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The anatomy demonstrator

Authors: Hudhaifah Shaker 

Publication date:  16 Apr 2009

Following his own experience Hudhaifah Shaker recommends anatomy demonstration, particularly as a stop-gap job for those trainees who haven’t got the jobs they wanted post-FY2/ST2 level

I knew as a medical student that I wanted to teach anatomy somewhere along my career path towards general surgery. Being among the first cohort of foundation trainees, and with the changes MMC brought, I knew fitting it in would be a challenge. Ironically it was the problematic management of training jobs by the architects of MMC and MTAS that eventually pushed me into working as an anatomy demonstrator. Having been offered an FTSTA in surgery and not being sure what the future held, I applied for and was offered an anatomy demonstrator post at the University of Manchester.

The challenge

Starting the job is quite daunting, especially in the first semester being faced with 18 year olds fresh from their A-levels, many of whom had never been so close to a dead body before. As well as introducing them to dissection of cadaveric specimens I had to teach them some difficult anatomical concepts, while trying to keep them interested and enthused. With the second year students the challenge was living up to their expectations and standards set by their previous demonstrators.

Eight other demonstrators and I were set the task of teaching nine groups each week, composed of first and second year medical and dental students who would stick together for each semester. Tutorials lasted around 90 minutes and involved teaching anatomy using dissection, prosections and models as well as using radiological images. Surface anatomy was also crucial in these tutorials to emphasise the clinical application of the anatomy. We were also involved in teaching anatomy to other students such as optometrists and biomedical scientists as well as playing a key role in examining the students at the end of the semesters.

On the job

In a typical week I would be scheduled to work for around 22-26 hours with some weeks being slightly busier, especially during revision periods. Although it may not sound like much, a lot of time was taken up preparing for lessons, especially with more difficult topics such as neuroanatomy.

To make sure we focused on the right things all the demonstrators would meet together with senior teaching staff to go through the topics that were going to be taught that week. There was a great group dynamic and on many occasions the demonstrators would discuss the topics between themselves to help in our own understanding and to swap tips on how best to present it to the students.

Teaching anatomy

Despite some weeks being extremely busy with lesson preparation, I did find that in most cases I actually enjoyed learning the material I needed to teach. I soon discovered that the bigger challenge was not necessarily knowing the topic itself but being able to present it to the students in an appropriate and interesting way. I tried to do this by making my lessons interactive and ensured all the students got involved both in dissecting and in answering my questions. Where possible I tried to mix in the clinical relevance of the anatomy I was teaching, particularly in relation to my own clinical experience.

I also felt that one of my most important roles as a demonstrator was to ensure that students grasped certain difficult anatomical concepts that dissection allowed them to understand rather than simply rote learning lists of facts from textbooks. My creative side was forced out in a bid to achieve this and I ended up making models of the brachial plexus and the inguinal canal.

It was extremely satisfying when a lesson went as planned and even more so when it was accompanied by positive feedback from students. My role sometimes extended beyond a tutor and I was giving out advice on electives, intercalating, and career paths into surgery.

A year well spent

My perspective on surgically applied anatomy improved during this year including a better understanding of tissue planes and the close proximity of certain important structures; the body suddenly became smaller and less complex week by week. The next time I went to theatre I found that I could orientate myself much quicker during, for example, a laparoscopy, and identify structures a lot more easily than before. Reading CT scans also became more straightforward as it was easier to think three-dimensionally about the relation of different structures having dissected them all out with my students during the year.

Undoubtedly the anatomy learnt also helped immensely with studying for my surgical exams. The academic timetable allowed more time to study than one would expect from a busy hospital job and many of the demonstrators, including myself, took advantage of this and access to the dissecting room to prepare for and pass the MRCS exams.

Standing up and speaking in front of scores of students every week has also helped to improve my presentation and communication skills. I also feel more confident in using different teaching styles and techniques when covering topics in a range of settings, which will help me back in the hospital setting when I continue teaching students and later on junior doctors.

Well worth trying

Although a few deaneries have managed to integrate anatomy demonstration into foundation and core surgical training schemes, many of the remaining posts have stayed as stand alone roles outside the surgical rotations. Due to the changes in the structure of training and the annual competition for posts, this type of post is likely to become a stopgap job for trainees who haven’t got the jobs they wanted post-FY2/ST2 level or for those who want a break from clinical medicine. I strongly recommend this post for anybody who likes teaching and is looking to go into a specialty where anatomy plays a role, particularly surgery and radiology. Although sometimes a challenge, it will not only enhance your CV but enhance your ability to teach and enhance your basic science knowledge helping you become a better all round clinician.

Hudhaifah Shaker core surgical trainee, ST1 Liverpool Heart and Chest Hospital, Liverpool

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