Integration of gross anatomy in an organ system-based medical curriculum: strategies and challenges

The University of Alabama School of Medicine (UASOM) instituted a fully integrated, organ system-based preclinical curriculum in 2007. Gross anatomy and embryology were integrated with other basic science disciplines throughout the first two years of undergraduate medical education. Here we describe the methods of instruction and integration of gross anatomy and embryology in this curriculum as well as challenges faced along the way. Gross anatomy and embryology are taught through a combination of didactic lectures, team-based learning activities, and cadaveric dissection laboratories. Vertical integration occurs through third- and fourth-year anatomy and embryology elective courses. Radiology is integrated with anatomy instruction through self-study modules and hands-on ultrasound sessions. Our model of anatomy instruction is time efficient, clinically relevant, and effective as demonstrated by student performance on the United States Medical Licensing Examination(®) (USMLE(®) ) Step 1 examination. We recommend that medical schools considering full integration of gross anatomy and embryology (1) carefully consider the sequencing of organ system modules, (2) be willing to sacrifice anatomical detail for clinical application, (3) provide additional electives to third- and fourth-year students, and (4) integrate radiology with anatomical education.