Konrad Karczewski, a bioinformatics student at Stanford University, learned quite a bit about himself over the summer.
He found out that his risk of prostate cancer is 24 percent – seven percentage points higher than the average man’s – and confirmed that his chance of having hypertension is higher than that of the general population, something he already suspected from his family history.
The doctorate student also learned his responsiveness to certain medications.
Not that any of that necessarily bothered him. He knew what he was getting into when he signed up for a controversial Stanford Medical School summer course that allowed students to test their own DNA.
Potentially troubling genetic results like Karczewski’s were at the center of a university task force’s yearlong debate over whether to allow med students to study their own genotypes. Some faculty members worried students might learn results that would be too upsetting and felt personal genetic testing wasn’t a necessary element for student learning.
Knowledge is better
But Karczewski disagrees with the critics.
“More knowledge is always better,” he said. “I fully understood the implications of this test because I have a genetics background. It’s important to remember that these predictions are not a diagnosis. It doesn’t mean you are or aren’t getting the disease. But you’re aware that there’s a risk early on, you can get screening and read up on prevention.”
The course was designed to teach future doctors and scientists to understand the commercially available genetic tests. All students had the choice of using their own genetic data or that of 12 anonymous patients. Class activities ranged from mapping patients’ ancestry to certain geographic locations to calculating the prescription drug dosages patients are genetically predisposed to respond to.
Thirty-three students in a class of 60 chose to participate in their own genotyping. Ten others mapped their DNA before the class using commercial services like 23andMe. Stanford offered free genetic counseling to the students, but only one student used the service.
As a member of the Stanford task force that helped develop and approve the class, Hank Greely, a Stanford law professor and director of the Center for Law and the Biosciences, said he favored the course being offered to med students, but he urged instructors not to offer personal genetic testing because the risk of getting bad news or misunderstanding test results was too great.
“I still wouldn’t have done it, but I’m not embarrassed or ashamed that Stanford did it,” Greely said. “I think we minimized the risks and maximized the learning opportunities.”
Krystal St. Julien, a doctoral student in biochemistry, took the course but opted not to participate in genotyping.
“I didn’t know at the time if this was something I could handle,” St. Julien said. “I kept hearing the words, ‘This may do harm,’ so I went back and forth a lot before I made my decision.”
Yet, St. Julien is adamant that the course was valuable and should be offered again. And her opinion of genotyping changed during her eight weeks of classes.
“I realized it probably wouldn’t have been such a traumatic experience if I had studied my own DNA,” she said.
Keyan Salari – who is working toward his doctoral degrees in medicine and genetics, and designed and co-taught the course – said he was pleased with how the class turned out.
“The students were fantastic, and the classroom was really dynamic and interactive,” he said. “I think students will walk away with a better understanding of genetic tests – their benefits and limitations – than most of the doctors practicing today.”
Salari and his co-instructor, Stuart Kim, are gathering student evaluations. Then they will share the results with the task force and leaders of the Stanford School of Medicine and determine whether the course will be offered again. Salari hopes it will be offered again in spring 2011.