy Dr Kat Sanders, give their insight, including: How anatomy is taught and what the experience is really like; How they use different tips and tricks to learn (and remember!) anatomy;  and how medical students apply their anatomy knowledge in their clinical placements with patients.

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Transcript

00:00:00 Karolina 

Hello and welcome to this podcast and we're going to talk about anatomy today in a life of medical students. 

00:00:10 Karolina 

So, my name is Karolina. I'm a third-year medical student. I've done Gateway prior to that, so this is my fourth year in medical school and we're just going to talk about the importance of anatomy today and why? Why do we do it in the first place? So, hi guys, if you’d like to introduce yourselves. 

00:00:28 Homam 

Hello, my name is Homam. I'm a third-year medical student as well here at the Hull York Medical School. 

And I love anatomy, so let's talk. 

00:00:37 Kat 

Hi, I'm Kat Sanders and I'm a Senior Lecturer in Clinical Anatomy and I also love anatomy. 

00:00:44 Karolina 

We all love anatomy. 

00:00:48 Homam 

Common ground established. 

00:00:51 Karolina 

So, guys why do we do anatomy in the first place, what’s the point? 

00:00:55 Kat 

So, for me I always say kind of at the start of students coming into anatomy from year one is, you know, we like to boast in the anatomy department that it's the foundation of Medicine. 

You're going to do loads of anatomy in your first couple of years and we call it anatomy, but then later on you're then applying that anatomy to other fields. 

So, imaging, radiology, that's anatomy through a different view than what we have in the lab. 

Pathology is anatomy gone wrong and the signs and symptoms are anatomy and clinical examination is anatomy applied, so it's something that gets followed through all the way through medical school. 

It's just once we've got those basics nailed down, we start calling it for what it is. Once it's applied to a new field. 

00:01:37 Karolina 

Definitely. Because we stick to anatomy in the first two years. We do core anatomy just to kind of once we’re thrown into the clinical years, we know what we're talking about, and when we’re quizzed by the surgeons, especially by the surgeons, we don't want to panic on the spot. And once Kat trained us to the core, we know what we’re talking about. 

00:02:02 Homam 

I think anatomy is like, it's got a special place in your heart as medical students isn’t it, it’s like a special thing. It's a new thing. You can still remember the initiation ceremony where you’ve got the cadaver. 

00:02:13 Kat 

Induction, yeah. 

00:02:15 Homam 

And you have like all the medical students and like the cadaver was uncovered bit by bit, it's just, like it's got a special feel to it. 

And then as you learn anatomy, you’re kind of like learning a new language in a sense. I remember the very first few sessions were like focusing on how to describe anatomy, how to describe anatomy composition. Where are things in relation to each other? Yeah, exactly yeah. 

00:02:44 Karolina 

You guys might not know this, but supination, pronation, abduction, adduction, flexion, it's ingrained. They do ask you throughout in your clinical years, they do like to quiz on those random little niche just to test your memory. 

00:02:58 Kat 

Yeah, and it's about you know that language making sense as well and finding ways for it to make sense. 

So, Karolina was just then showing supination, which is the palms facing up and we remember that as you know, if you put your palms and in front of you and cup them ‘can I have soup please?’ - that's supination. 

The other way is pronation like a pro basketball player, bouncing the ball with the palm facing down and these little like titbits that you use to remember it until you actually just know it straight off the bat. 

00:03:25 Homam 

100 per cent. And as you said, like when it comes to imaging and stuff like this, it is a basic language now. So, when you describe an image or when you describe an X-ray you’re using all the terminology without even realising. 

Yeah, because you might be like talking to the person on the phone or who may not have access to the image, so using the terminology you wouldn’t get too lost. 

00:03:47 Kat 

Yes, yeah, speaking the same language as other professionals you're working with. 

00:03:51 Karolina 

Yeah, definitely. And it's really important to establish basics because without the basics you can't progress further. And it feels tedious at the start because it feels like A Levels because you're going to lectures again but it does very help and like Homam said, radiology, and it does link in for the entirety of medical school and further on. 

00:04:16 Homam 

I'm pretty sure like you had the same experience as well, but when you come as a first-year medical student, you’re not really knowing what's expected of you or how much do you need to learn? 

It's just like an ocean isn’t it of things. You swim, swim, swim and you do some more swimming and I don’t know when to stop. But anatomy, you look and you see all those big, big words. I remember like first time I looked at the sternocleidomastoid and it was like quarter of the page and I was like what even is this? 

