Article Text

Download PDFPDF

Mainstreaming of genomic medicine in gastroenterology, present and future: a nationwide survey of UK gastroenterology trainees
  1. Ibrahim Al Bakir1,2,
  2. Gregory Malcolm Sebepos-Rogers3,
  3. Hilary Burton4,
  4. Kevin J Monahan5,6
  1. 1 Centre for Tumour Biology, Barts Cancer Institute, London, UK
  2. 2 Department of Gastroenterology, St. Mark's Hospital, Harrow, UK
  3. 3 Department of Gastroenterology, University College Hospitals NHS Foundation Trust, London, UK
  4. 4 PHG Foundation, University of Cambridge, Cambridge, UK
  5. 5 Family Cancer Clinic, St. Mark's Hospital, Harrow, UK
  6. 6 Genomic Medicine, Imperial College, London, United Kingdom
  1. Correspondence to Kevin J Monahan; k.monahan{at}imperial.ac.uk

Abstract

Objective Genomics and personalised medicine are increasingly relevant for patients with gastroenterological conditions. We aim to capture the current state of genomics training in gastroenterology to review current understanding, clinical experience and long-term educational needs of UK trainees.

Design and setting A web-based nationwide survey of all UK gastroenterology specialty trainees was conducted in 2017.

Results 100 trainees (14% of UK gastroenterology trainees) completed this survey. Only 9% and 16% of respondents believe that their local training programme adequately prepares them for the future clinical practice using genomic medicine and personalised medicine, respectively. Barriers identified include the need for greater trainee education (95%), inadequate clinical guidance to base interventions on the results of genomic testing (53%), concerns over misinterpretation by patients (43%) and overuse/misuse of testing by clinicians (34%).

Survey respondents felt prepared to perform HFE genotyping (98%), assess TPMT status (97%) and interpret HLA subtyping for suspected coeliac disease (85%). However, only a minority felt prepared to perform the following investigations: polyposis screening (34%), hereditary pancreatitis screening (30%), testing for Lynch yndrome (33%) and KRAS testing for colorectal cancer (20%).

Most respondents would support holding dedicated training days on genomic medicine (83%), formal training provisions for the mainstreaming of genomic testing (64%), an update to the UK gastroenterology specialty training curriculum and examinations (57%) and better-defined referral pathways for local genomic services (91%).

Conclusion Most gastroenterology trainees in this survey feel ill equipped to practise genomic and personalised medicine as consultants. We propose specific revisions to the UK gastroenterology specialty curriculum that addresses trainees needs.

  • genetic testing
  • genomics
  • survey
  • curriculum
  • education

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors IAB and KJM were responsible for survey design and dissemination. IAB and GMS-R were responsible for analysis of survey results and drafting of the manuscript. HB and KJM provided senior support and critical appraisal during survey result analysis and manuscript drafting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.