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Schmidt RL, White SK, Timme KH, McFarland MM, Lomo LC. Graduate Medical Education in Pathology: A Scoping Review. Arch Pathol Lab Med 2024; 148:117-127. [PMID: 37014974 DOI: 10.5858/arpa.2022-0365-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 04/06/2023]
Abstract
CONTEXT.— Pathologists have produced a substantial body of literature on graduate medical education (GME). However, this body of literature is diverse and has not yet been characterized. OBJECTIVE.— To chart the concepts, research methods, and publication patterns of studies on GME in pathology. DATA SOURCES.— This was a systematic scoping review covering all literature produced since 1980 in the PubMed and Embase databases. CONCLUSIONS.— Research on GME in pathology is evenly dispersed across educational topics. This body of literature would benefit from research based on theory, stronger study designs, and studies that can provide evidence to support decisions on educational policies.
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Affiliation(s)
- Robert L Schmidt
- From the Department of Pathology (Schmidt, White, Lomo) and Eccles Health Sciences Library (McFarland), University of Utah, Salt Lake City
| | - Sandra K White
- From the Department of Pathology (Schmidt, White, Lomo) and Eccles Health Sciences Library (McFarland), University of Utah, Salt Lake City
| | - Kathleen H Timme
- the Department of Endocrinology, Eccles Primary Children's Hospital, Salt Lake City, Utah (Timme)
| | - Mary M McFarland
- From the Department of Pathology (Schmidt, White, Lomo) and Eccles Health Sciences Library (McFarland), University of Utah, Salt Lake City
| | - Lesley C Lomo
- From the Department of Pathology (Schmidt, White, Lomo) and Eccles Health Sciences Library (McFarland), University of Utah, Salt Lake City
- ARUP Laboratories, Salt Lake City, Utah (Schmidt, Lomo)
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2
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Fukuto HS, Nelepcu II, Necula S, Galli NE, Viboud GI. International health initiative: Development and pilot testing of a molecular diagnostics training program in Romania. Am J Clin Pathol 2023; 160:276-283. [PMID: 37196173 DOI: 10.1093/ajcp/aqad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVES The implementation of nucleic acid testing in laboratory medicine has revolutionized clinical diagnosis. Unfortunately, incorporation of these technologies in less developed countries remains a challenge. Despite Romania's recent economic growth, the country is in dire need of medical and laboratory staff trained in modern technologies. The aim of the study was to develop a curriculum that could easily be delivered to laboratory professionals in Romania and to pilot test the effectiveness of the training in increasing their understanding of molecular tests. METHODS The program was developed in accordance with the US Centers for Disease Control and Prevention's (CDC's) quality training standards. It was offered to 50 laboratory professionals and consisted of online, asynchronous lectures and optional synchronous review sessions. Training effectiveness was evaluated using CDC guidelines based on pre- and postassessment questions answered anonymously. RESULTS Forty-two people participated in the program, and 32 (81%) completed the training successfully. Based on 16 participants' self-assessment, the course was successful in improving learners' overall knowledge of molecular diagnostics-specifically, their understanding of molecular techniques and how to interpret results. Those participants were highly satisfied with the overall training. CONCLUSIONS The piloted platform presented here is promising and can be a foundation for future larger-scale studies in countries with developing health systems.
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Affiliation(s)
- Hana S Fukuto
- Department of Clinical Laboratory Science, Stony Brook University, Stony Brook, NY, US
| | | | | | - Nora E Galli
- Diagnostics Division, Roche Romania, Bucharest, Romania
| | - Gloria I Viboud
- Department of Clinical Laboratory Science, Stony Brook University, Stony Brook, NY, US
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Haspel RL, Genzen JR, Wagner J, Fong K, Wilcox RL. Call for improvement in medical school training in genetics: results of a national survey. Genet Med 2021; 23:1151-1157. [PMID: 33580224 DOI: 10.1038/s41436-021-01100-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess, from the student perspective, medical school training in genetics and genomics. METHODS In 2019, the Undergraduate Training in Genomics (UTRIG) Working Group developed genetics-related survey and knowledge questions for the RISE-FIRST, an exam administered to postgraduate year 1 (PGY1) pathology residents in the United States during their first months of training. Survey questions focused on perceived knowledge in genetics and the structure and quality of training with responses compared with those in control areas. RESULTS There were 401 PGY1 pathology residents who took the 2019 RISE-FIRST (65% of those in the United States). There was significantly lower perceived understanding of genetics compared with nongenetics topics. Respondents also reported less time spent learning genetics and lower quality training compared with control areas. Only 53% indicated an interaction during medical school with a medical geneticist. Residents also did not perform as well on the UTRIG-developed knowledge questions than those in other areas of pathology. CONCLUSION The RISE-FIRST is a useful tool in assessing the current state of medical school training in genetics. This needs assessment may serve as a call to action to improve medical school genetics education and promote greater understanding of the role of genetics professionals in patient care.
