1. Integration of Genomic Medicine into Pathology Residency Training
Iris Schrijver, Yasodha Natkunam, Stephen Galli, Scott D. Boyd 
The Journal of Molecular Diagnostics 
Volume 15, Issue 2, Pages (March 2013)
DOI: /j.jmoldx
Copyright © 2013 American Society for Investigative Pathology and the Association for Molecular Pathology Terms and Conditions

2. Figure 1
Toward clinical implementation of a personalized genomic medical evaluation. In addition to learning about the new tools, methods, and data from genomic science, and the fundamental knowledge of human genetics that preceded them, residents learn the importance of integrating genomic data with the results of traditional clinical phenotyping of the patient, including bedside history and physical examination; radiologic and other imaging studies; laboratory tests measuring small molecules, levels of expressed RNA, and proteins; and histologic, cytologic, and immunophenotypic evaluation of blood, body fluid, and tissue biopsy samples, as well as microbiologic assessment of the microbiomes of the patient. The study of paired genomic and phenotypic data from sufficient numbers of patients offers the best opportunity for deriving medical knowledge that can be used to attempt to interpret the significance of sequence variants in the genome of an individual. A combination of retrospective studies and new prospective clinical trials and other studies incorporating genomic data will be needed to assess the potential benefits and costs of guiding management and therapy choices based on a medical evaluation of the patient that includes genomic findings. Over time, new consensus guidelines incorporating genomic data will be defined by appropriate expert panels. Progress in this new area of medicine will undoubtedly be influenced by factors external to the diagnostic laboratory, such as federal and state legislative actions, regulatory bodies, and the activities of the private sector, including insurers, diagnostic companies, pharmaceutical companies, and patient advocacy groups. Residents can expect to see significant changes in all of these areas during their training and as they enter independent clinical practice.
The Journal of Molecular Diagnostics  , DOI: ( /j.jmoldx )
Copyright © 2013 American Society for Investigative Pathology and the Association for Molecular Pathology Terms and Conditions