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The training of future clinical geneticists: Evaluation and reflection on the ACMG Foundation for Genetic and Genomic Medicine Summer Genetics Scholars Program
Correspondence and requests for materials should be addressed to Miriam G. Blitzer, Division of Human Genetics, Department of Pediatrics, University of Maryland School of Medicine, 655 W. Baltimore Street, Room 7-037, Baltimore, MD 21201.
The purpose of the Summer Genetics Scholars Program of the ACMG Foundation for Genetic and Genomic Medicine is to expose medical students to medical genetics and genomics early during school with the aim of increasing the number of physicians pursuing a career in this field. This survey study evaluated the Summer Genetics Scholars Program on the achievement of its goals.
Methods
Former Summer Genetics Scholars who had completed medical school were sent a 13-question survey aimed at evaluating the program and obtaining feedback about their experiences.
Results
Of 125 former scholars, 55 completed the survey with 2 additional participants partially completing the survey. The vast majority of former participants report either being very satisfied or satisfied with their experience (96%).
Conclusion
Whereas most participants found their experience to be beneficial, evaluation of the initial 6 years of the program did not show an increase in the number of students entering residencies in medical genetics and genomics. It likely is too early to assess the program’s true influence on entry into the field because data were only available for the first 6 years of the Summer Genetics Scholars Program, and many residents typically choose to complete another primary specialty before medical genetics and genomics.
There is a limited workforce of MD clinical geneticists. Current estimates from the 2020 US Government Accountability Office report estimated that there are 4 clinical geneticists per 1 million people in the US population, whereas the estimate from a 2019 workforce survey was closer to 2.2 full-time equivalent geneticists per 1 million people.
U.S. Government Accountability Office Genetic services: information on genetic counselor and medical geneticist workforces. U.S. Government Accountability Office.
The 2019 workforce study indicated that most clinical genetics practices are open to new patients but with wait times for nonemergency patients of more than 3 months, which increased from a 2015 study.
Working Groups of the National Coordinating Center for Seven Regional Genetics Service Collaboratives. Current conditions in medical genetics practice.
These highlight the shortage of MD clinical geneticists in our current professional landscape.
In 2020, there were 46 MD clinical genetics residency programs. As of July 2020, 36 first year residents entered categorical programs, although there were 60 funded positions. Categorical medical genetics and genomics residency programs are 2 years in length, following a minimum of 1 year in an Accreditation Council for Graduate Medical Education–accredited residency that includes 12 months of direct patient care. However, a significant majority of categorical clinical genetics residents have completed a previous residency in another clinical residency, such as pediatrics, internal medicine, or obstetrics/gynecology. An additional 26 first year residents matriculated into approved combined training programs (medical genetics and genomics residency combined with pediatrics, internal medicine, maternal fetal medicine, or reproductive endocrinology and infertility). These combined training programs are 4 years in length. Overall, in 2020-2021, there were 161 residents training in categorical and combined training programs compared with 143 in 2019-2020 (American Board of Medical Genetics and Genomics, personal communication).
Residency specialty choice is multifactorial, but it has been shown that clinical exposure to a field has increased the number of students pursuing that residency specialty.
Recruiting medical genetics and genomics residents earlier in their undergraduate medical education by providing opportunities to be exposed to and learn about clinical genetics as a career was postulated as a platform to expand the numbers of medical students entering the field.
The medical genetics workforce: looking to the next five years. The ACMG Medical Geneticist: Quarterly Newsletter of the American College of Medical Genetics.
From these discussions, the Summer Genetics Scholars Program was conceived in 2011.
The goal of the program, which is sponsored by the ACMG Foundation for Genetic and Genomic Medicine (ACMGF), is to expose medical students to the broad field of medical genetics and genomics and to increase the number of physicians entering accredited medical genetics and genomics residency training.
Institutions apply to the ACMGF to be accepted as training sites for a Summer Genetics Scholar Program. The program lasts for a minimum of 6 weeks and encompasses mainly clinical based experiences but does include a research component. Students receive a stipend for participating in the program. Individual institutions are responsible for selecting 1 ACMGF-funded student per summer. Applicants must be rising second year medical students who are enrolled in a US medical school and are in good academic standing. It is not yet clear whether this program has increased interest in the pursuit of a career as a clinical geneticist. This study attempted to assess the Summer Genetics Scholars Program on the achievement of its goals and solicit feedback on how to improve the program for future years.
