VIEWPOINT COMMENTARY Anatomy, Medical Education, and Human Ancestral Variation Goran S ˇ trkalj, 1 * Muhammad A. Spocter, 2 A. Tracey Wilkinson AQ1 3 1 Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia 2 Department of Anatomy, Des Moines University, Iowa 3 School of Biosciences, Cardiff University, Cardiff, Wales, United Kingdom It is argued in this article that the human body both in health and disease cannot be fully understood without adequately accounting for the different levels of human variation. The article focuses on variation due to ancestry, arguing that the inclusion of information pertaining to ancestry in human anatomy teaching materials and courses should be carried out and implemented with care and in line with latest developments in biological anthropology and related sciences. This seems to be of particular importance in the education of health professionals, as recent research suggests that better knowledge of human variation can improve clinical skills. It is also argued that relatively small curricu- lar changes relating to the teaching of human variation can produce significant educa- tional gains. Anat Sci Educ 00: 000-000. © 2011 American Association of Anatomists. Key words: gross anatomy education; medical education; health care education; human variation; race; anthropology The human body has resulted from a long and complex pro- cess of evolution. According to a model (Tattersall, 2009) strongly supported by archaeological, anatomical, and genetic data, the species Homo sapiens evolved from a rather small African population which started to disperse to other parts of the world between 125,000 and 60,000 years ago. In the years following, the descendants of this original population adapted to life in different environments through the process of natural selection, diversifying morphologically as a result. This process of diversification was further medi- ated (heightened or lessened) through other evolutionary forces. Examples are genetic drift, where allele frequencies are changed due to chance alone, and gene flow between populations due to migrations which have characterized most of human history and, indeed, prehistory (Relethford, 2009). As a result, modern humans exhibit biological hetero- geneity as a result of their geographic ancestry. This diversity is exceptionally complex, the complexity being further exacerbated by a variety of cultural and social factors (Rele- thford, 2009). The existence of variations has been long observed in anatomy, but their importance has not always been fully acknowledged (e.g., Bergman et al., 1988; Bergman, 2011). It should not be forgotten that while humans differ at various levels of biological organization (individually, due to age, sex), the one briefly described above—variation due to ances- try—provoked the most intense scientific debate. (From now on the phrase ‘‘human variation’’ will be used to denote an- cestral differences only). Historically the study of human bio- logical variation has primarily fallen into the research domain of biological anthropology (Brace, 2005), but this intricate subject has in recent years been intensely investigated in sev- eral other disciplines within the social, natural, and medical sciences (e.g., Ellison and Goodman, 2006; Metrosa, 2006; Koenig et al., 2008). In medicine in particular, interest in the etiology, incidence and risk factors associated with disease has seen intense investigation of modern human variation. In spite of this, disagreement and misunderstanding as to the nature and origin of biological variation and its relation to medicine abounds (Gravlee, 2009). For a lengthy period of time race was the key concept in studying and understanding human variation. Racial divisions were based on a typological approach which reached its peak in the late nineteenth and early twentieth centuries. Typolo- gists focused on average tendencies and tried to outline a set of defining characters that could be used to delineate races efficiently. Typology proved to be highly limiting, as it neglected ranges of variation and the complex patterns of dis- tribution of different traits. As a result of the advances in bio- logical sciences, and facilitated by social and political changes in the period after the Second World War, the typological J_ID: ZA9 Customer A_ID: 11-0092 Cadmus Art: ASE258 Date: 11-OCTOBER-11 Stage: I Page: 1 ID: nareshrao Date: 11/10/11 Time: 08:21 Path: N:/3b2/ASE#/Vol00000/110064/APPFile/JW-ASE#110064 *Correspondence to: Prof. Goran S ˇ trkalj, Department of Chiropractic, Macquarie University, Sydney, 2109 NSW, Australia. E-mail: goran.strkalj@mq.edu.au Received 28 July 2011; Revised 23 September 2011; Accepted 25 September 2011. Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/(ISSN)1935-9780 © 2011 American Association of Anatomists Anatomical Sciences Education MONTH 2011 Anat Sci Educ 00:000–000 (2011)