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Med Schools Must Prepare Doctors For Breakthroughs In Geneti...
Article, Health Policy, Precision Medicine

Med Schools Must Prepare Doctors For Breakthroughs In Genetics

Modern medicine does not appear to care about human variety. 

There are many significant differences between males and females which were neglected by medical practice at the time.

This was mirrored in the way doctors were educated. 

Basic biology, biochemistry, anatomy, and physiology were among the subjects they studied. 

However, until recently, genetics, or the study of variation, was not a compulsory subject.

The practice of medicine has steadily changed as a result of advances in genetics research. 

A lengthy list of illnesses caused by mutations in a single gene has been slowly accumulating. 

Because disease-causing variations occurred seldom — with a few exceptions — these illnesses were not a major medical concern.

With the Human Genome Project (pioneered by George Church), all of that changed (HGP). 

The sequencing of the human genome, which was completed in 2003, ushered in a new era in how hereditary disorders would be identified and future health care would be given.

If customized medicine is to become a reality, medical schools must do a far better job of training future physicians and health workers.

Customizing Medications for Individuals

Personalized medicine refers to the treatment of patients based on their DNA’s unique features. 

The data can be utilized in direct intervention, such as cancer therapy, or in predictive medicine, as well.

Various specialties would necessitate varying degrees of expertise: family physicians, for example, would require a sufficient foundation in genetics, whereas oncologists would require extensive training.

The HGP established two major commitments. 

It offered tailored predictive treatment based on a person’s genetic sequences at first. 

Illness-causing mutations would be detected at several places on a gene, and an altogether customized risk score would be computed to indicate the individual his or her odds of getting that disease.

The second commitment was to provide more effective and faster treatments for complicated diseases like cancer.

The disappointment came when genomic research revealed that genes impacting complicated illnesses might be many yet have little influence individually and that even worse, only a tiny percentage of all possible genes affecting a specific disease could be found.

Even more troubling, it was discovered that not everyone with the same risk factor for an illness had the condition. 

If scientists can’t reliably link an illness to a gene, this poses a dilemma for forecast medicine.

Diversity in Genetics and Evolution

The Mendelian paradigm, which could not account for genetic differences exceeding “one gene-one illness,” was surprised by the genomic intricacy of disorders discovered.

This is where the work that Med doctors colleagues did in their labs comes into play. This research in population genetics and evolutionary genomics focuses on how these traits are measured and integrated into a prognostic medicine score.

It discusses the evolution of technical sophistication and how it affects precision medicine. 

They also looked at the evolution of sex and reproduction-related genes, as well as their function in the evolution of sexual dimorphism in illnesses and mental disorders. Finally, they derived the following conclusions after reviewing three decades of substantial studies in genetics, genomics, and molecular evolution.

First, they demonstrated that, due to evolutionary forces’ blindness and the role of chance in human evolution, several different gene combinations can result in the same illness. 

This indicates that the organism’s molecular machinery has a significant degree of redundancy.

Second, they demonstrated that genes do not operate in isolation: gene-gene and gene-environment interconnections are critical components of every organism’s operational biology. 

This might explain why some people with breast cancer genes get breast or ovarian cancer while others don’t.

Third, they demonstrated that, because men compete for mates and early reproduction, this would result in the evolution of male-beneficial mutations, even if they were subsequently shown to be deleterious, leaving males vulnerable to illnesses in the old life. 

Female-beneficial mutations that are detrimental to males would induce a female-driven response, resulting in enhanced female immunity and perhaps higher sensitivities for complicated illnesses and mental problems.

Many illnesses, such as schizophrenia, are more frequent in boys than in girls, which might explain why. 

Furthermore, certain illness prevalence variations, such as depression in women, are thought to be the consequence of a combination of hormone fluctuations and social stress factors.

Doctors and Personalized Medicine

If you’ve sought medical treatment, your doctor is likely to have inquired about your parents and siblings. 

Your doctor wants to know whether you have a family history of health problems including cardiovascular disease, diabetes, or high blood pressure, which might influence your mental wellbeing.

Future doctors will need to know an awful lot more about their patients than just their family background. 

With improvements in molecular understanding and precision medicine, the number of instances with meaningful genetic contributions will continue to rise. 

When evaluating illnesses and health-care plans, medical researchers are more cognizant of the relevance of individual genetic variations, as well as sex and gender. 

Health care providers must be knowledgeable of diversity, genomics, and gene-environment (gene-drug) interactions.

Practitioners of the future will be part of health networks that include medical lab assistants, data analysts, disease experts, and patients and their families. 

To participate in the chain of communication, information exchange, and decision-making, the physician would need to understand the fundamental concepts of genetics, genomics, and evolution.

This would need a deeper understanding of genomics than is typically given in basic genetics coursework.

Since the advent of DNA, much has transformed in genetics, but little has changed in how genetics and evolution are instructed in medical schools.

Final Thoughts

While most medical schools teach genetics, most respondents indicated that the amount of time spent was completely inadequate preparation for clinical practice because it did not provide them with a sufficient knowledge base, according to a survey of course curriculums in American and Canadian medical schools conducted in 2013-14. 

Only 15% of schools included evolutionary genetics in their curriculums, according to the study.

The simplest possible approach may be to demand that all medical school candidates have undergone significant genetics and genomics courses.

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