Educating Physicians About Genomics: Are We Doing Enough?

Ricki Lewis, PhD

Disclosures

March 25, 2013

In This Article

Where Do We Go From Here?

The lack of formal standards has led to eclectic approaches to embracing genomics.

For example, medical students at Stanford University can take a course that covers risk evaluation; gene/environment interactions; GWAS; genome sequencing; ethics, legal, and social implications of genetic testing; and pharmacogenomics, which also is the subject of an entire course.

For the first time, in autumn 2012 the Graduate School of Biological Sciences at Mt. Sinai in New York offered an elective course, "Practical Analysis of Your Personal Genome." Participants, including medical students, sequenced, analyzed, and interpreted their own or a reference genome. Requests for the course, which accommodated 20 students, outnumbered slots 5 to 1. The course began with a 26-hour summer "boot camp" to learn techniques on a reference genome and applications of genetic counseling skills to convey risk estimates. "There was interest in searching for deleterious mutations, ancestry informative markers, and risk alleles for schizophrenia," said George Diaz, MD, who codirects the course with Andrew Kasarskis, PhD.

At the University of Miami, a master's degree program in genomic medicine has just begun; the 3.5-year degree is earned concurrently with the MD. Based on a successful MD-MPH program, the MA program is similar to efforts elsewhere that require 1 year beyond medical school. The motivation: "Students told us that they wanted additional opportunities to learn about the clinical applications of human genetics," said the program's director, Dr. Scott.

The faculty of 25, mostly PhDs, created a program that fit on top of the traditional medical school curriculum, rather than integrating the material. It consists of online learning and faculty-led weekly case-based discussion sessions, Dr. Scott said. Five students are currently enrolled.

Finally, upper-level genetics courses are starting to appear as well. Dr. Pyeritz teaches a fourth-year elective course in personalized medicine at the University of Pennsylvania. "It's an intensive 1-week course for 18 students, offering a series of presentations about how genomic medicine is being introduced in the clinic," he explained.

But efforts to educate about genetics/genomics should also extend to practicing physicians, said Dr. Friedman Ross of the University of Chicago. "We need to offer and encourage doctors to take continuing medical education hours in genetics, and include questions on recertifying examinations to motivate doctors to take those classes. We need to encourage more genetics as part of grand rounds and have review articles in mainstream journals, like the series in the New England Journal of Medicine on genetics in the past decade, to make sure that practicing doctors are up to speed. Other journals will need to follow suit."

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