IN FOUR years, I will be caring for patients as a resident physician, and I want the best education available. While in medical school, I want to learn everything I possibly can in order to best treat my patients. That said, I know I can receive a phenomenal medical education without participating in the "Emergency Life Saving Techniques" lab offered before my surgical rotation third year.
What the general public does not know is that most U.S. medical students do not practice surgeries on animals before they are given medical degrees. Ninety out of 126 medical schools have eliminated animal labs from their medical school curricula, including Harvard, Yale, Columbia, Duke and Stanford.
There is a reason why most medical centers do not use animals for surgical training. Simple surgical procedures are easily learned in the course of assisting at surgery. Students are poorly served by experimenting on dogs or other animals. Countless aspects -- from the amount of incision pressure needed to break the skin to the size and placement of internal organs -- on the dog are different from those of humans.
Board certified trauma surgeon Jerry Vlasak, M.D. corroborates, "surgeons learn their skills by doing simple procedures on patients under direct supervision, then progressing to more complex ones. Non-human animals have different anatomy and tissue characteristics that make them unsuitable for learning to do surgery on people. Most surgical residencies in the United States do not require animal labs. There may occasionally be an animal lab offered, but such labs are optional and are certainly not the focus of a surgeon's training.
"It's not just a matter of opinion. Research shows that animal labs do not improve surgeons' skills. A study published in the November 2002 issue of the Journal of the American College of Surgeons showed that when ATLS physician students performed cricothyroidotomy in canine models, placement accuracy was low (69.8 percent), but accuracy was high in human cadaver training (96.4 percent). Another study reported in the Southern Medical Journal concluded that animal laboratories for laparoscopic cholecystectomy had no measurable effect on surgical speed or complication rates."
In addition, Advanced Trauma Life Support (ATLS) courses, also required for surgeons, are now taught at many medical centers with either cadavers or simulators. Since the American College of Surgeons (ACS) gave its nod of approval to Trauma Man as a replacement for human cadavers or live animals in November, 2001, many surgeons have tested Trauma Man and are very enthusiastic about the realistic learning experience. The ACS notes that procedures can be performed "in the correct anatomical sites," and that the life-like model provides a "realistic response" while performing procedures.
The question remains, if the majority of medical schools in the United States no longer use live animal labs to train medical students, why is the University still doing it? I believe the answer is tradition. Many of the physicians and professors who plan our curriculum performed dog labs during their training, and assume that it is the only way to learn. However, the University should come up to speed with most other medical schools that have already modernized their curricula with newer and more effective techniques.
It is also important to note that the majority of students who graduate from medical schools go into fields where they will not perform these procedures. Seventy-two percent of the University of Virginia School of Medicine Class of 2001 went into non-surgical specialties. The ones that do go into ER or surgery will have many years of training learning those procedures on humans.
Proponents quickly point out that most University students do the lab. However, many students are simply too afraid to voice their discomfort with or opposition to the dog lab for fear of academic repercussions. In addition, third-year medical students are desperate for hands-on experience and are excited to get a break from classroom lectures. True, students enjoy putting on surgical gear and getting into the laboratory, but in terms of their education, the dog lab is one experience that they can certainly do without.
Moreover, if given the opportunity, most students would choose an alternative to doing the dog lab. Of students surveyed in a presentation at University of Virginia School of Medicine about non-animal alternatives last month, 76 percent said that they would choose an alternative over the lab, including over half of the people who said they still plan to do the dog lab.
The issue here is whether inexperienced third-year medical students should be sacrificing the lives of seventy healthy dogs to do these procedures once. Those of us who go on to surgical residencies will learn the ropes by assisting experienced surgeons in the human operating room. Why not save the tuition dollars and Virginians' taxes that would buy and raise these dogs and integrate a better, cheaper learning experience that respects all life?
(Lindsey Neal is a first-year stdent in the School of Medicine.)
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