Self-assessed knowledge of genomic medicine among non-genetics physicians - results from a nationwide Swedish survey.

Genomic medicine is becoming essential to clinical everyday practice in many medical fields. At the same time ethical, economic and practical challenges impede the mainstreaming of genomic medicine. Previous studies indicate that physicians without specific qualifications in genetic medicine may lack sufficient knowledge and/or confidence to efficiently practise genomic medicine. This study used a previously validated survey to investigate Swedish non-genetics physicians’ (n = 133) self-assessed knowledge, education needs and preferred mode of working with genomic medicine. Self-assessed knowledge varied widely between knowledge areas, with about 70% having knowledge in basic concepts and disorders/diseases, to about 35% having knowledge about cascade testing or legal implications. A majority reported that having more knowledge within the field of genomic medicine would change their clinical practice. Only 3% of participants preferred to manage genomic medicine patients fully on their own, while 56% preferred to manage such patients in their own practise but with support from regional genetics services or competence in-house. In contrast, 29% preferred to refer patients directly to regional genetics services. A majority desired more or better access to information material aimed at physicians and/or patients. Answering patterns generally corroborate previous findings from other countries. In summary, Swedish non-genetic physicians report sub-optimal levels of knowledge and desire much support in genomic medicine matters. The results have important implications for the interaction between regional genetics services and non-genetics physicians, as well as for the continuous education necessary to further the mainstreaming of genomic medicine.