Scope of coverage of medical genetics and genomics in pre‐clerkship programs of Canadian faculties of medicine: A curriculum analysis

Abstract

We appraised the scope of medical genetics and genomics concepts covered in the pre‐clerkship programs of Canadian faculties of medicine through an analysis of course objectives. All course objectives linked to medical genetics and genomics in pre‐clerkship programs of Canadian faculties of medicine were compiled. From this, the fraction of objectives dedicated to medical genetics and genomics was calculated. Course objectives were also categorized according to a curriculum and a competency classification. Of the 17 Canadian faculties of medicine, the complete set of course syllabi (5 faculties) or the listing of learning objectives (4 faculties) were obtained and reviewed. The fraction of learning objectives dedicated to medical genetics and genomics varied between 0.65% and 5.05%. From the objectives classification, “foundational knowledge” was most frequently covered (64% of the compiled objectives), while topics such as: “ethics and professionalism,” “communicate genetics information,” and “obtain specialist help” were covered by less than 5%. Coverage of medical genetics and genomics in pre‐clerkship programs of Canadian faculties of medicine appears to be low. Genetics and genomics are playing a rapidly expanding role in healthcare and clinical practice and educational programs should consider this new reality.

General Medical Practitioners Acting as Geneticists, a Risky Business?

“…Another Canadian study illustrated the necessity for better coverage of medical genetics and genomics in the medical profession curriculum. For instance, learning objectives linked to medical genetics for themes, such as "communicate genetics information for informed decision" and "obtain specialist help on inherited conditions", only reach 2 and 1% of students respectively in the pre-clerkship curriculum (Ouellet & al, 2023).…”

“…[41] Considering the importance of promoting accessible, high-quality healthcare, changing the liability standard to make it more lenient does not appear to be a responsible solution. Instead, what is required is a better implementation of genetic and genomic courses from pre-clerkship programs in faculties of medicine and professional settings to help physicians gain the appropriate knowledge and capacity to take on genetic healthcare professionals' tasks (Ouellet & al., 2023 ;Plunkett-Rondeau, Hyland & Dasgupta, 2015 ;Talwar & al., 2016). Developing standards and guidelines on clinical geneticists' tasks most likely to be carried out by non-genetic specialist MDs and…”

“…are devised to alleviate this situation, we have yet to find solutions to fully overcome this gap problem. Considering this challenge, in the context of genetics, we note that most non-genetic specialist MDs practicing today receive insufficient formal training in genetics in medical school (Ouellet & al., 2023). Thus, they are underprepared to function in an environment where genetics and genomics will assume increasing importance in health care delivery (Marchant & al., 2020).…”

“…[4] Common mistakes in genetics likely to trigger the liability of non-genetic specialists MDs and genetic specialists alike involve 1) failure to recommend a genetic test that would be relevant based on known family history, symptoms or biomarkers to a patient; 2) communication of erroneous or incomplete information in pre-test counselling; 3) choosing an inappropriate test or gene panel for the patient; 4) faulty interpretation of test results and/or inappropriate treatment plan recommended; 5) inadequate communication of results and post-test counselling. While both genetic specialists and non-genetic specialist MDs can make these mistakes, the lack of genetic training received by non-genetic specialist MDs makes them much more likely to be the ones providing faulty services (Bouchard & al., 2023 ;Ouellet & al., 2023).…”