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Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Jonathan R Genzen
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Jay Wagner
- American Society for Clinical Pathology (ASCP), Chicago, IL, USA
| | - Karen Fong
- American Society for Clinical Pathology (ASCP), Chicago, IL, USA
| | | | - Rebecca L Wilcox
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center and Larner College of Medicine, Burlington, VT, USA.
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4
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Haspel RL, Genzen JR, Wagner J, Lockwood CM, Fong K, Adesina AM, Browning L, Chabot-Richards D, Cushman-Vokoun AM, D’Angelo AR, DeFrances MC, Devarakonda S, Fernandes H, Fernandez P, Gupta R, Hurwitz ME, Lindeman NI, Nobori A, Nohr E, Payton J, Saylor B, Sobel ME, Stringer KF, Vanderbilt CM, Young M, Adesina AM, Browning L, Chabot-Richards D, Cushman-Vokoun AM, D’Angelo AR, DeFrances MC, Devarakonda S, Fernandes H, Fernandez P, Gupta R, Hurwitz ME, Lindeman NI, Nobori A, Nohr E, Payton J, Saylor B, Sobel ME, Stringer KF, Vanderbilt CM, Young M. Integration of Genomic Medicine in Pathology Resident Training. Am J Clin Pathol 2020; 154:784-791. [PMID: 32696061 DOI: 10.1093/ajcp/aqaa094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To assess current pathology resident training in genomic and molecular pathology. METHODS The Training Residents in Genomics (TRIG) Working Group has developed survey questions for the pathology Resident In-Service Examination (RISE) since 2012. Responses to these questions, as well as knowledge questions, were analyzed. RESULTS A total of 2,529 residents took the 2019 RISE. Since 2013, there has been an increase in postgraduate year 4 (PGY4) respondents indicating training in genomic medicine (58% to approximately 80%) but still less than almost 100% each year for molecular pathology. In 2019, PGY4 residents indicated less perceived knowledge and ability related to both genomic and traditional molecular pathology topics compared with control areas. Knowledge question results supported this subjective self-appraisal. CONCLUSIONS The RISE is a powerful tool for assessing the current state and also trends related to resident training in genomic pathology. The results show progress but also the need for improvement in not only genomic pathology but traditional molecular pathology training as well.
