Knowledge and attitudes of medical residents and fellows working in various hospitals of the

United States of America, on genetic testing for disease specific biomarkers and knowledge of

Precision Medicine

By: Shima Ghavimi, MDPGY- 2 Internal Medicine

Associate Clinical ResearcherHoward University Hospital

Washington, DC

Conflict of Interest / Relationship to disclose

I have nothing to declare. I have no conflict of interest.

Objectives:The aim of the study was to assess knowledge and attitudes of medical residents and fellows working in various hospitals of the United States of America.

- On the knowledge of genetic testing for disease specific biomarkers and,- Knowledge of Precision Medicine.

Method:We distributed self-administered questionnaire to the residents and fellows either through email or by being in contact with them with phone.

Statistical evaluation of the determinants of knowledge and attitudes towards their knowledge of Genetics and Precision Medicine.

Followed phone calls was made to all who wanted follow phone calls or whom called us.

Questions:Regarding:

APC – Colorectal CancerMSH3-MSH2-MSH6 – Mismatch repair systemBCRA1 – Breast CancerDiabetes, Vitiligo, RA, NAFLD and Auto Immune diseases.

Results:3835 residents and fellows answered the survey questions.

Male – (48%) 1842/3835

Female – (52%) 1993/3835

Age range – 24 to 44 years, Median age 31

Distribution of Resident FieldInternal Medicine (31%)

Pediatrics residents (28%)

OBGYN Resident (14%)

Family Medicine (12%)

Pathology (7%)

Surgery (3%)

Other fields (5%) – (Derm, IM/PED combined, Neurology)

Excluded (Genetic Based Residency and Training..MED-GEN, PED-GEN..)

~10% [ Overall] answered correctly the questions on regarding the genes involved in developing genetic disorders.

Involved in Scholarly activity   No 12%  Yes 88%

Exposure to cancer genetic testing during graduate training  

 No 95% Yes 5%

Postgraduate training courses in epidemiology and EBM   No 18% Yes 82%

Knowledge of Genetics and Biomarkers   Low 35%

 Intermediate 40% Good 15%

 Excellent 10%

Hours per week dedicated for continuing medical education   <1 30%

 1–5 57% 6–10 11% >10 2%

Patient request for any type of genetic tests during training   No 94% Yes 6%

Personal or family having done a Genetics test   No 97% Yes 3%

Having a Molecular Pathology Board in the hospital   No 95% Yes 5%

Promotional material about Cancer screening during training   No 98% Yes 2%

Conference on Precision or Personalized Medicine   No 98% Yes 2%

91% 3486 Recommended Classes on Precision MedicineWanted to learn how to incorporate precision

medicine and Genetics knowledge for their patients for the continuity of care

31% 1200 Requested Genetic testing class

65% 2487Wanted to learn how to interpret Genetics

tests

72% 2780willing to have 2 weeks of year dedicated to

Genetics and Precision medicine

91% 3458

Conclusion:The knowledge of Genetic testing for disease specific biomarkers and Precision Medicine among residents and fellows who answered the questionnaire appears to be insufficient.

There is a need for additional training in this field.

We suggest ACGME to incorporate at least one month of Genetic testing training for disease specific biomarkers

Further Continuing medical education on Genetic testing and Precision Medicine.

Acknowledgement - Special Thanks to Dr. Hamed Azimi, MDDr. Peter Sealy, MD