​​​​JOURNAL PUBLICATIONS


Murphy MJ, Russomanno K. Resident Education in Molecular and Genetic Testing in Dermatology: An Opportunity Not to Be Missed. Am J Dermatopathol (in press)


Specialty-appropriate instruction in molecular and genetic testing must become an integral component of dermatology training programs. In addition to improving the overall quality of patient care, other benefits of education and examination preparation in this area will include (1) promoting effective communication with patients, other healthcare professionals, and insurers, (2) stimulating research, and (3) establishing dermatologists as experts and future leaders. Studies in sociology and economics suggest that both “early adopters” and the dissemination of knowledge play important roles in the innovation and diffusion of new technologies in healthcare.



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Torre K, Russomanno K, Ferringer T, Elston D, Murphy MJ. Educational Gaps in Molecular Diagnostics, Genomics, and Personalized Medicine in Dermatopathology Training: A Survey of US Dermatopathology Fellowship Program Directors. Am J Dermatopathology (in press)

Molecular technologies offer clinicians the tools to provide high-quality, cost-effective patient care. We evaluated education focused on molecular diagnostics, genomics, and personalized medicine in dermatopathology fellowship. A 20-question online survey was emailed to all (n = 53) Accreditation Council for Graduate Medical Education (ACGME)-accredited dermatopathology training programs in the United States. Thirty-one of 53 program directors responded (response rate = 58%). Molecular training is undertaken in 74% of responding dermatopathology fellowships, with levels of instruction varying among dermatology-based and pathology-based programs. Education differed for dermatology- and pathology-trained fellows in approximately one-fifth (19%) of programs. Almost half (48%) of responding program directors believe that fellows are not currently receiving adequate molecular education although the majority (97%) expect to incorporate additional instruction in the next 2-5 years. Factors influencing the incorporation of relevant education include perceived clinical utility and Accreditation Council for Graduate Medical Education/residency review committee (RRC) requirements. Potential benefits of molecular education include increased medical knowledge, improved patient care, and promotion of effective communication with other healthcare professionals. More than two-thirds (68%) of responding program directors believe that instruction in molecular technologies should be required in dermatopathology fellowship training. Although all responding dermatopathology fellowship program directors agreed that molecular education is important, only a little over half of survey participants believe that their fellows receive adequate instruction. This represents an important educational gap. Discussion among those who oversee fellow education is necessary to best integrate and evaluate teaching of molecular dermatopathology.



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Murphy MJ. Promoting competency and use of molecular technologies in future clinical practice among dermatopathology trainees: role of early adopter-educators. J Cutan Pathol 2017 Jun;44(6):599-600.


Dermatopathology fellowship programs are ideally suited for early engagement of trainees in skin-directed molecular technologies. As identified in this study, the broad clinical expertise with molecular assays and strong advocacy for relevant training among dermatopathology fellowship directors supports the importance of early adopter-educators in promoting competency and use of molecular technologies in future clinical practice among dermatopathology trainees.



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Murphy MJ, Shahriari N, Payette M, Mnayer L, Elaba Z. Development of a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees. J Cutan Pathol 2016 Oct;43(10):858-65.

Results of molecular studies are redefining the diagnosis and management of a wide range of skin disorders. Dermatology training programs maintain a relative gap in relevant teaching. We developed a curriculum in molecular diagnostics, genomics and personalized medicine for dermatology trainees at our institution. The aim is to provide trainees with a specialty-appropriate, working knowledge in clinical molecular dermatology. The Departments of Dermatology and Pathology and Laboratory Medicine collaborated on the design and implementation of educational objectives and teaching modalities for the new curriculum. A multidisciplinary curriculum was developed. It comprises: (i) assigned reading from the medical literature and reference textbook; (ii) review of teaching sets; (iii) two 1 hour lectures; (iv) trainee presentations; (v) 1-week rotation in a clinical molecular pathology and cytogenetics laboratory; and (vi) assessments and feedback. Residents who participated in the curriculum to date have found the experience to be of value. Our curriculum provides a framework for other dermatology residency programs to develop their own specific approach to molecular diagnostics education. Such training will provide a foundation for lifelong learning as molecular testing evolves and becomes integral to the practice of dermatology.



