When entering medical students first don their white coats and begin the course, “Science Basic to the Practice of Medicine and Dentistry,” they immediately begin to understand the importance of genetics to medicine. The very first four-week block of their education is a genetics module, in which they meet a patient with a genetic condition, learning everything from biochemistry and molecular biology to the clinical aspects of genetics – how the genetic aspects of disease affect diagnosis, treatment, and daily life.
     That’s only the beginning. A program called Genetics in Medicine is threaded throughout the courses of a student’s first year. Rather than separating genetics into discrete, segregated specialty courses, genetic studies are integrated holistically into the curriculum, underscoring how fundamental this field has become in medicine.
     “During the first year, the curriculum has a systems approach, so as the students learn about the cardiovascular, pulmonary, and renal systems, they also learn about the genetic issues related to each of those systems,” explains Wendy Chung, M.D., Ph.D., assistant professor of pediatrics and director of the clinical genetics program. The Genetics in Medicine program resulted from an assessment done by Dr. Chung and Benjamin Tycko, M.D., Ph.D., associate professor of pathology in the Institute for Cancer Genetics. Dr. Chung now oversees the genetics section of the “Science Basic to the Practice of Medicine and Dentistry” course.
     “As students are learning about electrophysiology while they study the cardiovascular system, for example, we will have a patient come in and discuss with them long QT syndrome, a particular cardiac syndrome associated with sudden death," says Dr. Chung. "They get everything from the molecular biology of the condition up to hearing what it’s like to have your child die suddenly from such a disease.”
     Meanwhile, the human development course features lectures on the genetic control of development, including such issues as the transcription factors important to fetal development, congenital cardiac disease, and teratogenic exposure. Pathology and pathophysiology courses in the second year teach the genetic elements and modes of inheritance for various diseases, as well as the treatment implications when a disease is genetic rather than acquired.
     And within the clinical practice course, in which students begin their long journey toward interacting with patients directly as full-fledged physicians, many of the patient presentations include genetic conditions. “We try to make them aware of all the aspects of genetic medicine as part of the overarching curriculum,” says Dr. Chung.
     This integrated exposure to genetics continues in the third year, as students in ob-gyn and pediatrics rotations learn to do prenatal diagnosis, genetic testing, and family history assessment. In the fourth year, an optional genetics elective draws about 15 students annually to study clinical and molecular genetics within Dr. Chung’s program.
     With the field of genetics exploding, Dr. Chung says, the difficulty is keeping the curriculum up-to-date. “There are only so many hours we have, but we definitely want to expand genetics in the curriculum. Our goal is to increase the amount of exposure and material without increasing the burden on the students, by integrating it into other courses so that it flows seamlessly.”

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