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Abstract
Genomic testing has entered oncology practice. With reduced cost and faster turnaround times, clinical applications for next-generation sequencing-based assays will only continue to increase. As such, there is an urgent need for health professional education to allow implementation of these new diagnostic tools. However, current medical school, residency, and fellowship training has had limited success in educating physicians in the fundamentals of single-gene testing, let alone genomic methods. In this review, we describe the novel approach the pathology community has taken in genomic education and the potential for application to oncology trainees.
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Haspel RL, Rinder HM, Frank KM, Wagner J, Ali AM, Fisher PB, Parks ER. The current state of resident training in genomic pathology: a comprehensive analysis using the resident in-service examination. Am J Clin Pathol 2014; 142:445-51. [PMID: 25239410 DOI: 10.1309/ajcph2a4xtxjukdz] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To determine the current state of pathology resident training in genomic and molecular pathology. METHODS The Training Residents in Genomics (TRIG) Working Group developed survey and knowledge questions for the 2013 pathology Resident In-Service Examination (RISE). Sixteen demographic questions related to amount of training, current and predicted future use, and perceived ability in molecular pathology vs genomic medicine were included, along with five genomic pathology and 19 molecular pathology knowledge questions. RESULTS A total of 2,506 pathology residents took the 2013 RISE, with approximately 600 individuals per postgraduate year (PGY). For genomic medicine, 42% of PGY-4 respondents stated they had no training, compared with 7% for molecular pathology (P < .001). PGY-4 residents' perceived ability, comfort in discussing results, and predicted future use as a practicing pathologist were reported to be less in genomic medicine than in molecular pathology (P < .001). Based on PGY, knowledge question scores showed a greater increase in molecular pathology than in genomic pathology. CONCLUSIONS The RISE is a powerful tool for assessing the state of resident training in genomic pathology and current results suggest a significant deficit. The results also provide a baseline to assess future initiatives to improve genomics education for pathology residents such as those developed by the TRIG Working Group.
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Affiliation(s)
- Richard L. Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Henry M. Rinder
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT
| | - Karen M. Frank
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Jay Wagner
- American Society for Clinical Pathology, Chicago, IL
| | - Asma M. Ali
- American Society for Clinical Pathology, Chicago, IL
| | | | - Eric R. Parks
- American Society for Clinical Pathology, Chicago, IL
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Haspel RL, Olsen RJ, Berry A, Hill CE, Pfeifer JD, Schrijver I, Kaul KL. Progress and potential: training in genomic pathology. Arch Pathol Lab Med 2014; 138:498-504. [PMID: 24678680 DOI: 10.5858/arpa.2013-0359-sa] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Genomic medicine is revolutionizing patient care. Physicians in areas as diverse as oncology, obstetrics, and infectious disease have begun using next-generation sequencing assays as standard diagnostic tools. OBJECTIVE To review the role of pathologists in genomic testing as well as current educational programs and future training needs in genomic pathology. DATA SOURCES Published literature as well as personal experience based on committee membership and genomic pathology curricular design. CONCLUSIONS Pathologists, as the directors of the clinical laboratories, must be prepared to integrate genomic testing into their practice. The pathology community has made significant progress in genomics-related education. A continued coordinated and proactive effort will ensure a future vital role for pathologists in the evolving health care system and also the best possible patient care.
