Knowledge in Basic Sciences is Needed

[public5656]

Many medical students complain about the basic science classes they need to take and having to memorize minute information about this gene, that gene, and memorize this and that pathway. Yes, it can be quite tasking to have to remember all of this knowledge for an exam. We all know that the minute information escapes the memory after due time due to the unuse of the information. Medical students still need to take the basic sciences.

As it is, many studies have shown that physicians lack knowledge in the basics of genetics (the medical curriculum for medical genetics is very, very basic). Genetic tests results can be simple to very complex. Physicians need to have better knowledge about how genetics can lead to disease and how genetics is the clue to the treatment of many clinical conditions (pharmacogetics). When a physician understands how genetics can relate to the onset of diseases, then the physician is more likely to refer the patient to a genetic specialist. Remember, the input from a physician can determine the outcome of a person's health in the long haul. For example, a patient that is 46 years old is seen by a primary care doctor about being diagnosed with heart disease. If the physician would know that heart disease can be genetically caused, the physician could send the patient to a genetic specialist to have a family history done. The mother is worried their daughter/son might also get heart disease. The physician said the daughter/son should not have to worry about getting heart disease if they exercise and eat healthy. Well, 30 years later this 16 year old daughter/son has been diagnosed with heart disease. So a genetic test was done showing that the patient's heart disease was caused by a genetic mutation.

It turns out that there is therapy available for a person with the heart condition that the patient has. So instead of having the treatment option done at the age of 16 and possibly being healthy, the patient now has to have heart surgery.

This is a clear example of why physicians still need to be knowledgeable in the basic sciences.

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[notaroche]

This public service announcement is brought to you by the letter Q.

 

[CATallergy]

that brings up a good point - how long before genetotherapologist becomes a specialty?

 

[SeventhSon]

If the physician would know that heart disease can be genetically caused, the physician could send the patient to a genetic specialist to have a family history done.

alternatively, the physician could just do a FHx himself/herself.

 

[HopkinsOne]

For example, a patient that is 46 years old is seen by a primary care doctor about being diagnosed with heart disease. If the physician would know that heart disease can be genetically caused, the physician could send the patient to a genetic specialist to have a family history done.

Awareness of the role of genetics in health overall is certainly important, but it doesn't seem to me that medical education is lacking in the genetics-->health linkage. It seems that the main point that you actually bring up is that physicians should have an awareness of both the treatments available for different maladies and the tests available for diagnosis. As you addressed to a certain extent, whether or not someone should be referred for a test has to do with a constellation of factors, including:

• positive and negative predictive values of the test
  • (and therefore, on the specificity & sensitivity of the test as well as prevalence),
• the cost of the test,
• the existence of effective treatment given a positive result to the test,
• the physician's initial estimate of the likelihood that the patient has a given disease or genetic susceptibility, based on family history, physical exam, etc.

To conclude, I agree that physicians need to be knowledgeable in the basic sciences, but they also need to have facility with statistics and math in general, as well as communication skills. A lucky intuition doesn't hurt, either.

 

[tkatchev]

This public service announcement is brought to you by the letter Q.

Hahaha

 

[Instatewaiter]

50 bucks say that 'Genetics' changed his name to public5656.

Also, as basic science courses go, genetics is a pretty worthless course.