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Affiliation(s)
- Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | | | - Jay Wagner
- American Society for Clinical Pathology (ASCP), Chicago, IL
| | - Christina M Lockwood
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle
| | - Karen Fong
- American Society for Clinical Pathology (ASCP), Chicago, IL
| | - Adekunle M Adesina
- Department of Pathology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Devon Chabot-Richards
- Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque
| | | | - Alix R D’Angelo
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans
| | - Marie C DeFrances
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Helen Fernandes
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | - Pedro Fernandez
- Department of Anatomical Pathology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Ruta Gupta
- NSW Health Pathology, Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Neal I Lindeman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA
| | - Erik Nohr
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, Calgary, Canada
| | - Jaqueline Payton
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Benjamin Saylor
- Department of Pathology, University of Alabama at Birmingham
| | - Mark E Sobel
- American Society for Investigative Pathology, Bethesda, MD
| | - Keith F Stringer
- Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Chad M Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Young
- Cytopathology Department, Royal Free Hospital, London, UK
| | - Adekunle M Adesina
- Department of Pathology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | - Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Devon Chabot-Richards
- Department of Pathology, TriCore Reference Laboratories and the University of New Mexico, Albuquerque
| | | | - Alix R D’Angelo
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans
| | - Marie C DeFrances
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Helen Fernandes
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | - Pedro Fernandez
- Department of Anatomical Pathology, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Ruta Gupta
- NSW Health Pathology, Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Neal I Lindeman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Alexander Nobori
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA
| | - Erik Nohr
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, Calgary, Canada
| | - Jaqueline Payton
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO
| | - Benjamin Saylor
- Department of Pathology, University of Alabama at Birmingham
| | - Mark E Sobel
- American Society for Investigative Pathology, Bethesda, MD
| | - Keith F Stringer
- Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Chad M Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Young
- Cytopathology Department, Royal Free Hospital, London, UK
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Wilcox RL, Adem PV, Afshinnekoo E, Atkinson JB, Burke LW, Cheung H, Dasgupta S, DeLaGarza J, Joseph L, LeGallo R, Lew M, Lockwood CM, Meiss A, Norman J, Markwood P, Rizvi H, Shane-Carson KP, Sobel ME, Suarez E, Tafe LJ, Wang J, Haspel RL. The Undergraduate Training in Genomics (UTRIG) Initiative: early & active training for physicians in the genomic medicine era. Per Med 2018; 15:199-208. [PMID: 29843583 DOI: 10.2217/pme-2017-0077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Genomic medicine is transforming patient care. However, the speed of development has left a knowledge gap between discovery and effective implementation into clinical practice. Since 2010, the Training Residents in Genomics (TRIG) Working Group has found success in building a rigorous genomics curriculum with implementation tools aimed at pathology residents in postgraduate training years 1-4. Based on the TRIG model, the interprofessional Undergraduate Training in Genomics (UTRIG) Working Group was formed. Under the aegis of the Undergraduate Medical Educators Section of the Association of Pathology Chairs and representation from nine additional professional societies, UTRIG's collaborative goal is building medical student genomic literacy through development of a ready-to-use genomics curriculum. Key elements to the UTRIG curriculum are expert consensus-driven objectives, active learning methods, rigorous assessment and integration.
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Affiliation(s)
- Rebecca L Wilcox
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Patricia V Adem
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Ebrahim Afshinnekoo
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - James B Atkinson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Leah W Burke
- Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine, University of Vermont, Burlington, VT, 05401, USA
| | - Hoiwan Cheung
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Shoumita Dasgupta
- Department of Medicine, Biomedical Genetics Section, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Julia DeLaGarza
- Department of Pathology, New York Medical College School of Medicine, Valhalla, NY, 10595, USA
| | - Loren Joseph
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
| | - Robin LeGallo
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Christina M Lockwood
- Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, WA, 98195, USA
| | - Alice Meiss
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | | | | | - Hasan Rizvi
- Institue of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London, E1 2AD, UK
| | - Kate P Shane-Carson
- Division of Human Genetics, Department of Internal Medicine, Ohio State University Comprehensive Cancer Center, Columbus, OH, 43210, USA
| | - Mark E Sobel
- American Society for Investigative Pathology, Rockville, MD, 20852, USA
| | - Eric Suarez
- Pathology Department, Uniformed Services University, Bethesda, MD, 20814, USA
| | - Laura J Tafe
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH/Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA
| | - Jason Wang
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, MA, 02115, USA
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6
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Lawler M, Alsina D, Adams RA, Anderson AS, Brown G, Fearnhead NS, Fenwick SW, Halloran SP, Hochhauser D, Hull MA, Koelzer VH, McNair AGK, Monahan KJ, Näthke I, Norton C, Novelli MR, Steele RJC, Thomas AL, Wilde LM, Wilson RH, Tomlinson I. Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. Gut 2018; 67:179-193. [PMID: 29233930 PMCID: PMC5754857 DOI: 10.1136/gutjnl-2017-315333] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes. DESIGN RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants. RESULTS Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders. CONCLUSION Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.
