Educating Physicians About Genomics: Are We Doing Enough?

Ricki Lewis, PhD

Disclosures

March 25, 2013

In This Article

What Are Medical Students Taught About Genetics and Genomics?

Traditionally, genetics is an early, short course. "It's been a struggle in the past decade to get genetics taught in medical schools as something other than a basic science. Courses incorporate clinical information in the curriculum of the first or second year," said Dr. Pyeritz.

Clerkships can augment exposure to genetics/genomics -- or not. "If the attending doctors are not well versed, they will not discuss the genetics issues. This will function as negative feedback for the medical students, who will learn to ignore genetics because it is not reinforced in patient care," warned Lainie Friedman Ross, MD, PhD, Professor and Chief of Community Health Sciences at the Institute for Molecular Pediatric Sciences at the University of Chicago. So training may be hit-or-miss. "Maybe a student will have an occasional experience based on a particular patient with a clearly genetic condition," said Dr. Pyeritz.

Genetics courses are not only short, but still focused on Mendelian disorders. For example, in the first-year genetics course at the University of Texas Southwestern Medical Center that ran from October 18 until November 1, 2011, case studies presented inborn errors of metabolism, factor V Leiden, and Down syndrome -- echoing the emphasis circa 1980.

The Association of American Medical Colleges currently offers a dozen online learning modules for medical students, but nearly all cover Mendelian disorders, plus trisomy 21 (Down syndrome). And the heart disease module is about familial hypercholesterolemia, not more common forms of heart disease.

One factor countering genomics coverage is pressure to "teach to the test." "You teach students what they need to know to pass the board exams, and the topics in genetics that are part of the core curriculum reflect the topics on the exams," said William Scott, PhD, director of a master's program in genomic medicine at the University of Miami Miller School of Medicine.

But in many schools, students can pick up more genetics in advanced courses. "People in other specialties have developed a lot of expertise in genetics and genomics, so endocrinologists or rheumatologists or oncologists can actually be quite involved in genetics," said Dr. Pyeritz. Accordingly, medical schools are increasingly adding genetics content to pathophysiology and organ system-based courses.

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