Curriculum for General Practice - The Royal New Zealand College ...

Genetics
G
Genetics
With the mapping of the human genome,
advances in genetic medicine have been
significant and it is likely that the role
of the general practitioner will expand
to detecting and managing genetic
conditions. 1
Knowledge of the various genetic causes of conditions,
such as cystic fibrosis, and stem cell treatments for various
cancers have raised public awareness of genetics. The
relevance of genetics to disease is an expanding field that
the general practitioner is required to know about.
Genetics in general practice involves managing diseases
that run in families/whānau. Essentially all diseases and
conditions are said to have a genetic component. For every
10 patients that we see, one of them will have a genetic
component to their illness. 2 The management of genetic
diseases and conditions involves both the individual and
their family/whānau members.
Many of the common cancers have a genetic component.
Colorectal cancer, one of the most common cancers in
New Zealand, is currently being examined to determine the
clinical behaviour of the cancer. 3
Recent studies suggest that genetic factors are involved
with developing diabetes, with first-degree relatives having
a higher risk than unrelated individuals from the general
population. 4 Using family history as a way of recognising
risk factors for Māori is a way that the health inequalities
between Māori and non-Māori may be improved.
While not specifically genetically predetermined, families
can have a history of congenital conditions and the general
practitioner needs to be able to provide support and
appropriate care.
For example, in New Zealand congenital birth defects,
including common problems such as cleft palate, heart
defects and dislocation of the hips, affect about one in
every 30 children. 5
The impact of genetics in the context of general practice
is determining the allocation of the health dollar in New
Zealand and across the world. It is also having an impact
on individual consultations in the primary care setting.
The general practitioner requires skills in all domains to be
able to help patients deal with the vast array of information
that is available publicly and advise on what is best practice
for their particular situation.
1
Royal College of General Practitioners. 1998. Genetics in Primary Care: a report from the RCGP North West England Faculty Genetics Group. Occasional Paper 77.
London: RCGP
2
Hopkinson I. Clinical context of genetics in primary care. 2004. Presentation at: Reality not Hype: the new genetics in primary care. www.londonideas.org
3
http://www.hrc.govt.nz
4
http://www.who.int/genomics/about/Diabetis-fin.pdf
5
http://www.hrc.govt.nz/sites/default/files/HRC59%20(Robertson)%20(2).pdf
www.rnzcgp.org.nz
Curriculum for General Practice
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