Before the OR, students get more anatomy practice

UC 4th year med students complete unique, hands-on training before matching in surgical residencies

Fourth-year medical students Diana Le and Drew Philip intently examine their specimen in the lab on the University of Cincinnati’s medical campus, instruments in hand.

“You need to be at a 45- to 50-degree angle,” observes Charles Prestigiacomo, MD, professor of neurological surgery, as he walks towards the duo in the Goodyear Lab in the CARE/Crawley Building. “You’re at a 95- to 100-degree angle here. You want to be oriented the same way you would be if you were performing surgery. A patient would never be in this position on the operating table.”

This is the reason Prestigiacomo created the Advanced Anatomy of the Head and Neck elective, offered to fourth-year students at the college who are getting ready to match in surgical residencies and begin performing procedures on patients. He and colleagues are seeing how this class is better preparing students to begin their careers with a little more “real-life” practice.

Charles Prestigiacomo in the Goodyear lab with students

Charles Prestigiacomo, MD, explains a technique while Diana Le and Drew Philip observe. Photo credit/Colleen Kelley

Lowrie looks over specimen with classroom fellow

DJ Lowrie Jr., PhD, professor and educator in the Department of Medical Education at the UC College of Medicine (left), with Ahmed Hussein, a neurosurgery fellow who assists with the course. "It is ideal for students preparing for residencies in neurosurgery, ENT, ophthalmology and radiology because it provides an in-depth look at the anatomy in this region, with an eye toward surgical approaches," Lowrie says. Photo credit/Colleen Kelley

His two-week intensive course, only held three times so far at UC, was created to give students an edge and increase their anatomic knowledge to make them better physicians and surgeons. It combines classroom lectures with head and neck cadaver lab training and is offered to students hoping to match in neurosurgery, otolaryngology (ear, nose and throat), ophthalmology and oral and maxillofacial surgery programs, among other programs that focus of diseases of the head, neck and spine. The class is taught by experts in these fields at UC.

Prestigiacomo, who is also a UC Health neurosurgeon and member of the UC Gardner Neuroscience Institute, conceived the idea of a “refresher” course like this as a fourth-year medical student himself. He thought teaching fourth-year students in a more in-depth meaningful way would be more beneficial, and he promised himself that if he ever had the opportunity to put together this course, he would.

I tell my students that this is like the vocabulary of medicine and physiology is grammar. We need to make sure it is structured properly to ‘communicate,’ or function, best. These students already have a passion, but we’re just helping them become more precise, gentler — more poetic versus prosaic.

Charles Prestigiacomo, MD

“As a medical student, I always felt that gross anatomy was something that we needed to learn early but was offered too soon to benefit from the vast amounts of knowledge it provided,” he says. “You’re being taught so much as a first-year student; while it is important to see all the parts and systems of the body, in the gross anatomy lab, everything is opened up and completely visible and accessible, which is not how it actually is in the body when you’re doing surgery. You need to learn how to maneuver and access areas I call ‘corridors’ without causing damage to other parts of the body. You have to make the smallest footprint possible.

“I tell my students that this is like the vocabulary of medicine and physiology is grammar. We need to make sure it is structured properly to ‘communicate,’ or function, best. These students already have a passion, but we’re just helping them become more precise, gentler — more poetic versus prosaic.”

Charles Prestigiacomo in the Goodyear lab with students

Charles Prestigiacomo oversees the work of students in the Advanced Anatomy of the Head and Neck elective course. Photo credit/Colleen Kelley

‘Hands down, best course’

Diana Le, a self-described “Southern California girl,” says she fell in love with neuroscience early, and after graduating from UCLA with a neuroscience degree, went on to get her master’s degree in physiology and biophysics at Georgetown University, eventually making her way to the UC College of Medicine.

She matched early, in February, into the neurological surgery residency program at Baylor University in Houston, Texas. 

“As a recipient of the Health Professions Scholarship Program, I'll be fulfilling my service obligation to the military as a neurosurgeon of the U.S. Navy after the seven-year residency,” she says. “After that, who knows?”

Overall, this is hands down the best course that I have ever taken. It combines gross anatomy, history and surgical anatomy using the best resources that the UC College of Medicine has to offer.

Diana Le Fourth-year medical student

But before heading south, Le made sure she made time in her schedule for this course, rearranging classes just so that she could get this extra training.

“Overall, this is hands down the best course that I have ever taken,” she says. “It combines gross anatomy, history and surgical anatomy using the best resources that the UC College of Medicine has to offer. One of the most progressive aspects of the course is an emphasis on understanding rather than memorization, and on learning for the sake of learning, rather than for quizzes and exams."

Charles Prestigiacomo drawing on the chalkboard

Charles Prestigiacomo, MD, sketching an assignment on the chalkboard. His philosophy: "If you can draw it, you know it." Photo credit/Colleen Kelley

Le says you also get to test out your artistic abilities.

“The only true requirement of the course is to sketch your dissections. As Dr. Prestigiacomo says, ‘If you can draw it, you know it.’”

“The anatomy of the brain, or neuroanatomy, is one of the most intricate and complex in the human body,” she continues. “Operating in such an unforgiving landscape can cause severe neurological injuries if one does not understand the relevant anatomy. I cannot emphasize enough [the importance of] seeing firsthand what is behind a nerve or artery and [that] being able to master using a bone drill in a low-risk environment facilitates safety in the operating room.”

Le’s classmate Philip agrees. He will be completing a year of ophthalmologic research before beginning his residency in ophthalmology.

“This is the kind of course that makes you realize why you study everything that you do,” he says. “It teaches anatomy at the highest level but then goes further and shows how it applies to surgery and how we can use what we know to think like surgeons. My medical education and training would not be complete without courses like this.

“I have had the best training possible to become the best doctor that I can be, to have the option to go into any field that I could dream of and to be a caring and passionate teacher of future medical students and doctors-in-training. This is the UC way, and I couldn't imagine being part of any other system.”

Featured photo of Charles Prestigiacomo, MD, with Diana Le and Drew Philip by Colleen Kelley.

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