How much anatomy is enough?

Innovations in undergraduate medical education, such as integration of disciplines and problem based learning, have given rise to concerns about students' knowledge of anatomy. This article originated from several studies investigating the knowledge of anatomy of students at the eight Dutch medical schools. The studies showed that undergraduate students uniformly perceived deficiencies in their anatomical knowledge when they started clinical training regardless of their school's didactic approach. A study assessing students' actual knowledge of clinical anatomy revealed no relationship between students' knowledge and the school's didactic approach. Test failure rates based on absolute standards set by different groups of experts were indicative of unsatisfactory levels of anatomical knowledge, although standards differed markedly between the groups of experts. Good test performance by students seems to be related to total teaching time for anatomy, teaching in clinical context, and revisiting anatomy topics in the course of the curriculum. These factors appeared to outweigh the effects of disciplinary integration or whether the curriculum was problem-based or traditional.