Clinical Genetics
The UCLA Intercampus Medical Genetics Training Program provides training for individuals pursuing Board certification in clinical genetics at all three of its campuses. The clinical training components of the training program are developed and implemented by the Program¿s Executive Committee, but are run separately by each of the three campuses. Genetics residents/fellows spend the majority of their clinical training time at their home institution, however they are required to do a minimum number of clinical rotations at the other campuses. Integration of all trainees occurs weekly at the postgraduate level Medical Genetics Course, held on the UCLA campus, as well as at other Intercampus meetings during the year.
The Intercampus Clinical Training Program is two years in duration with an optional third year. The genetics residents/fellows receive extensive hands-on experience in clinical genetics, didactic information about the specialty of medical genetics, as well as skills in conducting clinical and/or laboratory-based research, writing manuscripts and research grants, and organizing and delivering lectures and seminars to a wide variety of groups.
Trainees spend a variable amount of time doing clinical work, depending on the track they have elected to pursue; e.g., research and clinical or primarily clinical training. At a minimum, they will be expected to attend two half-days of clinical activity during year 1 and one full clinic per week in year 2. Additional time must be spent doing consults and gaining experience in prenatal diagnosis, genetic screening, genetic counseling, and teratology counseling. Trainees also spend time obtaining experience in the cytogenetics, biochemical, and molecular genetics laboratories. They are expected to attend all research and clinical seminars at their base hospital. The mix of clinical cases, conferences, and lectures is intended to provide comprehensive training in medical genetics, dysmorphology, teratology, and prenatal diagnosis, molecular diagnosis, and biochemical genetics. Specialized clinics including craniofacial, skeletal dysplasia, metabolic disorders, and neurological disorders such as tuberous sclerosis, neuro-fibromatosis, Huntington disease and muscular disorders are also available as part of the training program.
Each campus offers a unique patient population and faculty that greatly broadens the residents educational experience.
Cedars-Sinai has a comprehensive Skeletal Dysplasia clinic, the adult Gen-Risk program, cancer cytogenetics and fetal dysmorphology.
Harbor-UCLA has a large indigent and minority population offering excellent cross-sections of genetic diseases, including older adolescents and adults with undiagnosed genetic conditions, and a rich array of patients from a variety of socio-economic, religious and/or cultural backgrounds with disorders unique to specific ethnic groups.
UCLA has a large molecular genetics clinic that treats patients with specific genetic disorders not seen elsewhere, as well as a large adult neurology population and a unique metabolic clinic.
ABMG Requirements
A clinical geneticist is an individual who holds an MD or DO degree, has had two years in an ACGME-accredited clinical residency program in another medical specialty and two years in an ACGME-accredited residency in clinical genetics (or four years in an accredited four-year clinical genetics residency program), has a valid medical license, and has demonstrated competence to provide comprehensive genetic diagnostic, management, therapeutic, and counseling services.
These requirements imply that the individual possesses:
- broad knowledge in human and medical genetics, including an understanding of the heterogeneity, variability, and natural history of genetic disorders;
- diagnostic and therapeutic skills in a wide range of genetic disorders;
- the ability to elicit and interpret individual and family histories;
- the ability to integrate clinical and genetic information and to understand the uses, limitations, interpretation, and significance of specialized laboratory and clinical procedures;
- the expertise in genetic and mathematical principles to perform risk assessment;
- the skills in interviewing and counseling techniques required to:
1. Elicit from the patient or family the information necessary to reach an appropriate conclusion;
2. Anticipate areas of difficulty and conflict;
3. Help families and individuals recognize and cope with their emotional and psychological needs;
4. Recognize situations requiring psychiatric referral; and
5. Transmit pertinent information in a way that is comprehensible to the individual or family; and
6. Knowledge of available health care resources (community, regional, and national) required for appropriate referral or support.
