Commentary: The Importance of Musculoskeletal Medicine and Anatomy in Medical Education

Day, Charles S. MD; Ahn, Christine S.

doi: 10.1097/ACM.0b013e3181cd4a89

Medical schools in the United States have continued to demonstrate deficiencies in musculoskeletal education. In response to the findings of numerous studies and to the objectives of the U.S. Bone and Joint Decade (an international collaborative movement sanctioned by the United Nations and the World Health Organization for the purpose of promoting awareness of musculoskeletal disease), several institutions, including Harvard Medical School, have reassessed the preclinical musculoskeletal curriculum at their respective medical schools. A cross-sectional survey at Harvard in 2004 found that students lacked clinical confidence in dealing with the musculoskeletal system. In addition, only one quarter of the graduating class of medical students passed a nationally validated exam in basic musculoskeletal competency. In 2005, 33 total hours of musculoskeletal medicine were added to the musculoskeletal blocks of the preclinical anatomy, pathophysiology, and physical examination courses. Alongside this movement toward more musculoskeletal education, there has been continued debate over the relevance and cost-effectiveness of cadaveric and surface anatomy labs. With the advent of advanced imaging technology, some argue that dissection anatomy is outdated and labor-intensive, whereas three-dimensional images are more accessible and time-effective for today's students. However, knowledge of anatomy is a critical foundation to learning musculoskeletal medicine. Thus, making room for more musculoskeletal curriculum time by cutting out cadaveric anatomy labs may ultimately be counterproductive.

Dr. Day is assistant professor, Department of Orthopedic Surgery, and director of the orthopedic curriculum, Harvard Medical School, Boston, Massachusetts, and chief of hand and upper extremity surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Ms. Ahn is a graduate, Harvard College, Cambridge, Massachusetts, and research assistant, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center.

Correspondence should be addressed to Dr. Day, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215; telephone: (617) 667-3940; fax: (617) 667-2155; e-mail:

© 2010 Association of American Medical Colleges