Cadaver Exome Sequencing Brings Modern Medicine to Anatomy 101

The Anatomy Lesson of Dr. Nicolaes Tulp depicts a 17th-century cadaver anatomy lesson. Incorporating exome sequencing into the practice of cadaver anatomy represents a significant update to the traditional medical school course. (image credit: Rembrandt van Rijn, 1632, public domain)

The Anatomy Lesson of Dr. Nicolaes Tulp depicts a 17th-century cadaver anatomy lesson. Incorporating exome sequencing into the practice of cadaver anatomy represents a significant update to the traditional medical school course. (image credit: Rembrandt van Rijn, 1632, public domain)

Modern genetics is finally finding its way into medical school.

Following our advances in understanding the human genome during the last 30 years, American medical education is entering an era of change, where the practice of genetics and genomic medicine is increasingly shaping the new landscape of physician training. Recognized nationally as an important education initiative [1][2], genomic medicine programs are being introduced by medical schools across the country into first- and second-year curriculum [3][4]. The goal is to train the next generation of physicians to understand how to utilize genomic technology and what insights it can offer for a patient's condition; however, study of this complicated and highly personal (and some argue, private) data can be difficult to incorporate into the classroom.

Faculty from the Lewis Katz School of Medicine at Temple University have developed an elegant approach for integrating modern genomic medicine into the first-year curriculum, which recently made headlines in the Journal of the American Medical Association [5]. Rather than limit their students to genotyping experience (where a subject’s genome is sparsely sampled at predefined points, and statistics is used to infer probabilities of conditions based on the sampling), and to avoid the ethical, legal, and social issues [3] of personal genetics (where a student analyzes his or her own genome data), Dr. Glenn S. Gerhard and colleagues built the genomic medicine study into the traditional first-year course on cadaver anatomy.

Students first practiced obtaining DNA samples from the cadavers, and then ordered exome sequencing procedures (where all 20,000 genes are simultaneously sequenced, and non-gene regions of the genome are skipped for efficiency). Along with the information gathered through traditional dissection, the students were able to examine selected sequence variations to speculate how they may have affected the person's traits, responses to pharmacological drugs, and cause of death. This research involved familiarizing themselves with clinical and academic genetic databases, and resulted in students being able to make direct links between genetic sequence and anatomical or physiological outcomes.

Exome sequencing can provide unique insight into an individual’s biology, making genomics a key component of precision medicine. Although the practice hasn’t made its way into every medical school, programs like Dr. Gerhard’s are bringing genomic medicine to our future physicians – and will eventually integrate some of our most modern technology into the clinic.


- Malika Kumar (@malika_kumar)
Art and Design Editor, Signal to Noise Magazine
PhD Student, Human Genetics


Citations:
[1] Korf BR, Berry AB, Limson M, et al. Framework for development of physician competencies in genomic medicine . Genet Med. 2014;16(11):804-809.
[2] American College of Medical Genetics and Genomics. American College of Medical Genetics and Genomics strategic plan. https://www.acmg.net/docs/ACMG_FINAL_Strategic_Plan_071715_V2.pdf?hkey=54b2055f-09ae-402d-9e34-d7cb7cd2eec3. Accessed January 5, 2016.
[3] Vernez SL, Salari K, Ormond KE, Lee SS. Personal genome testing in medical education: student experiences with genotyping in the classroom . Genome Med. 2013;5(3):24.
[4] Linderman MD, Bashir A, Diaz GA, et al. Preparing the next generation of genomicists: a laboratory-style course in medical genomics . BMC Med Genomics. 2015;8:47.
[5] Gerhard GS, Paynton B, Popoff SN. Integrating cadaver exome sequencing into a first-year medical student curriculum. JAMA. 2016;315(6):555-556.