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February 2016

Toward Individualization in Medical Education

Author Affiliations
  • 1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Pediatrics, All Children’s Hospital–Johns Hopkins Medicine, St Petersburg, Florida
JAMA Pediatr. 2016;170(2):103-104. doi:10.1001/jamapediatrics.2015.3819

“There is a tendency among young men about hospitals to study the cases, not the patients, and in the interest they take in the diseases, lose sight of the individual. Strive against this.”

William Osler, The Quotable Osler, 20081

During our residency training some 20 years ago, Barton Childs, MD, a revered pediatrician and geneticist, challenged us by asking, “Why did this child get this disease at this time?” With a few exceptions, this question was difficult to answer. At the time we just accepted that most diseases occurred simply by chance. We failed to appreciate the relevance of the why questions. Only now are things becoming clearer. In the past decade, the Johns Hopkins University School of Medicine launched the Genes to Society curriculum based on the work of Dr Childs.2 Other institutions have also developed curricula focused on a systems biology approach. Although these curricula emphasize the patient as an individual—particularly from a genomic perspective—most of the content is delivered early in a medical student’s training before he or she is engaged in the health care delivery environment. Many clinical teaching programs have failed to adapt to the “omic” advances,3 including personomics,4 and are not delivering on the promise that our next generation of physicians will embrace their patients as individuals more fully.

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