From Helices to Health: Undergraduate Medical Education in Genetics and Genomics

Abstract

Rapid advances in genomic technologies combined with drastic reductions in cost and a growing number of clinical genomic tests are transforming medical practice. While enthusiasm about applications of precision medicine is high, the existing clinical genetics workforce is insufficient to meet present demands and will fall increasingly short as the use of genetic and genomic testing becomes more routine. To address this shortage, physicians in all areas of medicine will require genomic literacy. Undergraduate medical students, therefore, need a solid foundation in genetics and genomics so they can apply genomic medicine across a range of specialties. Here, we review the current trends and challenges in undergraduate medical genetics education in North America, highlight innovations and offer recommendations.

Educational and Ethical Considerations for Genetic Test Implementation Within Health Care Systems

“…43 To increase physician trainees entering this specialty, a number of career development strategies and educational framework mechanisms are proposed, with a particular emphasis on development of premedical undergraduate genomics curriculums. 37 , 40 …”

“…However, the segment of the health care workforce classically trained in genetics/genomics is routinely identified as insufficient for wide scale PM implementation. [36][37][38] To ensure adequate diffusion of this valuable specialty into underresourced areas as the PM movement expands, this could be an area that may benefit from a more focused and structured workforce development analysis initiative, such as the process used by the U.S. Health Resources and Services Administration's (HRSA) National Center for Health Workforce Analysis. 39 Physicians.…”

“…43 To increase physician trainees entering this specialty, a number of career development strategies and educational framework mechanisms are proposed, with a particular emphasis on development of premedical undergraduate genomics curriculums. 37,40 Genetic counselors. According to the American Board of Genetic Counseling, there are presently *5172 certified genetics counselors in the United States who practice in cancer, prenatal, and pediatric settings located in university medical settings, public/private hospital facilities, and diagnostic laboratories.…”

Application of active learning modalities to achieve medical genetics competencies and their learning outcome assessments

“…Briefly, these include genetics educational objectives presented by the Association of American Medical Colleges’ Medical School Objective Project (AAMC MSOP; Contemporary Issues in Medicine: Genetics Education) in 2004, 19 genetics competencies for medical school education proposed as part of AAMC-Howard Hughes Medical Institute (HHMI) Scientific Foundations for Future Physicians in 2009, 20 and a detailed list of medical genetics competencies for Medical School Core Curriculum in Genetics developed by the Association of Professors of Human and Medical Genetics (APHMG) in 2013. 21 The main goal of these publications has been to promote the development of curricula in medical genetics that focus on competencies rather than mere acquisition of knowledge. 22 For example, the APHMG classified the list of genetics competencies into six categories in medical practice: patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills, and system-based practice, which are based on the residency program competencies set forth by the Accreditation Council for Graduate Medical Education (ACGME).…”

The Need for Education and Clinical Best Practice Guidelines in the Era of Direct-to-Consumer Genomic Testing

“…There is still no widely accepted approach to genomics education. Some medical schools are starting to incorporate more genetic content into the curriculum [15], but the recipients of these lessons are vastly outnumbered by physicians educated before the era of genomics. In 2017, the majority of PCPs were between the ages of 45-49 years, and over one-quarter of PCPs were older than 60 years [16].…”