But then you learn it, learn what it is, you learn how to say and use it, and you feel so good. Like, oh, I'm learning something now. It's like you feel that instant reward of knowing things and seeing you progress throughout what you know and what you don't, yeah. 

00:05:01 Kat 

And that sternocleidomastoid muscle as you said, you know, like the importance of knowing that and what it is. 

You know it's a muscle in the in the neck and you use it kind of as a landmark point to take the carotid pulse. Like it’s stuff that you use that day in, day out where you might not be thinking - Oh, I'm going to find the sternocleidomastoid and go for the pulse. You just know where to find the pulse because of that foundation, yeah. 

00:05:24 Karolina 

Exactly and because the way anatomy is taught within Hull York Medical School, we have PBL and its related. So, it's not like you're going into anatomy and we're talking about the hip, and then you go into PBL and you’re going to be talking about childbirth or something else and completely out of... everything is related in its initial steps. So, you will have the links and you'll be able to be supported by teaching staff. 

00:05:51 Homam 

100 per cent. Yeah it is clinically focussed, isn't it? We're not just going there to learn random words. 

00:05:57 Kat 

For the sake of it. 

00:05:59 Homam 

Yeah for the sake of it. So, as you said we’ll be leaning the physiology of the organ, how it actually works and then you go see it in anatomy and then learn the clinical things in clinical skills, like how to use and what landmarks to use as well. 

00:06:11 Karolina 

Yeah, because we do have prosections in Hull York Medical School and why is the reason? Why do we have prosections and not other things? 

00:06:19 Kat 

Yeah, so prosections. That word just means like professionally dissected, so its something that's been pre-dissected. And for me the reason why we don't teach by dissection is it's the opposite way of how you learn anatomy. 

So, you know, we kind of teach you the skeleton and the bones, and then we add on the ligaments and then the muscles and nerves and the arteries and the organs. 

And if you're dissecting or going from the skin down to the bones so you do it in like the opposite direction of the way you learn it 

If you use that skeleton as like a foundation, you kind of need to see things as we've been showing you in the lectures. See them in the lab, move things around. Think about how that then looks under the skin when you're doing clinical examination. 

So prosections are a really quick way to get you to grips with that anatomy and seeing those core structures. 

I mean, there's lots of advocates for teaching by dissection and we use it in the Masters in Clinical Anatomy programme. 

But you know the reason why people like to advocate for it is they say, oh well, if you cut something once by mistake, you're never going to forget that structure. But if you've not learnt the anatomy beforehand, you're going to cut so many things you will forget what it is that you've gone through because you know, you didn't have that foundation. 

So those prosections are really important. How have you found using those? 

00:07:38 Homam 

That's also, I agree. I looked into this, so when I was applying to medical school I was like, how does this medical school teach anatomy? 

And some medical schools, they said, teach dissection or there’s prosection. And even now like I talked to some of my medical students friends at other medical schools who do dissection. You have limited time at the end of the day, and you're there to learn. You can only spend so much time actually getting to the structur. And then when you do get to it, as you said, if you got the wrong thing or dissected wrong then are you having a clear look of what artery supplies that organ, or what vein supplies the organ? 

I feel like when you go in there, we're supplied with those pre-session worksheets that are quite handy so have an idea about we're going to be having a look at. And then you go in there, you're only focusing on something that looks how it's supposed to look because as I said like it's done by a professional. 

00:08:40 Kat 

Yeah, it’s not obscured by other tissues. 

00:08:43 Karolina 

And at the end of the day, if you want to go into dissection you can intercalate in anatomy. And that is open. You've got the basics and you've got the foundations and you can progress and you can intercalate and further develop your skills then. 

00:08:56 Homam 

Yeah, I think that's the main kind of selling point for dissection when I was looking at it. Like seeing how organs relate to each other. Where's this organ in relation to other structures? But I feel you do get that in prosections, and that's also supplemented by Complete Anatomy that we get as well. Yeah, so that's a digital app where, like you have access to the entire anatomy structures. 

00:09:19 Karolina 

So, we have both. We've got the prosections and we've got supplemented by the technology and we cannot be more grateful to the silent donors, we do hold masses to celebrate their donations. Especially as a medical student, I could not be more thankful for those donations because we do a great deal and it's not the same with a book, or with a model, because they're completely different and you can see the variation between every human. 

