Date Published: August 25, 2009
Publisher: Public Library of Science
Author(s): Keyan Salari
Abstract: Medical student Keyan Salari argues that it is crucial that medical students be trained to use and interpret patients’ genetic information appropriately and responsibly.
Partial Text: As personal genetic information becomes an increasingly frequent component of the patient medical record, it is crucial that medical students be trained to use and interpret this information appropriately and responsibly. Here, I argue the need for medical education reform that equips physicians with the knowledge, skills, and attitudes required to practice personalized medicine.
The sequencing of the human genome, followed by the related HapMap project, and the explosive number of genome-wide association studies conducted over the last decade, have heralded a new era of medicine. The vision of a personalized medicine, where a patient’s personal genetic and environmental information is used collectively to predict individual risks of disease and responsiveness to drugs, promises to revolutionize the medical management of many illnesses. Physicians have long used environmental factors like diet and exercise in preventative health and treatment strategies; however, despite being championed by genome scientists and those in the biotechnology industry, personalized medicine has yet to be adopted by most clinicians. It has, however, already reached a growing number of consumers, who are helping to usher in this new era as they arrive at their doctor’s office with their personal genetic code and a long list of questions in hand.
The genetics education that physicians-in-training typically receive in medical school and graduate medical education is ill-suited for practicing personalized medicine. Medical schools should improve their curricula to include not only more basic science concepts in genetics and genomics, but also practical training for their applications in clinical medicine. Unfortunately, in a recent study only 11% of US and Canadian medical schools reported practical training in the use of medical genetics as part of their curricula . A natural starting place to instill the essential core competencies is the first-year medical school curriculum.
As genetic and genomic health information become routine components of patients’ health records, we must as physicians become facile with the use and interpretation of this information as early as possible in our careers. Fundamental training in genetics and genomics, along with the attendant medical, legal, ethical, and psychosocial issues, should fall within the purview of medical school education. Moreover, such education should continue longitudinally throughout clinical training, including residency, fellowship, and continuing medical education programs, to reinforce concepts and target physicians who have already completed their clinical training. The potential of genetics and genomics to provide new paradigms for prevention, diagnosis, and treatment of disease is immense, but before the vision of a personalized medicine can be fully realized, medical trainees must be given the proper educational foundation.