BETHESDA, MD. — Few board certification examinations require physicians to understand concepts related to genetic testing and counseling or how to take or interpret family history, according to an analysis of the content outlines of such exams for 43 medical specialties.
“The lack of genetics and genomics knowledge by our current physicians is based in part on the competing priorities among the certifying specialty boards…. Few physicians are expected to know the practical applications of genetics to become certified; thus, the curriculum does not make genetics content a priority,” Carrie A. Zabel said at the annual meeting of the National Coalition for Health Professional Education in Genetics.
In an analysis of the exam outlines for 24 specialties certified by the American Board of Medical Specialties and 19 subspecialties certified by the American Board of Internal Medicine (ABIM), Ms. Zabel and her colleague at the Mayo Clinic in Rochester, Minn., Dr. Paul V. Targonski, found that 11 did not mention genetics or genomics in their certification exam content outline or no outline was available.
Fifteen exam outlines referred only to syndromes that were specific to the practice of a particular specialty and for which an underlying genetic etiology was known. These outlines did not otherwise specify basic genetics knowledge within their content, said Ms. Zabel, a certified genetics counselor at the Mayo Clinic.
A total of seven content outlines made reference to having an understanding of basic genetics. Another 10 content outlines provided a detailed listing of specific genetics content and concepts. These 10 mentioned family history in only two cases—the exams for the American Board of Medical Genetics and the American Board of Obstetrics and Gynecology. This “may be due to a lack of evidence of the utility of family history,” said Ms. Zabel, who had no relevant financial disclosures to make.
Even though 8 of the 10 detailed content outlines included genetic testing, only 4 also mentioned genetic counseling, “which is more than just services provided by a genetic counselor. It's the informed consent process and the discussion of the implications of results,” Ms. Zabel said. “I think this is potentially doing a disservice to those patients.”
The study was supported by the George M. Eisenberg Foundation for Charities.