00:09:50 Kat 

It’s that beautiful privilege to see the differences between individuals. I think that’s so important as medical students and you know doctors to be, is to appreciate the differences between each and every individual and that that can go right down to the anatomy, which then in itself is something you really need to be clinically aware of is knowing that sometimes things go in a different direction than the textbook says, or that the model has got it painted on. 

As you said we do have Thanksgiving ceremonies every few years to really acknowledge that gift and invite the families so that they can see what a huge gift their loved one's donation was. 

00:10:32 Homam 

I don't think I've been to anatomy once without, between me and myself, like thank you to those people. 

And like sometimes we do discuss as a group you’re actually gifting your body to strangers to learn and there's like the good from within and it’s just like you really appreciate it. 

00:10:52 Karolina 

Because that one donation is saving so many lives in the future because we are going to become doctors in the end, we're going to become surgeons in the end, and the learning we gained from that is saving so many lives in the future. It's just beautiful. It is beautiful. 

00:11:08 Homam 

It's a big gift. 

00:11:09 Karolina 

It is, it is, we are very privileged as a medical school to have that, because obviously like Homam, you've mentioned technology. We do have those VR kits further on in the clinical years, we have further models, but it's not the same. It's never going to be the same as a hands-on experience. 

00:11:29 Homam 

Yes, no, because like now when we go into surgery and see how surgery is done, we're always comparing what we've seen in surgery to what we've seen in the lab. 

00:11:39 Kat 

Yeah, that anatomy is getting applied. 

00:11:40 Homam 

Yeah, 100 per cent. 

00:11:42 Karolina 

And you do remember when Peter's coming around and quizzing you on the different parts and you just remember shoulders, knees... and you remember those little aspects of anatomy that help you in those clinical years when the surgeons are grilling you on that. 

00:12:00 Homam 

Yeah, and as Kat mentioned, we doing like the clinical examination. Like I felt an enlarged liver the other day and it was like cool but at the same time, if I hadn't felt a liver before, how would I know or like, how would I know where a liver is like or how does it feel like? Am I feeling a liver? 

00:12:21 Kat 

What’s normal? 

00:12:25 Homam 

Yeah, or am I feeling something else? Yeah so it is extremely important. 

00:12:27 Karolina 

Because I don't know if you remember, we did have a liver which was completely abnormal in the anatomy session, and you were feeling it like ‘This is not normal’. This patient had something and you step outside that lab and you think of so many different things and then you experience a patient and you feel something abnormal like you said and you just know, you just know don’t you. 

Which is beautiful because we’re all got those Sherlock Holmes minds now. It just links in, it just links in, and you’re grabbing those experiences and once you’ve got that puzzle complete it’s just beautiful. 

00:13:02 Homam 

So, Kat you've done a great job! 

00:13:05 Kat 

It's genuinely a team effort. I mean, we've got so many anatomists here at Hull York Medical School. And so yeah, we all get to see you and see you develop. But like you say, you're coming into anatomy thinking I'm going to learn the anatomy and by the time you're leaving that session you’re thinking, you know, why was it like that? And you know, what pathology might have caused that, and what impact would that have had on a person’s life? 

And then you're going into those years where you're going out on placement. You're examining patients, and ‘It's an enlarged liver, I know that’. And that's, you know, that extra add on of anatomy that you don't necessarily think about when you're going into the lab. 

But once you leave and you’re years down the line, you're applying it, that knowledge really coming to the fore. Yeah, it's like an unconscious competence, right? It's so ingrained that you don't have to think about the anatomy because that you just know it in the background, and that's what you need. 

00:14:05 Homam 

Top tip from me for any aspiring medics or people going to start medical school - learn your anatomy from anatomy booklets. Those anatomy booklets were so useful. The night before have a look, so when you go to the lab, you’re not really focused on ‘What is this?’ You’re more focused grabbing one of the anatomists, ask a question, to look where the organ is in relation to other organs and learning more. 

00:14:35 Karolina 

But you come out of it and you want to learn more, you do go back and you do look at the booklet, you want to learn more. You want to go back and you want to be prepared the next lesson. So, it does teach you a lot. 