Materials and Methods
Through the ACMGF, a total of 125 former scholars who completed the program between 2011 and 2016 and have since begun residency were identified. Contact information for these individuals were obtained from the ACMGF and through residency or hospital websites. Former scholars received 3 email requests over a period of 5 months from December 2018 to March 2019. A 13-question survey was developed and emailed to these former scholars to evaluate the program and obtain feedback about individual experiences within the program (Supplemental Figure 1). Basic participant information was collected, including residency specialty, medical school institution, and residency institution. In addition to this demographic data, the questionnaire asked about the participants’ experiences during the program and if they influenced their career choices. Participants were asked to provide feedback on improving the program and whether their experience led to any publications or presentations.
Data were collected via an online survey platform, SurveyMonkey (Momentive AI). Descriptive statistics such as percentages were calculated through the SurveyMonkey platform. Qualitative data were also collected in the form of written feedback regarding the experience.
Results
A total of 55 former Summer Genetics Scholars Program scholars completed the survey with 2 additional participants partially completing the survey. All but 10 medical school institutions that had former scholars were represented. More than 15 residency specialties were represented as follows: 29% of the participants pursued a pediatrics residency, 20% pursued internal medicine, and 9% pursued a combined pediatrics-medical genetics and genomics residency. Most participants indicated they completed the Summer Genetics Scholars Program to learn more about medical genetics and genomics (83%) as opposed to needing to fulfill a school requirement (5%). Almost all former scholars were either very satisfied or satisfied with their experience (96%), and 80% of the trainees felt that they use medical genetics and genomics in their current field. A majority of the participants noted that they continue to use the knowledge they learned during their summer experience in their current field (90%). Notably, 44% of former scholars agreed that the Summer Genetics Scholars Program influenced their residency choice (Figure 1). The number of survey participants who reported considering a career in medical genetics and genomics before and after the Summer Genetics Scholars Program was 75% and 65%, respectively. For scholars who were not in a medical genetics residency at the time of the survey, 9% reported that they were considering completing a residency in medical genetics and genomics in the future.
Figure 1The proportion of former scholars who agreed that the Summer Genetics Scholars Program influenced their residency choice.
Other outcomes the survey gathered was the proportion of scholars who presented or published their research. The proportion of scholars who presented their research as an oral presentation or a poster presentation were 22% and 29%, respectively (Figure 2). Regarding publication, 20% had already published their research, 4% had multiple publications from the experience, and 4% had submitted for publication. Some scholars reported actively writing a manuscript for publication (7%), whereas 65% of scholars reported they did not publish from their experience (Figure 3).
Figure 2The proportion of former scholars who presented their research.
Regarding the qualitative feedback, the most consistent suggestion for improvement was to include more research experience while recognizing the difficulties of completing a research project in 1 summer. In addition, common feedback from participants included the desire for more structure for both the clinical and research components of the program.
Discussion
Although nearly all participants indicated that they enjoyed their ACMGF Summer Genetics Scholars Program experience and participated in the program out of a desire to learn more about genetics as opposed to needing to fulfill a school requirement, it is difficult to determine whether the Summer Genetics Scholars Program influenced the number of medical students interested in medical genetics and genomics as a career. Our data showed a small decrease in the number of students who were interested in such a career in medical genetics and genomics before and after the program. However, there are many factors that were not assessed in our survey to determine the reasons for this finding, thus it would be imprudent to make assumptions on the efficacy of the program at this time. It is important to note that the former scholars recognized that they do use medical genetics and genomics in their current specialty. In addition, they report that the knowledge gained from the summer experience is applicable to their current careers. The landscape of medical genetics and genomics is exploding with new discoveries and increased availability and access to genetic testing. It will be important to continue educating primary care providers regarding sending and interpreting genetic test results and providing tools for pre- and post-test counseling. However, there are nuances that accompany genetic testing and specifically genetic test results, and as such, the demand for genetics health care professionals will continue to grow.
In addition, with the advent of new therapeutics and medical management of genetic disorders, clinical geneticists are in even greater demand.
It might be too early to assess the true influence of the Summer Genetics Scholars Program on entry into the field of medical genetics and genomics because data are only available for 6 years and many physicians choose a primary specialty (ie, pediatrics, obstetrics and gynecology, or internal medicine) before medical genetics and genomics formal training. In addition, many medical schools have their own summer research programs that potentially advance medical genetics and genomics, and these programs were not assessed in this survey. Mentorship can be a crucial pillar in early career development, fostering interest in a specialized field and overall satisfaction of medical education.
At this point, a re-evaluation of the structure of the ACMGF Summer Genetics Scholars Program may be of value with an emphasis on incorporating more structure to the experience and encouraging continued mentor/mentee interaction over the remaining years of medical school.
Data Availability
Data generated from this survey is available upon request.
Working Groups of the National Coordinating Center for Seven Regional Genetics Service Collaboratives. Current conditions in medical genetics practice.
The medical genetics workforce: looking to the next five years. The ACMG Medical Geneticist: Quarterly Newsletter of the American College of Medical Genetics.
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