Educating Educators

Addressing the shortage of clinically trained anatomists

Over the past 50 years, medical schools have had a front row seat to the decline of clinically trained anatomists. In 1969, 163 doctorates in anatomy were awarded nationally, while by 2017, there was a record low of eight.

The field of anatomy, a vital component of medical education where students learn about the physical makeup of the human body, is facing challenges as the number of doctoral graduates with this expertise declines, resulting in a shortage of qualified instructors. University of Idaho’s School of Health and Medical Professions (SHAMP) has developed a Doctor of Anatomical Sciences (DAS) program. The program is aimed at training anatomists in human anatomy and anatomy technologies, and filling anatomy educator positions that have been unfilled for years.

“As you follow the progression of medical education, the anatomy content has just been squeezed out more and more over the years,” said Joshua Johnson, Idaho WWAMI’s anatomy lab manager. “You can literally draw an almost exponential decrease in anatomy, from several thousand hours of content in a medical student’s career to barely a hundred. Curricula prioritizing biomedical sciences like pharmacology, genetics and immunology have steadily replaced anatomy content in medical schools. At the same time, doctoral programs have shifted their focus to producing researchers in these areas, perpetuating the lack of trained anatomists.”

The DAS will provide a terminal degree in anatomy, allowing its graduates to pursue careers as tenure track anatomy educators in medical schools and other health care programs. Students will study both human anatomy and the most effective methods of teaching the subject.

“The program addresses a need to train healthcare professions educators, to give them content mastery along with a strong foundation in how to teach,” said David Pfeiffer, director of anatomical sciences at Idaho WWAMI. “That teaching component, which is being coupled with content mastery, that’s not done in other programs.”

Research shows that medical school departmental leaders prioritize hiring anatomists who have teaching experience, something increasingly difficult to find. In the U.S., the number of anatomy educator job postings at medical schools more than doubled from 21 in 2017 to 52 in 2018. Twenty-one percent of those postings went unfilled.

“Anatomists have been crying out about this for the last 20 years,” Pfeiffer said. “The system is structured for research. It’s not geared toward producing students with a good foundation in anatomy and anatomy-related courses. They’re just not getting that training anymore, let alone training in how to teach. Consequently, as junior faculty begin their academic careers, they often face the challenge of being asked to teach content that falls far outside of their comfort zone and to do so with no training in how to deliver that content effectively.”

Anatomy “in black and white”

In anatomy labs and operating rooms, students and surgeons often physically pull back layers of the body to see the structures they are studying or operating on. But sometimes, they instead need to use imaging — technology used to create images of the inside of the body — to see inside their patients.

“One of the things that is changing in anatomy is in the clinical setting, how clinicians interpret anatomy and are using and relying more on imaging techniques or point-of-care ultrasound (POCUS),” Pfeiffer said. “Students in health professions need to understand how to use imaging techniques to interpret anatomy. That’s one of the really exciting things about this DAS — we have a lot of imaging coursework built into it. DAS students will have that content mastered so they can deliver the content effectively.” 

Imaging from some of these tools are powerful but can be challenging to interpret. Johnson explained how imaging is anatomy, just “in black and white,” and that, with the rise of POCUS — a modern, low-cost, portable imaging technology — and other imaging techniques, it is important for clinicians to have a strong foundation in anatomy. 

“One of the biggest challenges when you start teaching imaging, is you show the X-ray or the MRI, and you outline this gray blob, and you tell students, ‘This is the liver,’ or ‘This is the collateral ligament to the elbow,’” Johnson said. “And they don’t know what that structure is, let alone what it is supposed to mean on imaging. They need that knowledge and experience in anatomy to make it click.”

In the last 30 years, POCUS has become a valuable imaging technique, helping providers bridge resource gaps in rural and underserved areas lacking CT or MRI access — costly imaging tools. But this is only possible if providers have proper training. Since POCUS is so new, health programs are struggling to find faculty with POCUS experience. Anatomists are helping fill that gap.

The program addresses a need to train healthcare professions educators, to give them content mastery along with a strong foundation in how to teach. That teaching component, which is being coupled with content mastery, that’s not done in other programs.David Pfeiffer, director of anatomical sciences, Idaho WWAMI

“Students in health professions need to have adequate training to use POCUS clinically, and anatomy courses have been a natural avenue for implementing that content in many medical schools,” Johnson said. “That’s often where students are learning about CT scans and MRIs, so POCUS is a natural fit.”

As students spend less time in the lab, anatomists need to teach additional subjects to maintain their full-time professor status. By teaching topics like imaging and POCUS alongside traditional anatomy, they will bring more value to health programs.

“In many cases, medical schools lean on people who are not completely qualified to teach these subjects, and they are struggling,” Pfeiffer said. “Maybe they have some background in one area, but they’re not really trained to teach in another area. It is a real problem. That’s one of the reasons for developing the DAS.”

SHAMP’s DAS program will begin Summer 2025.

Article by Emma Zado, Idaho WWAMI.

Photos by University Visual Productions. 

Published September 2024.