Amid an aura of enthusiasm, curiosity and fresh thinking, some Mayo Clinic School of Medicine students discuss medicine of the future. Their lunchtime topic centers on precision medicine. For one week they are taking an up-close and intense look at topics like the microbiome, pharmacogenomics, clinomics, epigenomics, biomarker discovery and bioethics. It’s part of their Selective experience – a one to two week learning block for first and second year med school students in which they explore areas of practice they may want to further pursue.
“Education is key to integrating individualized medicine into daily clinical care. We are pleased to offerthese future health care leaders a closer look at individualized medicine that will build on their classroom learnings. In order for health care providers to bring the latest discoveries to patients, they must first have a solid understanding of the science of personalized medicine,” says Timothy Curry, M.D., Ph.D., director of the Center for Individualized Medicine Education program. “We are also working to introduce education in individualized medicine early in medical education so that students can think about this actively and perhaps make it a focus of their career.”
A strong foundation for delivering patient care
The students voiced a need to learn about this fast developing area of health care now, so they are prepared. They say they need a strong foundation in individualized medicine as they believe it will be at the very core of their goal to put the needs of the patient first.
“As an undergraduate biology major, I learned it’s important to keep the whole ecosystem in mind rather than apply a ‘one-size-fits-all approach’ to problems. I think the same concept will apply to each patient’s individual treatment. We should keep their whole ecosystem in mind, which includes their biology, their values and their experiences,” says Mylan Blomquist, a first year Mayo Clinic School of Medicine student.
The students believe patients will be much more informed about their own health care than they were in previous generations. They want to be able to answer complex questions that patients may not understand about genetic testing, genetic risk for disease and ways genomic medicine may open up new treatment options.
Areas of concern
The students recognized there are several issues that will need more exploration as individualized medicine evolves into regular clinical care. One issue that gives the students pause for concern is the ethical considerations around personalized medicine. They wondered if genomic testing capabilities will at times put them in ethical dilemmas.
“Just because we have the tools to do something, does that make it right? What if I learn that my patient has a genetic variant that puts her at risk of early onset Alzheimer’s disease? What should I tell her? Would she or should she know?” asks Laura Barron, a first year medical student.
Another area they want to watch is cost. Will individualized medicine drive up health care costs or will it make medical care more efficient by finding answers sooner? There were concerns that precision medicine could widen the health care disparity gap between those who can afford quality care and those who cannot. They wondered if they as health care providers might have difficulty convincing insurance companies to pay for genetic testing and individualized care.
This is the fourth time the Center for Individualized Medicine offered the Selective in which students could learn from faculty about this emerging area of health care. Plans are already underway for next year’s Selective. CIM seeks to inspire a new generation of health care leaders who are educated to handle some of the challenges of precision medicine.
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Save the date for this year’s Individualizing Medicine Conference. It will be held in Rochester, Minnesota, on Sept. 12-13, 2018.