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The Medical Metaphor: Gross Anatomy and Third Graders

Publication Date: 2004-03-22

Why do we treat third graders like medical students?


Body of Knowledge: One Semester of Gross Anatomy, the Gateway to Becoming a Doctor offers a detailed description of the grueling work endured by medical students enrolled in the Gross and Developmental Anatomy course at University of Medicine and Dentistry, Newark.

The reader witnesses the daily interactions in the lab between medical students and instructors. The instructors seem very cognizant of each student's strengths and weaknesses. But in the end it is, of course, the test that counts. University instructors aren't too worried how their students will fare on national tests--because the textbook contains lots of sample questions.

Third graders, too, find their daily classwork pales in comparison to how they do on a national test ranking them with students across the country. Third graders, too, use curriculum based on the national tests, curriculum with lots of test prep questions.

A future physician told the author of the book that passing this notoriously difficult course is "paying your dues for medicine. It's the bridge you have to cross if you want to become a doctor." More students leave medical school during this course than any other.

The parallels with third grade are obvious. Politicians have decided that third graders must "pay their dues": Read on grade level or else. One could wish for data on how many eight-year-olds give up on becoming students as a result of the tests they endure. Of course politicians and their academic lackeys ignore such data. They prefer metaphors, medical metaphors.

Plenty of people argue that the draconian procedures described in this book are inappropriate and destructive of producing the kinds of doctors we want. I don't pretend to know much about it. The five students pictured in this book seem like decent people who do manage to survive. Whatever the case for them, I do know a lot about third graders, and I know that it is inappropriate, malicious, and abusive to subject any of them to the task of crossing shark-infested waters.



Those who love the medical model for education, those who insist that teaching involves diagnosing a disease and curing it, should consider this: grade level is an artificial construct of testmakers; it is not so easily identifiable as, say, a spleen.

Below, in this brief account of what happens at the conclusion of the Gross Anatomy course, we see how third graders are treated like medical students.

As much as they wished it were so, the final written and practical exam for Medical Gross and Developmental Anatomy was not the last time the class would be called upon to summon their expertise on the anatomical compendium. The denouement would take place two weeks later with the shelf examination administered by the National Board of Medical Examiners. The test would not only determine how NJMS (New Jersey Medical School) students fared when compared with students across the country but also serve as a barometer for the program that had taught them. . . .The chance of getting ambushed by esoteric inquiries was greatly diminished by the course's primary textbook, Snell's Clinical Anatomy for Medical Students, which helpfully tendered sample shelf exam questions at the conclusion of every chapter.





The only difference is that with many standardized tests whose questions remain secret, third graders often get ambushed by esoteric inquiries. If you doubt this, read Children and Reading Tests by Clifford Hill and Eric Larsen (Ablex 2000). Using the methods of discourse analysis, the authors examine not only representative material from reading tests--actual passages and questions--but also children's responses to it. The book is particularly attentive to the role of culture in shaping children's understanding of what they read. You cannot read this and not be changed. Even if you already think these standardized tests are an unfair measure, this book shows they are worse than you think they are.

Body of Knowledge: One Semester of Gross Anatomy, the Gateway to Becoming a Doctor,
Steve Giegerich (Scribner, 2001)


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