00:14:43 Kat 

And it's like, coming into the anatomy lab is like the last thing you do, like each week in Medicine. So, you've had the lectures, you've had like the start of your PBL so you kind of know the case that you're working on, you’ve then got the workbook that you're looking at. 

So, by the time you come into the lab, you've learnt quite a bit of it already, and it's just that consolidation step and that working with the human tissue and with us and asking us questions and more often than not us asking you questions and being really awkward. 

And then that nice kind of progression through the week to get you to that point where when you're actually in that lab you know the stuff and you kind of know what you don't know yet and what you need to get out of it. 

00:15:28 Homam 

It consolidates everything for you before going placement and actually examine the organ of that system that you've been learning about. 

00:15:37 Karolina 

Looking back on everything as a third year now, you see why it's there. You see why was the purpose of anatomy, why we had PBL in relation to this. It all makes sense retrospectively. In the moment you're just getting on with it because you're just getting on with it, but it does have a massive impact on how we learn and why we're doing this. It's just as a medical student, some things you have to get through as doing anatomy, it was 100 per cent worth it and it was definitely useful. 

00:16:09 Homam 

And it was the highlight of our week, wasn’t it? 

00:16:11 Karolina 

Oh, that's definitely yeah. 

00:16:13 Homam 

Everyone was like, we have anatomy tomorrow. We were always excited to have anatomy and placement, because lectures, who's excited to go to lectures, no-one! 

00:16:22 Karolina 

We were Covid kids, we had lectures online. We didn’t know what it was like going into a lecture. 

00:16:26 Homam 

Like our lectures to the kitchen to watch the lecture. 

00:16:29 Karolina 

Exactly! 

00:16:31 Kat 

And we are constantly evaluating the anatomy sessions and our teaching. There’s stuff we're implementing this year. We've got plans, you know, three, five years down the track to be making it, you know, better and better. I mean it sounds like it's got a pretty good starting point. 

00:16:47 Homam 

Yeah, I do remember, like you guys were like always flexible. Like, how would you like to be to anatomy? Are there any things we can change? And you did actually change it for year two and some things were changed within the year as well. So, it's like very student focused in terms like how would you learn best and we’ll do it. 

00:17:03 Karolina 

Definitely, and with how the team was very open to change and how you guys recorded whilst we were in lockdown, the lectures and everything. And if we had honest feedback and we’d give it to you, you guys would have leapt on it and you would change around it and it felt like every student's point was valued. Definitely. 

00:17:25 Kat 

That’s core to our practise is making sure that, you know, students have that opportunity to learn the way they learn. Because anatomy is so heavy that people need to find their own way of learning it and to get it to stick in their minds so, you know, it's really important to us that everyone has those opportunities to make their own kind of curriculum out of the different learning resources and opportunities, to get the most out of it. 

00:17:50 Karolina 

And it’s not like you’re giving the support, you're giving the support by giving the booklets. We can approach you. We can approach and ask you questions. It's not like you guys sit in your office and just go away, don't touch us. We can approach you and the whole team and environment is so, we could say, comfortable and family-like that you can approach you guys and can ask questions and can ask for the extra support. 

And that's throughout Hull York Medical School. I have never found myself being in a group where I don't know what to do, because there's always someone a good approach, even if it's my friends within or just a team around. Because there's always support there. 

00:18:30 Homam 

And the best thing is like when you’re like so stuck and they come up with a trick to help you memorise something, you go woah! This makes it worth it. 

00:18:40 Karolina 

It's just the alien drawings and different mnemonics and you just remember it for the rest of your life and there's always tricks and things to help you around everything. 

00:18:52 Kat 

One of the true joys, as an educator, is to just see that light bulb click behind the eyes. I can see that you've got it now. It makes sense to you now and just to have those moments you know, trying to strive them every day that we are in there. Because also the look of satisfaction and happiness at like yeah, it makes sense. 

00:19:15 Homam 

There are some things in anatomy are named for a reason and there’s like a structure kind of to be followed. And then when you get taught something or like learn one way of like how things are called or named then you would apply it to other kind of structures to make educated guesses of what they might be called. 

00:19:37 Kat 

Yeah, or if someone, you know, when you're out on clinical placement, says a word, that you've got enough of that language that if you don't quite remember it straight off the bat, but I can work out what that is based on its name. 

00:19:50 Karolina 

And in terms of how we approach anatomy in later years, we spoke about radiology. Is there anything that and we spoke about quite a few clinical bits? Is there anything that you've found specific in relation to anatomy Homam? Can you think of anything? 

