Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Acad Med. 2010 Mar;85(3):498-506. doi: 10.1097/ACM.0b013e3181ccbebf.
In August 2009, the Johns Hopkins University School of Medicine implemented a new curriculum, "Genes to Society" (GTS), aimed at reframing the context of health and illness more broadly, to encourage students to explore the biologic properties of a patient's health within a larger, integrated system including social, cultural, psychological, and environmental variables. This approach presents the patient's phenotype as the sum of internal (genes, molecules, cells, and organs) and external (environment, family, and society) factors within a defined system. Unique genotypic and societal factors bring individuality and variability to the student's attention. GTS rejects the phenotypic dichotomy of health and illness, preferring to view patients along a phenotypic continuum from "asymptomatic and latent" to "critically ill." GTS grew out of a perceived need to reformulate the student experience to meet the oncoming revolution in medicine that recognizes individuality from the genome to the environment. This article describes the five-year planning process that included the definition of objectives, development of the new curriculum, commission of a new education building, addition of enhancements in student life and faculty development, and creation of a vertical and horizontal structure, all of which culminated in the GTS curriculum. Critical ingredients in meeting the challenges of implementing GTS were leadership support, dialogue with faculty, broad engagement of the institutional community, avoidance of tunnel vision, and the use of pilot courses to test concepts and methods. GTS can be viewed as the foundation for the scientific and clinical career development of future physicians.
2009 年 8 月，约翰霍普金斯大学医学院实施了一项新的课程，名为“基因到社会”（GTS），旨在更广泛地重新构建健康和疾病的背景，鼓励学生在包括社会、文化、心理和环境变量在内的更大的综合系统中探索患者健康的生物学特性。这种方法将患者的表型表现为内部（基因、分子、细胞和器官）和外部（环境、家庭和社会）因素在特定系统中的总和。独特的基因型和社会因素使学生注意到个体性和可变性。GTS 拒绝健康和疾病的表型二分法，而是倾向于沿着表型连续体从“无症状和潜伏”到“病危”来看待患者。GTS 的出现是出于对重新制定学生体验以适应即将到来的医学革命的需要，该革命从基因组到环境承认个体性。本文描述了五年的规划过程，包括目标的定义、新课程的开发、新教学楼的落成、学生生活和教师发展的增强、以及垂直和水平结构的创建，所有这些都促成了 GTS 课程的开设。在实施 GTS 面临的挑战中，关键的因素是领导层的支持、与教师的对话、机构社区的广泛参与、避免狭隘视野以及使用试点课程来测试概念和方法。GTS 可以被视为未来医生的科学和临床职业发展的基础。
