Background: Autopsies are commonly seen on television, but are less common in real life. Worldwide, the autopsy rate has declined drastically over the past half century, from approximately 50% to only five to 22% in the 1990s. These percentages are inflated by the number of forensic autopsies, which suggests that hospital autopsy rates for other purposes are very low. Some students graduate without witnessing a formal autopsy, and some students and medical practitioners consider the autopsy to be of little value. The purpose of this study was to assess the thoughts and feelings of students towards autopsies at the end of their medical training.

Method: A survey of final-year medical students' thoughts and feelings on the autopsy, death and grief was performed by means of a self-administered questionnaire. Informed consent was obtained and the study was approved by the Ethics Committee.

Results: Of the 164 respondents, 64 were female and 100 male. Their ages varied from 22 to 40, with a mean of 27,7 years. Only 11% had discussed their wishes with regard to an autopsy on themselves with their family, while 33% had discussed funeral arrangements. Most students thought that aspects of the autopsy should be changed, e.g. the deceased should remain anonymous, the number of students observing an autopsy should be reduced, the atmosphere should be more respectful and the organs should be handled with more care. During training, students have insufficient opportunities to discuss their thoughts and feelings about the autopsy, and issues of grief and death are insufficiently dealt with.

Conclusions: Students' emotional reactions are an important, but unfortunately neglected, aspect of medical training. Student teaching needs to deal effectively with expected reactions through the understanding and management of these emotional responses towards cadaver dissection and other medical procedures. At both undergraduate and postgraduate levels, medical education must emphasise the importance of the autopsy. This means that academic institutions need to perform a sufficient number of autopsies for students to have the opportunity to observe and participate in them.