As an ear, nose and throat surgeon, I frequently have to wrestle with complex areas of human anatomy. However, I cannot agree with Prof Bernard Moxham’s assertion (Letters, 10 July) that all medical graduates need detailed knowledge of human anatomy to the level that I was taught during the 1980s; hours spent learning the details of the layers of the sole of the foot are now fortunately forgotten.
Some knowledge is certainly required, but I do not believe that a GP (for instance) requires anything more than a general idea of where in the chest the heart sits, or where the appendix hides in the abdomen. Gold-star students might identify the thyroid sitting bow-tie-like in the route of the neck, but unless intervention is required, further detailed knowledge of nerve and blood supply is largely superfluous. As a trainee I was taught that, unless I was about to dismantle my car, a detailed knowledge of the workings of the internal combustion engine was largely unnecessary.
Graeme M Weiner
Consultant otolaryngologist, Exeter
• As a doctor in training in my second year of qualification, and an aspiring medical education researcher, I was interested to read both Chris Ward’s defence of a truncated medical course (Letters, 4 July) and Bernard Moxham’s rebuttal focusing on the teaching of anatomy.
I would take this further: medical students deserve adequate time to learn the first principles of anatomy, physiology and indeed the scientific process. As a first‑ and second-year medical student, I found learning these topics that were seemingly unrelated to clinical practice frustrating when I was itching to see patients. But as I become increasingly senior, I rely more and more on the knowledge of these principles when signs and symptoms aren’t adding up, or there is uncertainty about a diagnosis or course of management action.
When we talk about training doctors, we must remember that we are not just training for the first year of practice, but for a lifetime career, with increasing responsibility for managing increasingly complex cases. For many, going “back to basics” is a useful way of thinking through complex problems – and so we need to ensure that these basics are adequately taught and understood.
Dr Anna Harvey Bluemel
Newcastle upon Tyne
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