Human Genetics: "Physicians should be able to counsel patients on the process"

Interview with Prof. Klaus Zerres, Director of the Institute of Human Genetics in Aachen and Chairman of the German Society of Human Genetics

Human genetics is the study of the genetic makeup of human beings. DNA, chromosomes, and genes are extensively analyzed by medical specialists. Physicians of Germany need to have a qualification in genetic counseling to successfully advise patients. Until now, this was possible by participating in an online knowledge assessment. Starting mid-year, this regulation expires and 72 hours of classroom instruction need to be completed for credit.

04/01/2016

Photo: Klaus Zerres

Prof. Klaus Zerres; © UK Aachen

In this interview with MEDICA.de, Prof. Klaus Zerres of the Institute of Human Genetics in Aachen, in Germany, talks about the contents and guidelines of the new classroom instruction and the general requirements.

Prof. Zerres, how was it previously possible to work in genetic counseling? Why do physicians now have to complete a 72-hour course? 

Prof. Zerres: According to the German Genetic Diagnostics Act, since 2012, physicians need to meet a special qualification to be able to schedule specific human genetic testing. Human genetics specialists and physicians with an added qualification in “medical genetics“ already have the necessary qualifications; all others need to meet the qualification in genetic counseling.  Until now, they were able to directly obtain it by successfully participating in an online questionnaire, consisting of several multiple choice questions. This knowledge assessment test is conducted by the medical associations, but in no way meets the criteria of a real examination. Starting July 11, 2016, the previous temporary regulation expires and a new regulation pertaining to qualification requirements takes effect. It states that physicians who have not already been active as medical specialists for five years are no longer allowed to take this online knowledge assessment but must complete 72 hours of actual classroom instruction. This course is intended to train physicians in comprehensively counseling patients on the process and potential problems with genetic testing.

The course is meant to include theoretical as well as practical learning content. What subject matters and exercises are participants studying?

Zerres: Since the field of human genetics is very broad, the subject matter cannot be sufficiently deepened even during a 72-hour course. This includes the basic concepts of human genetics but also the various problem areas of genetic testing such as indications, validity, and meaning of genetic test results. Several training courses were already conducted in Würzburg; aside from imparting knowledge through lectures, discussions also play a big part. For example, participants are asked which genes should be checked based on the respective health issue. Essentially aspects that need to definitely be conveyed when patients are being counseled.  The course is intended to basically reflect the situation a physician is faced with when he wants to order genetic testing so that he is better able to make well-founded decisions. If a patient with hearing loss, for instance, wants to find out whether his condition is genetically based, the physician who orders the tests should know that there are literally hundreds of different hereditary dispositions for this symptom, making it difficult to identify the specific cause of hearing loss. In addition, physicians should examine why they often order costly genetic testing and what consequences this might entail for patients. For example, whether the test might involve family counseling if it turns out that there is a high risk for hereditary breast cancer. Prior to the consultation, patients should be made aware of potential consequences if genetic testing is being conducted. The course tries to make physicians aware of these subjects and provide them with a fundamental knowledge.

Photo: DNA section

Human genetics decode the genetic makeup of human beings. The genome include around 20.000 until 25.000 genes; ©panthermedia.net/Sergey Volkov

What is the timetable for the course?

Zerres: The training courses consist of a number of modules. The course is conducted in collaboration with the Academy of Human Genetics and the Bavarian Medical Association in Würzburg and is divided into four blocks. They consist of a section on human genetics, a section dealing with psychosocial and ethical aspects, a subject-specific portion and a section involving practical communication skills. 

Is there a limited number of participants?

The class in Würzburg is currently limited to 25 participants. The courses to obtain a professional qualification in human genetics and genetic counseling is very popular, which is why we informed the medical associations about this big demand and hope there will be nationwide courses throughout Germany in the future. Currently, classroom instruction in the cities of Düsseldorf, Tübingen and Berlin is in the works.

How often are these training courses offered?

Zerres: We are not yet able to provide an exact number of how many courses are planned to be offered each year. It depends on the demand. Since the temporary regulation will expire this year, it is difficult to make a prediction at the present time. However, the proposals are currently prepared in collaboration with the respective medical associations. You can register online for the classes on the website of the Academy of Human Genetics at the German Society of Human Genetics.

Photo: Lorraine Dindas

© B. Frommann

The interview was conducted by Lorraine Dindas and translated from German by Elena O’Meara.
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