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Murphy MJ. Attitudes concerning clinical molecular testing among dermatology trainees at a single institution. Am J Dermatopathol. 2015 Jul;37(7):590.

All dermatology trainees at our institution completed an evaluation that was designed to determine (1) their attitudes and experiences concerning molecular testing in daily practice and (2) their perceptions of the value of education on molecular technologies and their clinical applications. All trainees believed that routine molecular testing will begin to “play a greater role” in the management of patients with skin diseases, although most described their level of understanding of the role of molecular diagnostics in dermatology as “average” or “could be better.” All respondents desired more education on molecular technologies pertaining to dermatology in their curriculum.



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LaChance A, Murphy MJ. Keeping up with the times: revising the dermatology residency curriculum in the era of molecular diagnostics and personalized medicine. Int J Dermatol. 2014 Nov;53(11):1377-82.


The clinical use of molecular diagnostics, genomics, and personalized medicine is increasing and improving rapidly over time. However, medical education incorporating the practical application of these techniques is lagging behind. Although residencies in some fields, such as pathology, have begun to incorporate practical molecular diagnostics training, this area remains a relative gap in dermatology residency programs. We advocate for the incorporation of training in molecular diagnostics and personalized medicine into dermatology residency programs and propose a basic curriculum template for how to begin approaching these topics. Dermatologists have the opportunity to lead the way and actively shape the specialty's transition into the era of personalized medicine.



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Murphy MJ. A call to action: dermatopathology in the age of molecular testing--education in molecular diagnostics, genomics and personalized medicine. J Cutan Pathol. 2013 Jul;40(7):687-9.

Dermatopathologists must acquire a greater understanding of molecular diagnostic and advanced genomic (i.e., next generation sequencing) technologies, in order to provide guidance to dermatologists and other clinicians regarding clinical utility, cost-effectiveness and, importantly, proper test selection and result interpretation. Dermatopathologists can emerge as leaders in the development of personalized medicine in the field of dermatology. Instruction in molecular pathology must become integral to dermatopathology fellowship training and should be increasingly incorporated into continuing medical education activities for practicing dermatopathologists. Committees and organizations which oversee fellowship education need to develop and implement additional requirements, or expand on current recommendations, for both dermatopathology training programs and their trainees.



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Elaba Z, Phelps A, Murphy MJ. Molecular diagnostic strategies: a role in the practice of dermatology. Int J Dermatol. 2012 Nov;51(11):1292-302.

Molecular diagnostic strategies are gaining wider acceptance and use in dermatology and dermatopathology as more practitioners in this field develop an understanding of the principles and applications of genomic technologies. Molecular testing is facilitating more accurate diagnosis, staging, and prognostication, in addition to guiding the selection of appropriate treatment, monitoring of therapy, and identification of novel therapeutic targets, for a wide variety of skin diseases. Dermatologists and dermatopathologists require a broad working knowledge of available tests, including their design, advantages, limitations and evolving applications.



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CONFERENCE PRESENTATION


Shahriari N, Elaba Z, Mnayer L, Grant-Kels J, Murphy M. Development of a curriculum on molecular diagnostics, genomics and personalized medicine for dermatology residency programs. 23rd World Congress of Dermatology, Vancouver, Canada 06/2015 (Poster).

We developed a multidisciplinary curriculum in molecular diagnostics, genomics and personalized medicine for the dermatology residency program at our institution. The aim is to provide trainees with a broad, but specialty-appropriate level of knowledge in clinical molecular dermatology. Residents who participated in the curriculum have found the experience to be invaluable, and resident feedback has been used to improve the training program. We provide a framework for other residency programs to develop their own approach to molecular diagnostics education.



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