The Class of 2017’s Kymia Khosrowani, Kaila Redifer and Andy Green discovered an unusual structure in the course of their dissection. They sent a biopsy to the pathology lab to determine if it was an enlarged lymph node or a mis-shaped adrenal gland as they suspected.
In an era when some other medical schools have dropped or limited the gross anatomy lab, it’s more pertinent than ever on the MCV Campus.
Just as in years past, first-year medical students learn from their “first patient.” But now they have an unprecedented opportunity to expand beyond their anatomical observations. For the first time, they can send suspicious tissue biopsies to the pathology lab and even submit the cadaver itself for a full body CT-scan. In return, as first-year sleuths, they’re asked to assemble a plausible clinical picture of the cadaver from their different observations.
It’s called Cadaver Rounds.
“Each cadaver is different and has a different medical life history,” says M. Alex Meredith, Ph.D., course director and professor of anatomy and neurobiology. “Studying the cadaver has been so valuable in helping students develop a visual picture of the body’s 3-D structure and to see the body’s variability. Now, we are pushing those observations further to estimate – from discovered things like scars, shunts, implants, tumors and the like – what that person’s health profile was like and how those problems may have impacted their lives.” ”
Working in teams, the students dissect the cadaver with intensive study of 20 different regions of the body. Along the way, they make daily logs of important anatomical or pathological findings as well as suspected medical problems from scars, implants and tumors.
M. Alex Meredith, Ph.D.
Meredith points out “Some clinical syndromes exhibit multiple pathologies.” By spotting and recording clues along the way, students eventually may be able to correlate separate observations to a single disease process. The reports from pathology and radiology provide an opportunity to confirm, enhance or even refute or explain the students’ observations.
The dissection experience culminates in August, when the student teams formally present their findings to their classmates. They’ll be expected to describe any major clinical problems identified, the typical prognosis of diseases found, suggest clinical or lab tests relevant to the case and, finally, a likely cause of death. As a result, the whole class will have the chance to learn from 32 “first patients.”
Through Cadaver Rounds, students have early exposure to new skills. For example, they test out their dexterity with a scalpel as they slice biopsies and prepare them for the pathology lab. Once submitted, the Pathology Department prepared the slides and Davis Massey, M’96, PhD’96, H’01, associate professor of pathology, read each specimen and provided a standard Path report.
Students also learned how to read a CT-scan thanks to the Class of 2006’s Peter Haar, M.D., Ph.D., who is now on faculty in the Department of Radiology, who arranged the CT scans for all 32 cadavers. He also organized tutorials by the radiology staff for the students to examine and interpret the scans.
Meredith says Cadaver Rounds will ultimately prepare students for participating in Grand Rounds. A medical school staple, in Grand Rounds a physician presents a patient’s case or a new medical advance to an audience consisting of doctors, residents and medical students. Less common now, traditionally the patient would also attend the session.
The four teams who earn the highest scores on their presentation will receive the distinction of “Best Cadaver” along with a copy of the recently published biography Medicine’s Michelangelo: The Life & Art of Frank H. Netter, M.D. Netter was described in a NY Times book review as “possibly the best-known medical illustrator in the world.”
Meredith was a medical illustrator himself (Hopkins, 1978) before completing his Ph.D. in anatomy on the MCV Campus in 1981. He says “Cadaver Rounds has moved what was a purely anatomical experience into the clinical realm.”