The carpal bones: a basic test of medical students' and junior doctors' knowledge of anatomy

With the changing emphasis of the modern medical school curriculum, many senior doctors and authors are commenting on a decline in anatomical knowledge of trainees. This study was conceived to provide a snapshot of medical students' and junior doctors' knowledge of anatomy. The carpal bones were chosen as a benchmark for anatomical knowledge as they are easily objectively examined and have clinical relevance to junior doctors in a number of disciplines. Twenty five fourth and final year medical students, fifteen pre-registration house officers (PRHOs) and ten senior house officers (SHOs) were recruited and the questionnaires were completed in the presence of one author. Of all participants recruited only fifteen could correctly name all eight carpal bones. Seven of these were SHOs in Surgery or Accident and Emergency (A&E). Seventeen medical students (68%) and nine PRHOs (60%) correctly identified less than five carpal bones. Most SHOs (90%) could name five or more bones; the proportion of PRHOs and medical students correctly naming more than five bones was similar (40% vs 32%). The scaphoid was the most frequently identified bone, with an accuracy of 92%. Only 15 candidates (30%) managed to name the triquetrum. The overall recognition scores obtained by medical students was poor, however the SHO's results were more reassuring. Anatomy teaching should be encouraged in undergraduate and postgraduate training.