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Affiliation(s)
- Richard L Haspel
- From the Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts (Dr Haspel); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Olsen); the Department of Pathology, University of California San Francisco, San Francisco (Dr Berry); the Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (Dr Hill); the Department of Pathology, Washington University, St Louis, Missouri (Dr Pfeifer); the Departments of Pathology and Pediatrics and the Center for Genomics and Personalized Medicine, Stanford University Medical Center, Stanford, California (Dr Schrijver); and the Department of Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, Illinois (Dr Kaul)
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Flynn C, James J, Maxwell P, McQuaid S, Ervine A, Catherwood M, Loughrey MB, McGibben D, Somerville J, McManus DT, Gray M, Herron B, Salto-Tellez M. Integrating molecular diagnostics into histopathology training: the Belfast model. J Clin Pathol 2014; 67:632-6. [PMID: 24493649 DOI: 10.1136/jclinpath-2014-202176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Molecular medicine is transforming modern clinical practice, from diagnostics to therapeutics. Discoveries in research are being incorporated into the clinical setting with increasing rapidity. This transformation is also deeply changing the way we practise pathology. The great advances in cell and molecular biology which have accelerated our understanding of the pathogenesis of solid tumours have been embraced with variable degrees of enthusiasm by diverse medical professional specialties. While histopathologists have not been prompt to adopt molecular diagnostics to date, the need to incorporate molecular pathology into the training of future histopathologists is imperative. Our goal is to create, within an existing 5-year histopathology training curriculum, the structure for formal substantial teaching of molecular diagnostics. This specialist training has two main goals: (1) to equip future practising histopathologists with basic knowledge of molecular diagnostics and (2) to create the option for those interested in a subspecialty experience in tissue molecular diagnostics to pursue this training. It is our belief that this training will help to maintain in future the role of the pathologist at the centre of patient care as the integrator of clinical, morphological and molecular information.
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Affiliation(s)
- C Flynn
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - J James
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Queen's University, Belfast, Northern Ireland
| | - P Maxwell
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Queen's University, Belfast, Northern Ireland
| | - S McQuaid
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Queen's University, Belfast, Northern Ireland
| | - A Ervine
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M Catherwood
- Haemato-Oncology Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M B Loughrey
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - D McGibben
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - J Somerville
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - D T McManus
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M Gray
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - B Herron
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - M Salto-Tellez
- Tissue Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Queen's University, Belfast, Northern Ireland
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Abstract
Genomics-based diagnostics have become part of patient care. As pathologists have the expertise in clinical laboratory testing as well as access to patient samples, all genomic medicine is genomic pathology. This article will review the evidence that there is a critical need for pathology resident training in genomics. Several individual program curricula are described as well as the progress of the Training Residents in Genomics Working Group. This group has made significant advances toward developing, implementing, and evaluating a national curriculum in genomics for pathology residents. The novel approach of the Training Residents in Genomics Working Group can be used as a model for training pathology professionals in any new technology.
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Haspel RL, Atkinson JB, Barr FG, Kaul KL, Leonard DG, O'Daniel J, Rinder HM, Scott J, Sobel ME, Speights VO. TRIG on TRACK: educating pathology residents in genomic medicine. Per Med 2012; 9:287-293. [PMID: 29758790 DOI: 10.2217/pme.12.6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Genomic technologies are dramatically changing the practice of medicine. Next-generation sequencing has allowed prognostic stratification of cancer patients, personalized drug therapy and the identification of genetic risk factors for a multitude of diseases. As the physicians who oversee tissue- and laboratory-based diagnostic testing, pathologists must understand and utilize this new technology for the benefit of patients; however, only a minority of pathology residency programs currently provide training in genomics. In response to this urgent need, the Training Residents in Genomics (TRIG) Working Group has made significant progress towards creating, implementing, evaluating and disseminating a national curriculum in genomic pathology. Although presented in the context of pathology training, the approach described in this review can serve as model for education in genomic medicine of students, trainees or professionals in other areas of healthcare.
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Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, USA.
| | - James B Atkinson
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frederic G Barr
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Karen L Kaul
- Department of Pathology & Laboratory Medicine, North Shore University Health System, Evanston, IL, USA
| | - Debra Gb Leonard
- Department of Pathology & Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | - Henry M Rinder
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Joan Scott
- National Coalition for Health Professional Education in Genetics, Lutherville, MD, USA
| | - Mark E Sobel
- American Society for Investigative Pathology, Bethesda, MD, USA
| | - V O Speights
- Department of Pathology, Scott & White Memorial Hospital, Texas A & M Health Science Center, Temple, TX, USA
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Application of Next Generation Sequencing to Molecular Diagnosis of Inherited Diseases. CHEMICAL DIAGNOSTICS 2012; 336:19-45. [DOI: 10.1007/128_2012_325] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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