|On good form|
|Friday, 23 November 2012|
Mark Baillie speaks to David Sinclair, Pro-Dean of Medicine at the University of St Andrews, about his passion for teaching and recent appointment as RCSEd’s Professor of Anatomy
Speaking to David Sinclair less than one year into his role as Professor of Anatomy at the RCSEd, one gets an impression that he is a natural fit for the position and that he knows instinctively how to progress its learning programme: “There was a need to assess the requirements of the full College membership in relation to anatomy. We have established a Surgical Anatomy Steering Group and we’ve used the early stages to speak to different groups about their needs,” says Professor Sinclair. The steering group includes Mr Ian Currie, transplant surgeon in Edinburgh, who was recently appointed Monro Prosector of Anatomy at the RCSEd, and Skills Laboratory Manager Dr Sarah Sholl.
David Sinclair was appointed Professor of Anatomy in February 2012, and much of his work will come under the banner of the Wade Programme in Surgical Anatomy, established following a generous grant from the Pilmuir Trust, set up by Sir Henry Wade, a former College President.
“It’s wonderful that the College has invested in creating the Professor of Anatomy role,” he says. “I was attracted to it because I felt it would build on work I was already doing and I’m also very interested in helping to identify the anatomical needs of different surgical groups.”
David Sinclair graduated MB ChB from St Andrews University in 1972 before surgical training appointments in Nottingham and Edinburgh. He was elected FRCSEd in 1982 and became a Fellow of the British Association of Clinical Anatomists that same year. He returned to St Andrews in 1979 as Lecturer in Anatomy, becoming Pro-Dean of Medicine in 1989 and Senior Lecturer in Anatomy
Discussing his plans at the RCSEd in more detail, Professor Sinclair sees the anatomy programme catering for three groups: students and FYs; early trainees preparing for the MRCS and those at a later stage, preparing for the exit exam.
In addition to placing the College’s existing anatomy courses within the Wade Programme, plans are afoot for extra courses aimed at MRCS candidates. Professor Sinclair explains, “Feedback from candidates on our revision courses has indicated that they would like to spend more time on anatomy. One of the reasons they are reporting this is because of the reduction in anatomy learning at undergraduate level. We are initially trying to meet this need by establishing three one-day workshops – for the Head and Neck, the Trunk and the Limbs. “It’s always best when we let the body teach us – the body is the book. I’m always inspired by the fact that one of our first functions as a college was to ensure that that those who practised surgery had a very good knowledge of anatomy”
“These workshops will include presentations providing a systematic review of the surgical anatomy – but these will be linked with practical teaching using the body itself. This is primarily aimed at those preparing for the MRCS exam – but at an early stage of their preparation, not just before the exam.”
Regardless of career-stage of those he is teaching, Professor Sinclair is clear about the broad underlying theme: “Patient safety is a major topic. At least one study has shown that a number of medico-legal problems are related to damage to ‘underlying structures’. I’d like to focus on this and make patient safety part of the Wade Programme.”
He continues: “I also saw an article recently that suggested that without enough anatomical knowledge it may not be possible to gain proper consent. In addition, although trainees will be taught to protect the main structures which could be injured in any operative field, what about the anatomy related to the field: where does the blood and nerve supply come from? What about lymphatic drainage? What might unexpectedly be present in terms of anatomical variation or through abnormal development?”
He continues: “And what happens when you get to the outskirts of the anatomical area that you know about? For example, trauma is no respecter of body demarcations or subdivisions – it can cut across different areas.”
In this context, Professor Sinclair believes firmly that broad anatomical reviews – even for more advanced professional audiences – are always welcome: “Because of the nature of increasing specialism – even within broader specialties – there is a sense that trainees are concentrating more and more on the areas they are going to be involved in. That’s alright, as long as you’ve also seen and understand anatomy as a whole.”
This raises the ever-increasing ways in which anatomy teaching can be delivered. “Now is a very exciting time for looking at the learning needs of those at different career stages,” Professor Sinclair says. “Advances in operative techniques and the way in which the body can now be seen in cross-sections, and non-invasively, raises new possibilities for learning and understanding. We should embrace any technological developments that help us meet the needs of training and professional advancement, but information technology is developing so quickly that it’s very difficult to make predictions about what might happen next.”
Although Professor Sinclair is very passionate about the possibilities offered by technology, he’s clear about how basic anatomical knowledge should be gained: “It’s always best when we let the body teach us – the body is the book. I’m always inspired by the fact that one of our first functions as a college was to ensure that that those who practised surgery had a very good knowledge of anatomy – so the link between surgery and anatomy is very deep and very important.
“A sound 3D visualisation of the human body within the mind of each practitioner is the ideal basis on which to build further specialty knowledge… After that, there are possibilities to extend that understanding with digital visualisation technology.”
Coming back to the Wade Programme in Anatomy, one aim is to offer courses in different parts of the country but this is not without some challenges. Professor Sinclair explains, “To deliver an anatomy programme regionally the issue will not be linking with medical schools who can provide prosections, it will be the teaching aspect of it. There is an international shortage of medically-qualified professional anatomy teachers, and those who are surgically-qualified are even rarer. So we also plan to offer anatomy masterclasses to assist surgical colleagues who may be interested in contributing to our new workshops.”
Having purchased his first atlas of anatomy at the age of 10, Professor Sinclair has a deep love of teaching and learning. Teaching is a process, he says, which is very “creative, complex and exciting. When you are working with people who really want to learn, teaching can be magical.”
“There is a huge and increasing mass of knowledge that describes the body, but only a certain proportion of that descriptive mass is actually needed for professional training. So there is a big question over defining that ‘certain proportion’ and it’s an issue that needs to be constantly reviewed and reappraised.”
Although he’s due to retire from full-time work at St Andrews at the end of 2013, it looks certain that David Sinclair will continue reviewing and reappraising the critical questions in anatomy for some time to come.