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Affiliation(s)
- Mark Lawler
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
| | | | | | - Annie S Anderson
- Research into Cancer Prevention and Screening, University of Dundee, Dundee, UK
| | - Gina Brown
- Department of Radiology, Royal Marsden Hospital, Sutton, UK
| | | | - Stephen W Fenwick
- Hepatobiliary Surgery Unit, Aintree University Hospital, Liverpool, UK
| | - Stephen P Halloran
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Daniel Hochhauser
- Department of Oncology, University College London Cancer Institute, London, UK
| | - Mark A Hull
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - Viktor H Koelzer
- Molecular and Population Genetics Laboratory, University of Oxford, Oxford, UK
| | - Angus G K McNair
- Centre for Surgical Research, University of Bristol, Bristol, UK
| | - Kevin J Monahan
- Family History of Bowel Cancer Clinic, Imperial College London, London, UK
| | - Inke Näthke
- School of Life Sciences, University of Dundee, Dundee, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
| | - Marco R Novelli
- Research Department of Pathology, University College London Medical School, London, UK
| | - Robert J C Steele
- Research into Cancer Prevention and Screening, University of Dundee, Dundee, UK
| | - Anne L Thomas
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Lisa M Wilde
- Bowel Cancer UK, London, UK
- Atticus Consultants Ltd, Croydon, UK
| | - Richard H Wilson
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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Putra M, Idler J, Dai J, Blitzer MG, Feldman G, Sokol RJ. Medical genetics and genomics training in obstetrics and gynecology residencies: are we ready for the future? J Matern Fetal Neonatal Med 2017; 32:1184-1190. [DOI: 10.1080/14767058.2017.1402879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Manesha Putra
- Department of Obstetrics and Gynecology, Detroit Medical Center/Wayne State University, Detroit, MI, USA
| | - Jay Idler
- Department of Obstetrics and Gynecology, Detroit Medical Center/Wayne State University, Detroit, MI, USA
| | - Jing Dai
- Department of Obstetrics and Gynecology, CS Mott Center for Human Growth and Development, Wayne State University, Detroit, MI, USA
| | - Miriam G. Blitzer
- Department of Pediatrics, Division of Genetics, University of Maryland School of Medicine Baltimore, Baltimore, MD, USA
| | - Gerald Feldman
- Department of Pediatrics and Pathology, Center for Molecular Medicine and Genomics, Wayne State University School of Medicine, Detroit, MI, USA
| | - Robert J. Sokol
- Department of Obstetrics and Gynecology, Detroit Medical Center/Wayne State University, Detroit, MI, USA
- Department of Obstetrics and Gynecology, CS Mott Center for Human Growth and Development, Wayne State University, Detroit, MI, USA
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Adeola HA, Soyele OO, Adefuye AO, Jimoh SA, Butali A. Omics-based molecular techniques in oral pathology centred cancer: prospect and challenges in Africa. Cancer Cell Int 2017; 17:61. [PMID: 28592923 PMCID: PMC5460491 DOI: 10.1186/s12935-017-0432-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 05/29/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and "big data" processing have contributed immensely to individualized/personalized medicine in the developed world. MAIN BODY At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratification of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the proficiency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among different human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences. CONCLUSION In this review, we examined the challenges and prospects of using currently available omics-based technologies vis-à-vis oral pathology as well as prompt cancer diagnosis and treatment in a resource limited setting.
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Affiliation(s)
- Henry A. Adeola
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, University of the Western Cape and Tygerberg Hospital, Cape Town, South Africa
- International Centre for Genetic Engineering and Biotechnology, Cape Town, South Africa
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Olujide O. Soyele
- Department of Oral Maxillo-facial Surgery and Oral Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Anthonio O. Adefuye
- Division of Health Sciences Education, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Sikiru A. Jimoh
- Department of Anatomical Sciences, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape South Africa
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA USA
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Korczak JF, Chung DW, Rosemond E, Von Hoff DD, Haspel RL, Waterbor JW, Chang S, Ramirez AG, Perkins S, Wiest J, Lei M. The National Cancer Institute R25 Cancer Education Grants Program: A Workshop Report. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:3-10. [PMID: 28064401 PMCID: PMC5290060 DOI: 10.1007/s13187-016-1161-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Through the R25 Cancer Education Grants Program (CEGP), the National Cancer Institute (NCI) has been supporting the broad educational needs of the cancer research and cancer healthcare communities since 1974. NCI sponsored a workshop on September 13, 2016 in Bethesda, Maryland, with the objectives of sharing best practices in cancer education, communicating R25 CEGP programmatic information, and gathering ideas to strengthen the R25 CEGP to better meet the emerging needs in cancer education in the face of a rapidly changing landscape in cancer research and cancer care. With 53 leaders in cancer education in attendance, the workshop featured an overview of the R25 CEGP by NCI Program Staff, a showcase of several types of CEGP programs by current R25 grantees, and in-depth discussions on a broad range of questions critical for the continued success of the R25 CEGP. The workshop afforded an opportunity, for the first time, for cancer researchers and clinicians conducting different forms of cancer education activities to gather in one place as leaders of a community of increasing importance. The discussion resulted in a set of suggestions that will benefit the R25 CEGP and cancer education in general. There was a general consensus among the participants that bringing the cancer education community together is a significant achievement of the workshop that will have a long-lasting impact on cancer education.
