winterwind_23

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I'm preparing for interviews right now, and one question that I'm wondering about is this one:
  • What most recent advances in medicine have occurred that you believe will have the greatest impact on how you will practice medicine?
I speak about being interested in primary care, so I want to choose something that would be relevant to my interest in primary care. Would it be OK to discuss the human genome? I took a genomic medicine class last semester, and we talked a lot about genome-wide association studies which aim to find links between certain diseases with certain alleles. I know this is in its infancy, and it is also not very well-established, but if it were, it would be a huge help in preventative medicine. Would this be a good topic to bring up for this question?

I was also thinking of talking about gene therapy using CRISPR. CRISPR is quickly developing and allowing precise modifications to specific genes. Would this be OK to bring up?

What kind of medical advances do medical schools expect interviewees to discuss? Should I discuss face transplants? Or prosthetic limbs? Or immunotherapy? What would you talk about in your interview if asked this question?

Thanks!
 

Doug Underhill

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You could answer CRISPR, and I guarantee 1000 premeds applying to that school will use it. However, do you really think that all the problems with indels and off-target double-stranded breaks and delivery systems, as well as the huge ethical barriers to germline modification, will make the technique the most impactful on your medical career?

The GWAS is a good choice if you have a genetics background and can talk about it.
 

Pastamahn

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I feel like people who didn't prepare for this question may not be able to come up with really good answers on the spot, so as long as you have a topic that is related to what you think you might want to specialize in, then I think you're good. For me, I want to go into something neuro related, so I would probably talk about deep brain stimulation's promising future to treat Parkinson's and other motor disorders.
 
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You could mention using personalized medicine in primary based on your genetics. For example maybe give a lower dose of warfarin to someone because they have a specific gene, or something like that.

But stay away from crisper/cas9 mediated genome editing (of humans). The ethics of that are far too controversial at this point in time.
 
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Doug Underhill

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You could mention using CRISPR/Cas9 to do non-germline editing of IPSCs. However, you could just mention IPSCs in and of itself to answer the question.

Deep brain stimulation is an exciting technique, although it was FDA approved to treat Parkinson's in 2002, so talking about the future promise of it for that condition may be a little out of date. Is it recent enough? Most likely.
 

Pastamahn

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You could mention using CRISPR/Cas9 to do non-germline editing of IPSCs. However, you could just mention IPSCs in and of itself to answer the question.

Deep brain stimulation is an exciting technique, although it was FDA approved to treat Parkinson's in 2002, so talking about the future promise of it for that condition may be a little out of date. Is it recent enough? Most likely.
For me it would most likely be about trying to untangle how it exactly works, and applying that understanding to other areas.
 

winterwind_23

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You could answer CRISPR, and I guarantee 1000 premeds applying to that school will use it. However, do you really think that all the problems with indels and off-target double-stranded breaks and delivery systems, as well as the huge ethical barriers to germline modification, will make the technique the most impactful on your medical career?

The GWAS is a good choice if you have a genetics background and can talk about it.
I don't have a formal genetics background, but I took genetics and genomic medicine classes last semester, so I feel like I could be well-prepared to discuss GWAS. There are definitely some diseases where certain alleles gives a pretty accurate assessment of a person's risk for certain diseases (BRCA gene for breast cancer, for example), which could be extremely helpful in a healthcare setting. Getting these tests to become more accessible and reliable would be quite effective in the clinic I believe.

You could mention using personalized medicine in primary based on your genetics. For example maybe give a lower dose of warfarin to someone because they have a specific gene, or something like that.

But stay away from crisper/cas9 mediated genome editing (of humans). The ethics of that are far too controversial at this point in time.
I would incorporate personalized medicine into my GWAS studies answer. Your example of Warfarin dosing is a good example.

You could mention using CRISPR/Cas9 to do non-germline editing of IPSCs. However, you could just mention IPSCs in and of itself to answer the question.

Deep brain stimulation is an exciting technique, although it was FDA approved to treat Parkinson's in 2002, so talking about the future promise of it for that condition may be a little out of date. Is it recent enough? Most likely.
I am definitely against germ line editing. It opens a slippery slope. But for disease treatment, I think it could be a good topic to bring up. For example, using CRISPR-Cas9 to disrupt the CCR5 gene in HIV-positive individuals.

In addition, I find these genetic therapy/genome studies really interesting, so hopefully it'll carry the conversation along!
 

Goro

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Anything, really. The prompt is to demonstrate that you know something about your intended profession.

I'm preparing for interviews right now, and one question that I'm wondering about is this one:

What kind of medical advances do medical schools expect interviewees to discuss? Should I discuss face transplants? Or prosthetic limbs? Or immunotherapy? What would you talk about in your interview if asked this question?
 
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Also I am unsure if all "medical advances" are technical/scientific in nature, or if changes in health policy count too. Anybody take a non-science approach to this?
 
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avgn

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great link, thanks
theyre probably expecting science/tech, but maybe policy would work if particularly unique and innovative
Man, the science hivemind is so tunnel vision. It is highly unlikely that the latest genetics technique or some other device BS is going to significantly impact your practice in a way you can meaningfully predict now before knowing what specialty you're in. The stuff that is really going to matter no matter what you do is the landscape in which we will be practicing medicine. "Recent advances in medicine" (NOT "medical advances," which would be completely different) should include everything related to medicine. ALL the stuff that matters most right now is pure non-science. On the non-science front (not necessarily "policy"), there is so much to talk about: ACOs, PCMHs (for you primary care folks, @winterwind_23), EHR expansion/integration, CMMI pilot projects, SGR repeal (!!!!!!!), Medicaid demonstration waivers, bidirectional messaging systems, the list goes on and on and on. These are 100000000% the stuff that is going to matter the most, not some random genomics techniques that won't matter to a clinician sitting in his office with a stethoscope.

IMO this question, if asked, is a great way for you to demonstrate that you have done some long-term thinking about the future of the medical landscape and recognize that more changes are underway that ever before since the original passage of the Medicare Act 51 years ago. Look up any of those topics and you're guaranteed to find another 15 related things that would easily make this question a fodder for great conversation (if you're knowledgeable)
 

cantankerous

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How would genetics have much relevance to primary care?
I suppose in the long run yes, but it probably wouldn't affect how you would practice as a physician.
 

Goro

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