Essential anatomy for core clerkships: A clinical perspective.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

Rare cadaveric finding of a grossly enlarged mucocele appendix.

Appendicular mucoceles are rare clinical findings characterized by dilation and distention of the appendicular lumen by the accumulation of mucus. Their discovery is often incidental from abdominal imaging or more commonly as a secondary surgical finding. In this case study we report the first known recorded case of a cadaveric mucocele appendix discovered during routine dissection of the gastrointestinal system. The recorded cause of death for the 86-year-old female patient was congestive heart failure. We compared the gross anatomy and histology of this enormous appendix with another cadaveric appendix. A pathology report identified the appendicular mucocele as a mucinous cystadenoma.