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Affiliation(s)
- Jeannette F Korczak
- National Cancer Institute, 9609 Medical Center Dr., Room 2W110, Rockville, MD, 20852, USA
| | - Davyd W Chung
- National Cancer Institute, 9609 Medical Center Dr., Room 2W110, Rockville, MD, 20852, USA
| | - Erica Rosemond
- National Center for Advancing Translational Sciences, Bethesda, Maryland, USA
| | | | | | - John W Waterbor
- University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Shine Chang
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amelie G Ramirez
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Susan Perkins
- National Cancer Institute, 9609 Medical Center Dr., Room 2W110, Rockville, MD, 20852, USA
| | - Jonathan Wiest
- National Cancer Institute, 9609 Medical Center Dr., Room 2W110, Rockville, MD, 20852, USA
| | - Ming Lei
- National Cancer Institute, 9609 Medical Center Dr., Room 2W110, Rockville, MD, 20852, USA.
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10
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Gerhard GS, Jin Q, Paynton BV, Popoff SN. The Anatomy to Genomics (ATG) Start Genetics medical school initiative: incorporating exome sequencing data from cadavers used for Anatomy instruction into the first year curriculum. BMC Med Genomics 2016; 9:62. [PMID: 27716216 PMCID: PMC5053090 DOI: 10.1186/s12920-016-0223-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 09/24/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The increasing use of next generation DNA sequencing in clinical medicine is exposing the need for more genetics education in physician training. We piloted an initiative to determine the feasibility of incorporating exome sequencing data generated from DNA obtained from cadavers used for teaching Anatomy into a first year medical student integrated block-style course. METHODS We optimized the procedure to obtain DNA for exome sequencing by comparing the quality and quantity of DNA isolated from several tissues by two different extraction methods. DNA was sequenced using exome capture and analyzed using standard methods. Single nucleotide variants (SNVs), as well as small insertions/deletions, with potential functional impact were selected by faculty for student teams to independently investigate and prepare presentations on their findings. RESULTS A total of seven cadaver DNAs were sequenced yielding high quality results. SNVs were identified that were associated, with known physical traits and disease susceptibility, as well as pharmacogenomic phenotypes. Students presented findings based on correlation with known clinical information about the cadavers' diseases and traits. CONCLUSION Exome sequencing of cadaver DNA is a useful tool to integrate Anatomy with Genetics and Biochemistry into a first year medical student core curriculum.
