Are we making a difference? Genetics in Undergraduate Medical Education

Abstract

The ASHG and the APHMG have published consensus core curricula for both the basic and clinical science years of undergraduate medical education. Despite wide circulation of these recommendations in the medical literature, how well are the goals of these curricula being met?

Methods: Review of 4 Data sets. 1. Review of clinical clerkship curricula from Chicago area medical schools. 2. Survey of delegates of the Medical Student Section of the American Medical Association (MSS) inquiring when and what of genetics in years M1-M4. 3. Review of the Liaison Committee on Medical Education (LCME) survey of all 125 accredited medical schools ‘96-’97. 4. Results of the Association of American Medical School exit interview of medical school graduates from 1998 and 1999.

Results:

1. Review of Chicago area clinical clerkship curricula-Genetics is predominantly included in pediatrics and obstetrics and gynecology electives with infrequent appearance in other specialty electives.

2. MSS survey-The majority of genetics education occurs in the first and second year with very little in the M3 and M4 years.

3. 1996-97 LCME survey: This survey looked at the numbers of hours that medical students receive in genetic counseling (3.5 hr), principles of inheritance (6.6 hrs), molecular basis of genetics (15.5hr), and gene therapy (2.0). There is large variation in the amount of time devoted to genetic counseling across the 125 school, with 26 schools who reported no hours at all.

4. AAMC exit interview: The question: Did you receive an appropriate amount of instruction in genetic counseling? 45.8% (1998) and 44.3% (1999) perceived the time spent was inadequate, while 53.2% (1998) and 55.0% (1999) believed it was appropriate, and 1.1% (1998), and 0.7% (1999) said the time spent was excessive.

Conclusion: Current surveys do not adequately assess recognition of consensus recommended curricula. However the four data sets do suggest that genetic education is inadequate, fragmented, and uncoordinated. Recommendations include more concerted efforts to promote adoption of the consensus recommended curicular goals by approaching directors of clinical clerkships by specialty.