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Tufts Study Explores Introduction of Personalized Genomic Testing to Medical Training

By a GenomeWeb staff reporter

NEW YORK (GenomeWeb News) – Personalized genomic testing should be carefully folded into existing medical school training programs, according to the authors of an education report in the latest issue of the journal Genetics in Medicine.

Researchers from Tufts University looked at the consequences of introducing personal genomics-related training into the curriculum at Tufts University School of Medicine. Within the training program, several medical school faculty members were voluntarily genotyped using 23andMe tests and before medical students analyzed and discussed these tests and information provided by them.

Based on their experiences in implementing this program over more than a year, the multi-disciplinary team urged gradual and calculated incorporation of genomic material into medical school training programs.

"We strongly advocate that genomic analysis and personalized medicine is a necessity for modern medical school education, both to be able to translate the advances made in genetic analysis and knowledge into improvements in human health and to begin to think of diseases as disruptions in specific pathways," lead author David Walt, a Tufts University chemistry researcher and Illumina co-founder and director, said in a statement.

"Our experiences illustrate that adding this material to a medical school curriculum is a complex process that deserves careful thought and broad discussion within the academic community," Walt added.

Though they agreed from the outset that training related to genomics and personalized genetic and genomic testing is necessary for physicians, the researchers wanted to explore the steps needed to effectively introduce and improve such training.

"There is an expanding gap between the availability of direct-to-consumer whole genome testing and physician knowledge regarding interpretation of test results," they wrote. "Advances in the genomic literacy of health care providers will be necessary for genomics to exert its potential to affect clinical practice."

To explore this in a real-world setting, Walt and his colleagues looked at the positive and negative consequences of introducing personal genomics-related training at Tufts University School of Medicine.

As part of a larger curriculum focused on translational medicine, seven faculty members received personal genotyping services from 23andMe at a discounted price.

Results from the tests were anonymized before students and their instructors tackled the genomic information, looking at everything from the underlying statistics, clinical utility, and applications of personalized genetic testing to the psychological consequences and possible harms or benefits of such testing.

"We thought that introducing a personal genetics component into the medical school curriculum would offer an exceptional opportunity for students to learn first-hand about the process," Walt explained in a statement, "and would enable them to be trained to evaluate the analytic and clinical validity, as well as the clinical utility, of the data."

Among their recommendations, the researchers argued that medical students should have the opportunity to not only learn about personalized genetic testing, but also about related topics such as genome-wide association studies and genome sequencing.

Even so, they urged careful consideration of how genomics and personalized medicine should be incorporated into medical training. "Our experiences illustrate that adding this material to a medical school curriculum is a complex process that deserves careful thought and broad discussion within the academic community," the authors wrote.

With respect to the potential use of student genomic test data in this training process, the team pointed to a need for appropriate counseling, privacy measures, and strategies for dealing with unusual test results. They also cautioned that the use of such testing may lead to a need for discussions with family members and follow-up referrals to physicians, in some cases.

"We concluded that if an institution is going to offer personalized genetic testing to its trainees, a plan should be made regarding both protection of privacy and follow-up of abnormal tests," senior author Diana Bianchi, a genetics researcher with the Floating Hospital for Children at Tufts Medical Center, said in a statement. "Students should be told in advance of testing where to go for counseling regarding abnormal results, and who will pay for such counseling."