Over the past several years I've read with interest, and some concern, a number of articles that attempt to define the knowledge of human anatomy ''essential'' for the practice of medicine. In many instances, the authors propose to identify a group of terms or facts that are used most often by ''generalist physicians'' in their practice of medicine. The focus of these endeavors is to provide a guide for reducing the curricular content of the discipline being taught. Certainly, in light of the explosion of biomedical information that is presented in the 4-year undergraduate medical curriculum, such endeavors provide one approach for streamlining a discipline facing reductions in curricular exposure. However, this practice misses an important point.
Using the discipline of anatomy as an example, let me illustrate my objections to this limited view of identifying the ''essential'' content relevant to the daily practice of generalist physicians. First, the recollection of discrete anatomical terms or facts used on a daily basis by generalist physicians probably is quite small relative to the potential list of available terminology. However, merely recalling an isolated term or fact does not constitute the physician's full repertoire of items that could be recalled if that were the object of diagnostic medicine. More importantly, and this is really my point, a practicing physician really uses many more factual items when consciously thinking about a medical problem. The learning and application of the anatomical knowledge is fundamental to an understanding of a larger concept that is defined structurally and functionally by terminology. Whereas the physician in daily practice may not directly utilize a large anatomical knowledge base as defined by single items or terms, he or she does bring a conceptual understanding to bear on the clinical problem at hand and that understanding is framed by the terms used initially to define and learn the concept.