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Affiliation(s)
- Glenn S. Gerhard
- Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 USA
- Department of Medical Genetics and Molecular Biochemistry, 960 Medical Education and Research Building (MERB), Lewis Katz School of Medicine at Temple University , 3500 N. Broad Street, Philadelphia, PA 19140 USA
| | - Qunyan Jin
- Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 USA
| | - Barbara V. Paynton
- Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 USA
| | - Steven N. Popoff
- Lewis Katz School of Medicine at Temple University , Philadelphia, PA 19140 USA
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Kinney SN, Slayten J, Waxman DA. The Need for Education in Molecular Immunohematology: A Survey of Specialists in Blood Banking. Lab Med 2016; 47:330-337. [DOI: 10.1093/labmed/lmw042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Murphy MJ, Shahriari N, Payette M, Mnayer L, Elaba Z. Development of a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees. J Cutan Pathol 2016; 43:858-65. [PMID: 27328619 DOI: 10.1111/cup.12760] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/13/2016] [Accepted: 06/19/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Results of molecular studies are redefining the diagnosis and management of a wide range of skin disorders. Dermatology training programs maintain a relative gap in relevant teaching. OBJECTIVE To develop a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees at our institution. The aim is to provide trainees with a specialty-appropriate, working knowledge in clinical molecular dermatology. METHODS The Departments of Dermatology and Pathology and Laboratory Medicine collaborated on the design and implementation of educational objectives and teaching modalities for the new curriculum. RESULTS A multidisciplinary curriculum was developed. It comprises: (i) assigned reading from the medical literature and reference textbook; (ii) review of teaching sets; (iii) two 1 hour lectures; (iv) trainee presentations; (v) 1-week rotation in a clinical molecular pathology and cytogenetics laboratory; and (vi) assessments and feedback. Residents who participated in the curriculum to date have found the experience to be of value. CONCLUSIONS Our curriculum provides a framework for other dermatology residency programs to develop their own specific approach to molecular diagnostics education. Such training will provide a foundation for lifelong learning as molecular testing evolves and becomes integral to the practice of dermatology.
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Affiliation(s)
- Michael J Murphy
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Neda Shahriari
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Michael Payette
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Laila Mnayer
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT, USA
| | - Zendee Elaba
- Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT, USA
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Rangachari D, VanderLaan PA, Le X, Folch E, Kent MS, Gangadharan SP, Majid A, Haspel RL, Joseph LJ, Huberman MS, Costa DB. Experience with targeted next generation sequencing for the care of lung cancer: insights into promises and limitations of genomic oncology in day-to-day practice. ACTA ACUST UNITED AC 2015; 4:174-181. [PMID: 26601054 DOI: 10.1016/j.ctrc.2015.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Tumor genotyping using single gene assays (SGAs) is standard practice in advanced non-small-cell lung cancer (NSCLC). We evaluated how the introduction of next generation sequencing (NGS) into day-to-day clinical practice altered therapeutic decision-making. METHODS Clinicopathologic data, tumor genotype, and clinical decisions were retrospectively compiled over 6 months following introduction of NGS assay use at our institution in 82 patient-tumor samples (7 by primary NGS, 22 by sequential SGAs followed by NGS, and 53 by SGAs). RESULTS SGAs identified abnormalities in 34 samples, and all patients with advanced EGFR-mutated or ALK-rearranged tumors received approved tyrosine kinase inhibitors (TKIs) or were consented for clinical trials. NGS was more commonly requested for EGFR, ALK, and KRAS-negative tumors (p<0.0001). NGS was successful in 24/29 (82.7%) tumors. Of 17 adenocarcinomas (ACs), 11 (7 from patients with ≤15 pack-years of smoking) had abnormalities in a known driver oncogene. This led to a change in decision-making in 8 patients, trial consideration in 6, and off-label TKI use in 2. Of 7 squamous cell (SC) carcinomas, 1 had a driver aberration (FGFR1); 6 had other genomic events (all with TP53 mutations). In no cases were clinical decisions altered (p=0.0538 when compared to ACs). CONCLUSIONS Targeted NGS can identify a significant number of therapeutically-relevant driver events in lung ACs; particularly in never or light smokers. For SC lung cancers, NGS is less likely to alter current practice. Further research into the cost effectiveness and optimal use of NGS and improved provider training in genomic oncology are warranted.
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Affiliation(s)
- Deepa Rangachari
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Paul A VanderLaan
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Xiuning Le
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Erik Folch
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA ; Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael S Kent
- Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sidharta P Gangadharan
- Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Adnan Majid
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA ; Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Richard L Haspel
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Loren J Joseph
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Mark S Huberman
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Daniel B Costa
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
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Wilson ML. Resident training in new technologies. Am J Clin Pathol 2014; 142:431. [PMID: 25239406 DOI: 10.1309/ajcpc35pdqhtjfem] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Michael L. Wilson
- Department of Pathology & Laboratory Services, Denver Health, Denver, CO, and Department of Pathology, University of Colorado School of Medicine, Aurora
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