The current state of resident training in genomic pathology: a comprehensive analysis using the resident in-service examination

Abstract

Objectives: To determine the current state of pathology resident training in genomic and molecular pathology.

Methods: The Training Residents in Genomics (TRIG) Working Group developed survey and knowledge questions for the 2013 pathology Resident In-Service Examination (RISE). Sixteen demographic questions related to amount of training, current and predicted future use, and perceived ability in molecular pathology vs genomic medicine were included, along with five genomic pathology and 19 molecular pathology knowledge questions.

Results: A total of 2,506 pathology residents took the 2013 RISE, with approximately 600 individuals per postgraduate year (PGY). For genomic medicine, 42% of PGY-4 respondents stated they had no training, compared with 7% for molecular pathology (P < .001). PGY-4 residents' perceived ability, comfort in discussing results, and predicted future use as a practicing pathologist were reported to be less in genomic medicine than in molecular pathology (P < .001). Based on PGY, knowledge question scores showed a greater increase in molecular pathology than in genomic pathology.

Conclusions: The RISE is a powerful tool for assessing the state of resident training in genomic pathology and current results suggest a significant deficit. The results also provide a baseline to assess future initiatives to improve genomics education for pathology residents such as those developed by the TRIG Working Group.

Keywords: Genomics; Medical education; Next-generation sequencing; Pathology; Residency training.

Figure 1

PGY-4 resident reported training in molecular pathology and genomic medicine. Examinees were asked “please indicate how much training you have completed during your residency in (molecular pathology/genomic medicine).” Mean(molecular)= 2-4 weeks, Mean(genomics) =< 1 week; p <0.001, independent samples t-test.

Figure 2

PGY-4 resident reported use of molecular pathology vs. genomic medicine during their training. Examinees were asked “I am using (molecular pathology/genomic medicine) as a pathology resident.” Likert score mean(molecular)= 3.03, mean(genomics) =2.39; p<0.001, independent samples t-test

Figure 3

PGY-4 resident predicted use of molecular pathology vs. genomic medicine as a practicing pathologist. Examinees were asked “I will use (molecular pathology/genomic medicine) as a practicing pathologist.” Likert score mean(molecular)= 3.23, mean(genomics) =2.82; p<0.001, independent samples t-test

Figure 4

PGY-4 residents’ reported ability to discuss molecular pathology vs. genomic medicine test results with a provider. Examinees were asked to rate their ability to “knowledgably discuss the results of (molecular pathology/genomic medicine) testing with a clinician.” Likert score mean(molecular)=2.61, mean(genomics) =2.33; p<0.001, t- test for independent samples.

Figure 5

2013 RISE molecular pathology vs. genomic medicine knowledge question score comparison by PGY. The scaled results for the 19 molecular pathology questions and 5 genomic medicine questions are presented by PGY.