Basic Science Course Directors and Chairs, Selected Faculty and Administrators,

I am writing to pass along some information about enhancing/introducing molecular (genomic) medicine into the basic science curriculum.  As some of you know, I have been interested in this topic having an increased role in our curriculum and am here proposing that we meet to discuss this topic: its significance to modern medicine, the need for its inclusion in the curriculum, and how it might be incorporated in an already very tight schedule.  In fact, it may require relatively small changes in an appropriately integrated, but discipline-base curriculum as we have at present.

This is a continuation of a discussion begun at the July, 2003 and meeting of IAMSE (International Association of Medical Science Educators).  This year, Paul Monaco and I attended this meeting; I have been attending the yearly meetings since 2001.  At this meeting there were three sessions dealing with molecular (genomic) medicine highlighting its importance clinically and how it might be presented to medical students.

  1. Dr. David Valle, Pediatrics at Johns Hopkins University Medical School, gave a plenary session talk on Genetics, Individuality and Re-Thinking of Medical Education.
  2. Also, there was a related workshop on the Need for Increased Role of Genomics/Molecular Medicine in the Medical Curriculum by two clinicians, Dr. Jay Ellison, Pediatrics/Genetics at the Mayo Clinic, and Dr. Charles Weiner, Pulmonary/Respiratory Medicine at Johns Hopkins University Medical School.
  3. A panel discussion by representatives of the six basic science disciplines on “What is the role of molecular medicine in medical science education?“  I was pleased to represent Biochemistry on the panel discussion. 

One important point arising from these discussions is the lack of an appreciation for the role of molecular medicine in clinical medicine and how it might be incorporated into the education of medical students.  Below, I have listed numerous citations of interest that relate to this topic and document it clinical significance.  We in B&MB have found these citations to be very useful in introducing medical genomics to medical students.  I provide this very partial list as an information resource for a discussion meeting I would like to hold latter in August or early in September, 2004.

Websites with links to some of these articles are also listed and our library has direct access to the other cited journals.

  1. http://www.ornl.gov/sci/techresources/Human_Genome/medicine/medicine.shtml:  Medicine and the New Genetics: Human Genome Project Information

Review articles:  (hotlinks to #2-#13 can be found at http://content.nejm.org/misc/genmed.shtml)

  1. Genomics as a Probe for Disease Biology Burke W. N Engl J Med 2003; 349:969-72
  2. Cardiovascular Disease Nabel E.G. N Engl J Med 2003; 349:60-72
  3. Breast and Ovarian Cancer Wooster R., Weber B.L. N Engl J Med 2003; 348:2339-47
  4. Molecular Diagnosis of the Hematologic Cancers Staudt L.M. N Engl J Med 2003; 348:1777-85
  5. Alzheimer's Disease and Parkinson's Disease Nussbaum R.L., Ellis C.E. N Engl J Med 2003; 348:1356-64
  6. Hereditary Colorectal Cancer Lynch H.T., de la Chapelle A. N Engl J Med 2003; 349:919-32
  7. Drug Therapy: Pharmacogenomics — Drug Disposition, Drug Targets, and Side Effects Evans W.E., McLeod H.L. N Engl J Med 2003; 348:538-49
  8. Inheritance and Drug Response Weinshilboum R. N Engl J Med 2003; 348:529-36
  9. Population Screening in the Age of Genomic Medicine Khoury M.J., McCabe L.L., McCabe E.R.B. N Engl J Med 2003; 348:50-8
  10. Genetic Testing Burke W. N Engl J Med 2002; 347:1867-75
  11. Genomic Medicine — A Primer Guttmacher A.E., Collins F.S. N Engl J Med 2002; 347:1512-21
  12. Sounding Board: The Charitable Trust as a Model for Genomic Biobanks Winickoff D.E., Winickoff R.N. N Engl J Med 2003; 349:1180-4
  13. Pharmacogenetics goes genomic Goldstein D.B., Tate S.K., Sisodiya S.M. Nature Reviews - Genetics 2003; 4:937- 47
  14. Pharmacogenetics of cytochrome P450 and its applications in drug therapy:  the past, present and future Ingelman-Sundberg M. Trends in Pharmacological . 2004; 25:193-200
  15. Pharmacogenetics: potential for individualized drug therapy through genetics Johnson J.A. Trends in Genetics 2003; 19:660-6
  16. Genetic testing for cancer susceptibility: the promise and the pitfalls Lerman C., Shields A.E. Nature Reviews - Cancer 2004; 4:235-41

Specific Diseases/Cancers:

  1. Pharmacogenetic Study of Statin Therapy and Cholesterol Reduction Chasman et al. JAMA. 2004;291:2821-27
  2. Using Pharmacogenetics to Improve Drug Safety and Efficacy S. Haga and W. Burke. JAMA. 2004; 291:2869-71
  3. A two-gene expression ratio predicts clinical outcome in breast cancer patients treated with tamoxifen Ma, X.J. et al. Cancer Cell 2004; 5:607-16
  4. Tamoxifen resistance by a conformational arrest of the estrogen receptor α after PKA activation in breast cancer. Michalides, R. et al . Cancer Cell  2004; 5:597-605
  5. Constitutional genetic variation at the human aromatase gene (Cyp19) and breast cancer risk Siegelmann-Danieli,N.; Buetow,K.H. Br. J. Cancer 1999; 79:456-463

In addition, the site below is quite good for keeping one informed of new genomic news in clinical medicine and is a good source for looking up some past publications on these same items.  This is another excellent resource for putting molecular medicine into the basic science curriculum:

HOME PAGE: http://www.genomenewsnetwork.org/

or go to TOPICS http://www.genomenewsnetwork.org/categories/

For example, for an interesting metabolism and cancer topic start from the HOME PAGE to TOPICS to DISEASES to CANCER and select “Predicting Resistance to the Breast Cancer Drug Tamoxifen (10 Jun 2004)” for a review of a citations 20 and 21 above.

For an example of an interesting physiological topic start from the HOME PAGE to TOPICS to GENES AND GENOMES to GENE TESTS and select "Physicians Recommend Gene Test for Families with Hypertension (23 Jul 2004)" for a review of a paper from American College of Chest Physicians, "Diagnosis and Management of Pulmonary Arterial Hypertension." CHEST 126, Supplement (July 2004).