No abstract

The dissection experience has evolved over the past 500 years, following broader cutural trends in science and medicine. Through this time each period has recruited human gross anatomic dissection for characteristic purposes. Key variables have been: (1) the motivating philosophies of medicine and science, (2) how well clinical medicine and basic science have been integrated by anatomy, and (3) how explicity thoughts or feelings about death and dying have been addressed in the context of anatomy. The authors are especially interested in the third variable, and suggest that although anatomy is scientifically in decline, dissection is currently enjoying a revival as a vehicle for teaching humanist values in medical school. Changes in the culture of medicine have carried anatomy from a research science, to a training tool, nearly to a hazing ritual, to a vehicle for ethical and moral education. Physicians, scientists, and medical students, as well as observers such as sociologists and writers, have been only intermittently aware of these cultural shifts. Yet anatomic dissection has been remarkably persistent as a feature of medical education-indeed it stands out as the most universal and universally recognizable step in becoming a doctor. This paper attempts to explore and interpret in detail the history of anatomy education, drawing on both subjective commentary and objective data from each period.

Ensuring that online patient education materials are written at an appropriate reading grade level would be expected to improve physician-patient communication.

The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future.

Predictors of success of orthopaedic residents on the American Board of Orthopaedic Surgery (ABOS) examination are controversial. We therefore evaluated numerous variables that may suggest or predict candidate performance on the ABOS examination. We reviewed files of 161 residents (all graduates) from one residency program distributed into two study groups based on whether they passed or failed their first attempt on the ABOS Part I or Part II examination from 1991 through 2005. Predictors of success/failure on the ABOS I included the mean percentile score on the Orthopaedic In-Training Examination (OITE) (Years 2 through 4), the percentile OITE score in the last year of training, US Medical Licensing Examination (USMLE) score, Dean's letter, election to Alpha Omega Alpha (AOA), and number of honors in selected third-year clerkships. All but the USMLE score predicted passing the ABOS Part II examination. These data suggest there are objective predictors of residents' performance on the ABOS Part I and Part II examinations.

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Level II, randomized controlled study. See Instructions for Authors for a complete description of levels of evidence.

Our results demonstrate a substantial worldwide burden and disparities in femoral shaft fracture incidence between low to middle income and high income countries, and the young are disproportionately affected, underscoring the potential impact of improved access to treatment. We believe that the methodology of this study can be applied to estimate the burden of other diseases, allowing for better direction of global health efforts.