Updated 16 Jan. 2013
This blog was stimulated by this article in The Scientist:
- Wall DP, Tonellato PJ. Genomics-informed pathology. Twenty-first century lab reports will include test results read by a new breed of pathologist. The Scientist, 1 Jan. 2013.
*Authors are from Harvard Medical School. Dennis Wall is Director of Computational Biology. Peter Tonellato is Director of the Laboratory for Personalized Medicine and heavily involved with promoting pathology in personalized medicine.Not sure that pathologists feel the love supporting the 'backbone of modern medicine'. Girdles were never very sexy. Several have told me that they occasionally feel they are at the bottom of the physician totem pole, more like a jockstrap.
It's analogous to how medical laboratory technologists / scientists (lab boy, lab girl in the recent past) feel compared to higher salaried and more respected docs and nurses.
Before musing about transforming pathology education, let's briefly review OMICS, a term with many types and a plethora of definitions. I like this site as it's not replete with bafflegab:
- The OMICS revolution and beyond (Has a cancer slant but discusses terms clearly)
Back to revolutionizing pathology education. The bit in the article that most got me was the need for core competencies in genomics and personalized medicine, and it is likely that "within 2 years it will be required that all residents in pathology demonstrate proficiency in these areas."
Wow! Competencies and proficiency impose heavy duty training needs. Quite different from the meaningless learning objectives (educators, bear with me) that too often accompany physician presentations:
- Become familiar with the complications of blood transfusions
- Learn about blood components and products
- Understand how to select the best blood product
I'd prefer that educational institutions first focus on giving all medical and nursing students, and practitioners whose initial education training was lacking, a few key competencies in transfusion medicine.
- Transfusion medicine in American undergraduate medical education (2011) Yikes: ~50% of med students get only 1-2 hrs of instruction
- Overview of transfusion medicine in Europe: training and education (2005)
The result is that errors in prescribing and administering transfusions occur all too frequently.
Soooo... Before revolutionizing medical education by training pathologists to be proficient in genomics and personalized medicine, perhaps medical and nursing education should deal with existing deficiencies as documented in
Sure, let all pathologists, indeed all health professionals, know about, be aware of and understand genomics and its relevance. Perhaps even develop specialty training.
It's not like pathologist education isn't rigorous enough already. For example, residency programs in :
Spending scarce educational resources transforming pathologist education to make genomics a priority seems ridiculous. Those who advocate it have personal agendas to promote their specialty. They are true believers, as it were. No doubt OMICs will evolve and become increasingly important. Exactly how is impossible to predict.
Will genomics and personalized medicine be ~ blood substitutes (aka hemoglobin-based oxygen carriers and similar), over-hyped and a long time coming? My guess is yes, mainly because disease is complex and determined by genes, environment, lifestyle, and more. As well, there are many other competing medical advances and health initiatives that can improve health more effectively, better diet and more exercise, to name but two.
As hematopathologists, transfusion nurses, and medical laboratory technologists and scientists who work as specialists in transfusion services are well aware, the competency of many, perhaps most, physicians who order blood, and nurses who administer it, ranges from dismal to needs improvement.
And since blood transfusion is common, you'd think being competent would be basic to all docs and nurses who prescribe and administer transfusions, an educational PRIORITY.
Apparently not. More hip to promote genomics and be seen as visionaries.
Oh, did I mention that industry is very keen on genomics and personalized medicine? See 2010 blog:
- Snip, snip, the party's over? (Musings on the seductive rise of DNA typing of blood groups)
Seems that OMICS is the new religion with many true believers, which reminds me of another true believer, Kathy Bates in Primary Colors, one of the best political films ever.
The music below was selected to contrast techie innovation with an instrument that has been around for hundreds of years.
First, this 1998 'techno' song by Cher, one of the best selling singles of all time. If you dislike this music, you may sympathize with those pathologists who hate techie innovations, because it threatens their comfortable ways.
- Believe (Cher)
- Asturias (Andre Segovia)
OMICS in personalized medicine (2010 European Commission workshop)
Personalized medicine: caught between hope, hype and the real world. Clinics (Sao Paulo). 2012;67 Suppl 1:91-7.
Platelet proteomics in transfusion medicine: a reality with a challenging but promising future. Blood Transfus. 2012 May;10 Suppl 2:s113-4.
Shaking hands with the future through omics application in transfusion medicine and clinical biochemistry. Blood Transfus. 2012 May; 10(Suppl 2): s1-s3.