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Review of genomic education in the preclerkship at U.S medical school

Education and Research Strategies
  • Primary Categories:
    • General Education
  • Secondary Categories:
    • General Education
Introduction:


Genomic medicine has the potential to transform healthcare but many physicians feel unprepared to apply genomic medicine in their practice as genomics is superficially covered in the dense pre-clerkship medical curriculum with less than 10% content weighting in the USMLE STEP 1 exam. A greater emphasis needs to be placed on genomics in medical education by altering the way that it is presented from the outset of the preclerkship, as the current model is not adequate. One approach would be the creation of distinction, scholarly or concentration pathways in genetics for medical students. It is currently not known how many US medical schools offer such programs, their design and outcomes. The purpose of this study is to provide an overview of genomic medicine in the preclerkship phase of undergraduate education. 

 

Methods:
A review 153 allopathic US medical school websites was performed in order to identify how genomics is taught in their curricula; what concentration pathways in genetics are present for students, and their correlation with concomitant categorical genetics residency program or geneticist faculty at the respective institution. Additionally, review of the scientific literature and the web for genetics/ genomics; distinction; scholarship/scholarly pathway; pathway; concentration; and or selective was performed. Clerkship level electives/ selectives were excluded from the analysis. Thematic analysis was used to categorize data.  Data collection occurred between November 2023-August 2024 by two medical students and reviewed by one clinical geneticist. 

Results:
Analysis of the data set found that seventy-seven schools offered distinction/scholarly pathways; only 5 described curricular pathways in genetics on their websites and two additional schools described selective experiences in genetics to help with career choice through the web search.  Of the 5 schools, one described an integrated curriculum with genetics and a distinction pathway in basic sciences as an offering. Six of these institutions had a categorical residency program in genetics, except one that had a geneticist on faculty in the department of medical education. The structure and design of two programs was described in the scientific literature and outcomes was presented for one distinction program. The curriculum  distinction/ scholarly pathway in genetics tract was available for review for three programs. Curricular elements in common included: longitudinal experience for select students that span different phases of the curriculum, a clinical elective and a research requirement. Differences were noted in laboratory experiences. Twelve schools did not include terms related to genetics in their curricula. 

Conclusion:
This analysis sheds light on the state of genomics education in the preclerkship curriculum in the US, describes the curricula of three distinction in genetics programs for medical students and explores additional genetic educational offerings in US allopathic medical schools.While there are 44 institutions that offer categorical residency programs in genetics and genomics only 6 include a genetics pathway for medical students in the preclerkship. Results also identified possible target U.S  schools for enhanced genomic education outreach. Limitation: some medical school may offer limited information about their curricula on the web, and only US allopathic medical schools were included in the analysis.

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