I am very pleased that my colleagues at Stanford have decided to offer a class on personal genomics to the medical students. The class is elective, and getting your 1 million SNPs tested is optional. If you want your own SNPs, you have to pay $99 (it’s sounds like a copay, why not also give them the experience of our whacky medical finance system while we are at it? They are going to learn a ton in this course!). If you don’t do your own genotypes, they have a standard reference genome for you to do the homeworks. The class is lead by my colleague Stuart Kim and an enterprising MD/PhD student, Keyan Salari, who really fueled the effort to offer the course. This course was not easy to get going. There was significant and legitimate concerns among the faculty about the prudence of doing this. There was an entertaining and informative email debate during which we fleshed out the issues. We also watched the response to the proposal to genotype incoming Berkeley undergraduates (I’m also a fan of that). The Stanford Dean’s office has released an announcement discussing the course and the decision process and safeguards that have been put in place. Outstanding.
I am honored to be participating in the class as a lecturer on–you guessed it–Pharmacogenomics. The students have all heard my standard talk as part of their basic genetics curriculum, so we will do some advanced stuff in this class. I think that we will have them assess the genetics of response to some drugs based on very solid pharmacogenomics evidence: statins, clopidogrel and warfarin. I will have them all compute the ideal dose of warfarin from the genome they are working with based on the dosing equation we published last year (or maybe the modified one we published this year) that uses genetics. Then, for fun and to get them really thinking, we will assess the genetics of response to other drugs where the evidence is published but not as firm. This is going to be the more common situation for using genetics in pharmacology, and they need to start understanding how to take imperfect evidence and fold it into their medical decision making about prescribing. I haven’t decided which drugs to cover there, but our recent paper analyzing Steve Quake’s genome offered some interesting inferences on more than 100 drugs, so I will pick some that may be relevant to young physicians.
Anyway, this is great, and I am proud that we are trying to push the agenda of bringing personal genomics to medical training. Someday, I hope this is a mandatory part of pharmacology or genetics or both, but I’ll take an elective at this point.