Today’s medical student can carry an astounding amount of reference material on their iPhone or laptop. And when they graduate they’ll be seeing patients who’ve had independent genetic testing done to determine disease risk. How do medical schools adjust their curricula to cope with these 21st century realities?

Medical educators gathered at the New York Academy of Sciences yesterday to hash out answers to this question at a forum titled “Innovating and Updating the Medical School Curriculum”. At the meeting Carol Storey-Johnson, a dean for education at Weill Cornell Medical College, talked about the need to integrate biomedical science and clinical experience throughout medical school. Charles Weiner, from the Johns Hopkins School of Medicine, echoed this in a presentation on his institution’s new curricular model, “Genes to Society”, which emphasizes a systemic view of disease tuned to individual variability.

The use of simulations, it seems, will continue to grow exponentially, whether through the use of 3-D anatomical models or robotic patients. Hands-on cadaver dissections will soon no longer be a common staple of the first-year medical school experience. They’re being replaced by dissection demonstrations and fixed-tissue specimens. But this is more due to a lack of bodies than a conscious philosophical shift. Fewer people are donating their remains to medicine, and the number of anatomists is dwindling to an aging few. It’s hard to attract young people to the field, since there’s little research money in it, except perhaps if you’re going into neuroanatomy. “There’s no surprises below the neck,” I heard conference-goers say on more than one occasion.

There was a palpable sense of regret in the attendees that future generations of doctors wouldn’t go through the familiar rite of passage. Others take a matter-of-fact view of the disappearance of cadaver dissections. “I used to feel the same way about the light microscopes, when they got rid of those,” a Harvard gastroenterologist told me at lunch. “But the students are doing just fine without them.”

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