Molecular Medicine and biomedical education: reshaping our mission.

As biomedical research expands this understanding, medicine is expected to change (or to continue changing): hopefully, medical practice will soon become more predictive and preventive, and available treatments will be more selective (and ultimately specific). It is envisioned that linking genome-wide genetic information with disease predisposition will allow predictions of which disease(s) one might suffer from in the future. Genetic testing for BRCA mutations, which predispose to breast and ovarian cancer, serves as a good example. Expanding this concept, it is conceivable that a DNA analysis performed at birth, at the outpatient office, in the emergency room, or during a hospitalization, could be the molecular equivalent of the “family history”. As information on the determinants (genetic, epi-genetic and environmental) and molecular mechanisms of disease becomes available, focus could be shifted altogether from treating sickness to maintaining health. This is already adequately evidenced by the prevention of heart disease through cholesterol-lowering medications, and the prevention of breast cancer with Selective Estrogen Receptor Modulators (SERMs). When such approaches fail to preserve health, treatments could be tailored to the individual patient and their disease. PersonalThe biomedical sciences are currently in transition between the bloom of fundamental knowledge and the fruition of specialized clinical application. Following the success of the Human Genome Project, the roadmap is now in place for the description of physiology and illness in molecular terms. Through the advancements of the biosciences, medicine is being transformed from an empirical “art” to a rational (“ortho-molecular”) science. This is often viewed as a new medical “paradigm”, termed Molecular Medicine or Genomic Medicine. It can be argued that medicine has always been both “molecular” and “genomic”, because it employs drugs, which are molecules, that act on other molecules encoded by the genome. Yet, despite their long heritage, the terms “molecular” and “genomic” medicine today emphasize the importance we now attribute to understanding the role of molecular mech-