Resident Training on Methylenetetrahydrofolate Reductase: a National Survey

Methylenetetrahydrofolate reductase (MTHFR) is an enzyme important in folate metabolism. Genetic polymorphisms of MTHFR have potential clinical implications, particularly in treating mental disorders, where a biologically active form of metafolin is FDA approved in the treatment of major depressive disorder and schizophrenia. Therefore, residents in a variety of specialties must understand the link between genetic polymorphisms of MTHFR and clinical disorders.

To identify current gaps in residency curricula with regards to the MTHFR gene.

Using a snowball sampling method, a national online survey was sent to residency program directors in family medicine, internal medicine, and psychiatry to be forwarded to their corresponding residents. Data was collected between April 5, 2019, and May 14, 2019. Statistical tests included a Pearson chi-square test. Qualitative content analysis for open item responses was conducted in which recurring keywords and phrases were summarized. The primary outcome of interest was a dichotomous question: Does your curriculum teach about MTHFR?

The results showed that many of residency programs surveyed do not include MTHFR in their courses (family medicine 153/166, 92%; internal medicine 135/151, 89%; psychiatry 70/90, 78%) and a majority of residents are unaware of the clinical associations of MTHFR genetic polymorphisms with cardiovascular diseases and psychiatric disorders.

While many residents were aware of the MTHFR gene, knowledge about the gene was minimal and many curricula do not include MTHFR as part of their program. Therefore, we recommend residency training programs assess their level of training on MTHFR and its genetic polymorphisms.