The history of the term pudendum: Opening the discussion on anatomical sex inequality

While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient-doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.

Historians of medicine have struggled for centuries to make the case for history in medical education. They have developed many arguments about the value of historical perspective, but their efforts have faced persistent obstacles, from limited resources to curricular time constraints and skepticism about whether history actually is essential for physicians. Recent proposals have suggested that history should ally itself with the other medical humanities and make the case that together they can foster medical professionalism. We articulate a different approach and make the case for history as an essential component of medical knowledge, reasoning, and practice. History offers essential insights about the causes of disease (e.g., the non-reductionistic mechanisms needed to account for changes in the burden of disease over time), the nature of efficacy (e.g., why doctors think that their treatments work, and how have their assessments changed over time), and the contingency of medical knowledge and practice amid the social, economic, and political contexts of medicine. These are all things that physicians must know in order to be effective diagnosticians and caregivers, just as they must learn anatomy or pathophysiology. The specific arguments we make can be fit, as needed, into the prevailing language of competencies in medical education.