Dr. Todd Olson, a professor of anatomy at Albert Einstein College of Medicine in the Bronx, noted, "There are some excellent computer-based resources, but they are not a replacement for the cadaver."
Dr. Carol Scott-Conner, a professor of surgery at the University of Iowa who is president of the American Association of Clinical Anatomists, said she was not sure "that every medical student needs an intensive anatomy course."
"But everybody needs to learn anatomy," she said, adding that actively participating in a dissection is a better way to learn than looking at an exhibit or a computer screen.
Even when the details of anatomy and the Latin names fade from a doctor's memory, memories of the experience remain vivid, Dr. Scott-Conner said.
Further, drawings and models ignore the huge variability in human anatomy, in which duplicated, misshapen or aberrant structures are common. Students who spend time searching for an important nerve or a blood vessel that surfaces nowhere near where it is supposed to be learn a hands-on lesson about the huge range of normal in medicine.
Anatomists also emphasize that working with a cadaver elicits a sense of reverence that pictures and models do not.
Medical attitudes toward human specimens have varied over the years. Apocryphal stories from the 19th and early 20th centuries describe medical students jumping rope with the intestines of cadavers, and playing lewd practical jokes with cadavers' genitalia.
As recently as 30 years ago, medical students who expressed any fear or squeamishness about human dissection were often told they were "weak" and in the wrong field, Dr. Olson of Einstein said.
Now, however, schools uniformly encourage students to work through their emotions, he said, and also make sure they understand the gravity of the proceedings.
"Students are informed at the beginning of the course that gross anatomy is a solemn endeavor and disrespect will not be tolerated," said Dr. Charles Maier, who directs the anatomy course at Case Western Reserve University Medical School.
Dr. Maier, like many other course directors, tells students the cadavers are their "first patients," to be treated with all the respect that living patients would command.
Funeral services held at the end of anatomy courses emphasize this point.
"Many if not most schools have memorial services of one sort or another" Dr. Maier said.
The nondenominational service at Case is held at a local cemetery and is similar to a standard graveside ceremony. Family members of the deceased are invited, and afterward, they mingle with the dozens of students who attend. Dr. Maier said he routinely received letters of thanks from families after the events.
Medical students at the State University of New York at Stonybrook keep a two-month diary of their time in the dissection laboratory as a part of a course on medicine in society.
"Some say they're not affected by it and it hasn't changed them at all," said Dr. Jack Coulehan, a professor of preventive medicine there, but a majority record a cascade of emotions, which the class then discusses.
At the Yale School of Medicine, practicing doctors periodically visit the first-year anatomy course to describe some of their dying patients to the students and to talk about the doctor's role in dealing with terminal illness and death.
"In medicine now there's a big emphasis on teaching students professionalism," said Dr. Lawrence J. Rizzolo, the director of the Yale course. "In anatomy we begin the discussion ? how the student will function as a professional, learning how to react to an uncomfortable situation, facing death and dying. We get them in touch with their feelings."
When the anatomy course ends, the Yale students thank their donors, as they call the cadavers, in a ceremony that includes original poems and musical compositions. Every first-year student attends, Dr. Rizzolo said, and the service has come to celebrate not only the rite of passage of the anatomy course but also the students' immersion in medicine.
"Studying medicine is a privilege, and the service paid homage to that," said Zach Goldberger, a Yale student who performed an original piano elegy at the ceremony his class held three years ago.
Two years ago, Yale students created a colorful quilt to commemorate the anatomy course, with panels dedicated to each cadaver in their course.
Asked to contemplate medical education without cadaver dissection, Yale students were unenthusiastic.
"It's not just about the information," said Dagan Coppock, a fourth-year medical student. "It's about the process."
Mr. Coppock called the anatomy class "a powerful, sacred experience."
Without dissection, students would never get to see "how it all fits together," said his classmate Kavita Mariwalla.
"It gives you a real appreciation for the beauty of the human body," she said. "It's amazing. You are so thankful for it. It made me stand in awe."