Medical students in Singapore face shortage of cadavers – a crucial learning tool

SINGAPORE: Cadavers are a crucial learning tool for medical students, but for medical students in Singapore, there are not enough of them to go around.

Prof Bay Boon Huat, head of the anatomy department at the NUS Yong Loo Lin School of Medicine, said: "In 2000, we received 28 cadavers from the Health Sciences Authority. This dropped to eight cadavers in 2010." This year,the school only received six.

Cadavers can be obtained in several ways - some are unclaimed bodies, some are donations made by next-of-kin, and some people also pledge to donate their bodies for scientific research.

"We started the human body donation programme in 2012, facilitated by the National Organ Transplant Unit," said Prof Bay.Donated bodies received so far include that of Dr Tan Chee Beng, the former chief executive officer of SingHealth Polyclinics.

Mr Benjamin Tan, the son of Dr Tan and a second-year medical student at NUS, shared more about his father's decision to donate his body: "He was already dying of prostate cancer. It was already in the terminal stages, so I was just sharing with him causally about what's going on in our medical school. And he jokingly questioned why the medical school would want his body, because it is so damaged."

Before taking practical classes that use cadavers, students have to take the Anatomy Student's Oath to emphasise the importance of approaching these cadavers or 'silent mentors' as they are fondly referred to, with the dignity and respect they deserve. "Although the silent mentors have lost the ability to speak, they use their bodies to teach the intricacies of human anatomy," said Prof Bay.

Mr Tan also spoke of the importance of cadavers to medical students: "Being able to go down and actually examine a real, what you call 'silent mentor', it's actually a very special and important thing... It's really hard to put something that is three-dimensional into a textbook that is just 2D. It really helps us in developing our anatomical knowledge, understanding things like variations because every person is different."

The shortage of cadavers means medical schools have to find ways to maximise the precious resource. Since 2003, NUS has done away with the dissection of cadavers by first-year students. Instead, the cadavers are dissected by prosectors - staff who work on cadavers. This is to ensure the bodies are preserved in the best shape and structure so students can scrutinise various organs and tissues during practical sessions. After about three years, the body will be cremated and returned to the family.

Nanyang Technological University's Lee Kong Chian School of Medicine has pioneered the use of plastinated bodies for the education of their medical students. Plastinated bodies are real human bodies where the water and fat have been replaced by plastics - to produce specimens that can be touched and do not smell nor decay.

Assistant Professor Dinesh Srinivasan, the lead for anatomy and head of examinations at NTU's Lee Kong Chian School of Medicine, said: "Plastination allows students to have hands-on experience many times without exposure to chemicals such as formalin... There's room for them to grow eventually when they are attached to hospitals in later years."

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Medical students in Singapore face shortage of cadavers - a crucial learning tool

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