00:20:07 Homam 

I think like other than obviously radiology, and then the clinical examinations, you can imagine if you're like interested of going into surgery, anatomy is going to be your bread and butter, isn't it?  

00:20:18 Karolina 

Of course. 

00:20:19 Homam 

So, you have to have some basics and foundations going into it. 

Then, before like if you aspire to become a surgeon, then a lot of people do intercalation as well isn’t it, where they take a year out and they do specialise in anatomy. 

00:20:34 Kat 

Yeah, in depth. 

00:20:39 Karolina 

And we do support each other, don't we? 

00:20:41 Homam 

Yeah, 100 per cent, like loads of the time before or after anatomy is like oh, I didn't quite get that and then you'd have someone like, oh yeah, there's that trick to learn it or remember it's next to this, so yeah. 

00:20:53 Karolina 

At the end of the day, we are aspiring to be doctors and you can be an aspiring surgeon and in the back of your head you think OK, and competing with each other. But it's not like that in medical school. We're here to help each other. We all want to be doctors, and there's all spaces to be those doctors. So, it's not like there's only two places for 200 people. 

00:21:12 Homam 

Loads of people think that, like you're in a competition and you're in that, but you're actually a team and in here we really support each other, and I'm pretty sure other medical schools would be a similar culture as well. 

And we have a community going in here, but I haven't found it like in many other courses to be that necessarily. We look after each other, we go socialise with each other outside of learning as well and we do actually like, I think care for one and other. 

00:21:44 Karolina 

We do, we do. 

00:21:45 Homam 

We do like look after, and its important because our week is like pretty full on and it is nice so please don't think that if you're going to come to medical school, you're going to be alone or anything like this. 

00:21:58 Karolina 

It is hard, yeah. But we get through it together, we do. And we get the support from not only each other, but we do get the support from staff members and Hull York Medical School as a school as well. 

00:22:10 Homam 

Weekly emails! 

00:22:11 Karolina 

Weekly emails! 

00:22:12 Homam 

Support and wellbeing. 

00:22:14 Karolina 

And there's so many different opportunities outside just the learning. For example, you did do anatomy clubs outside and revision sessions outside, so there is, it’s a whole... 

00:22:30 Homam 

Yeah, Anatomy Soc as well where like other students would be kind of doing some sessions to teach other students and those were really useful. 

00:22:38 Kat 

Yeah, a lot of our Masters students on the Clinical Anatomy and Clinical Anatomy and Education programmes. You know they've intercalated from HYMS as they come back into their fourth year, and you know they're straight to Anatomy Soc. They're making videos and hosting revision sessions because, like they've done it in so much detail over that year as well, they you can share that knowledge because teaching is a fantastic way to learn as well. 

So, it's like sharing those mnemonics with each other. No matter what year you’re in, helping each other to remember it and then know it and then understand it. It is a team effort. 

00:23:13 Karolina 

It is and throughout as you progress on to being those doctors or healthcare professionals we do work as a team anyway. 

00:23:21 Homam 

Teaching is a big part of being a medical student and also being a doctor, I think, isn't it? 

00:23:27 Kat 

Yeah, yeah. 

00:23:28 Karolina 

We love the doctors that love to teach, we love them! 

Because to find a doctor that is willing to teach and being good at teaching is really important for us as medical students. 

That's why getting yourself involved in those Anatomy Socs and helping each other teach anatomy, you're gaining those skills of teaching that you could progress on with in life and then teach medical students. 

00:23:52 Homam 

So in supporting each other, like not necessarily like teaching anatomy like when supporting someone else explaining another topic, physiology, whatever. Because as a doctor as well, if you think about it, if you explain a condition to a patient who's never heard the jargon words before or like heard those fancy anatomy words before, you have to explain things in a way that would make sense that would help them make sense of their condition. So, I think being a bit of a teacher is a core competency. 

00:24:21 Karolina 

And understanding what we're talking about as well? Yeah, yeah, definitely. 

Well great, thank you guys. I hope you guys enjoyed this podcast today and if you like to visit the Hull York Medical School website for more information, and to see other podcasts as well. 

I hope you get into the medical school and you find this really useful. Thank you, guys. 

00:24:44 Homam 

Thank you, guys, bye. 

00:24:45 Kat 

Thanks, bye.