GENETIC COUNSELING TRAINING PROGRAM
Introduction and Program Goals
The Genetic Counseling Training Program, leading to a Master of Science degree in Genetics, is a two-year academic program comprised of didactic course work, laboratory exposure, research experience and extensive clinical training. The program, directed by Anne L. Matthews, R.N, Ph.D., is an integral component of the teaching and research programs in the Department of Genetics and Genome Sciences at CWRU under the leadership of Professor Mitchell Drumm, Ph.D., acting chairman of Genetics and the program's medical director, Shawn McCandless, M.D., Associate Professor of Genetics and Pediatrics and Director of the Center for Human Genetics, University Hospitals Case Medical Center. The Program is accredited by the American Board of Genetic Counseling (ABGC) and graduates of the program are eligible to apply for Active Candidate Status and sit for the ABGC certification examination.
The overall objective of the Genetic Counseling Program is to prepare students with the appropriate knowledge and experiences to function as genetic counselors in a wide range of settings and roles. With unprecedented advances in our understanding of the genetic and molecular control of gene expression and development, and in our ability to apply this knowledge clinically, the Program strives to train students who can interface between patients, clinicians and molecular and human geneticists. Students gain insightful and multifaceted skills that will enable them to be effective genetic counselors, aware of the many new technical advances and often-difficult ethical, legal and social issues that have surfaced in the light of the Human Genome Project. Graduates of the Program will be prepared to work in a variety of settings including both adult and pediatric genetics clinics, specialty clinics such as cancer genetics and metabolic clinics, and prenatal diagnosis clinics, as well as in areas of research or commercial genetics laboratories relevant to genetic counseling and human genetics.
A unique aspect of the Genetic Counseling Training Program that it is housed within Case Western Reserve's Department of Genetics and Genome Sciences that is internationally known for both its clinical expertise and cutting edge research in molecular genetics, model organisms and human genetics. Thus, the Department of Genetics and Genome Sciences at CWRU provides an interface between human and medical genetics with basic genetics and provides an exciting atmosphere in which to learn and develop professionally. The direct access to both clinical resources and advanced technologies in human and model organisms affords students with an unparalleled environment for achievement. The Graduate Program in Genetics in the Department of Genetics and Genome Sciences provides an interactive and collaborative environment for both pre (genetic counseling and PhD students)- and post-doctoral trainees to come together in a collegial atmosphere. By fostering interactions between pre- and post-doctoral trainees in genetic counseling, medical genetics, and basic research at an early stage of their careers, it is anticipated that graduates will be well-rounded professionals with an understanding of the importance of both clinical and basic research endeavors. Moreover, such resources as the Department of Biomedical Ethics, the Center for Genetic Research, Ethics and Law, the Mandel School of Applied Social Sciences, and the Law-Medicine Center provide for an enriched learning experience for students.
Curriculum and Course Requirements
The curriculum consists of 40 semester hours: 22 semester hours of didactic course work and a minimum of 7 semester hours of thesis research. Additionally, there are three 10-week clinical rotations, one 3-week laboratory rotation and one 6-week summer rotation required of all students, which provide an additional 11 credit hours. Courses include material covering basic genetics concepts, eukaryotic genetics, embryology, medical genetics, biochemical genetics, molecular genetics, cytogenetics, cancer genetics, population genetics, genetic counseling principles, human development, psychosocial issues, interviewing techniques, ethical and professional issues in genetic counseling.
Clinical rotations include one intensive three-week laboratory rotation in diagnostic cytogenetics and clinical molecular genetics as well as the Maternal Serum Screening program. There are three ten-week clinical rotations during year 2 during which students obtain clinical experience in General Genetics (children and adults) including Specialty Clinics such as Marfan Clinic, Prader-Willi Clinic and Craniofacial Clinic; Prenatal Diagnosis Clinic, and Cancer Genetics Clinic. These rotations take place at The Center for Human Genetics at University Hospitals Case Medical Center, the Genomic Medicine Institute at the Cleveland Clinic and MetroHealth Medical Center. Additionally, there is one off-site rotation - a six-week clinical rotation which is held at Akron Children's Hospital in Akron Ohio during the summer. Moreover, students rotate through the Cleveland-based institutions for observational experiences starting early in year 1 of the program.
Students are also required to attend and participate in a number of other activities such as weekly Clinical Patient Conferences, Genetics Grand Rounds, Departmental Seminars and Journal Club. . Students also participate with the doctoral graduate students in the Department of Genetics annual retreat and present their research projects during the poster sessions. Students also have an opportunity to give educational talks to local schools and other groups when available.
Course of Study
|Gene 528||Principles & Practices of Genetic Counseling|
|Gene 524||Advanced Medical Genetics: Cytogenetics|
|Gene 525||Advanced Medical Genetics: Clinical|
|Gene 526||Advanced Medical Genetics:Molecular/Quantitative (even years)|
|Gene 527||Advanced Medical Genetics: Metabolic Disorders (odd years)|
|Gene 532||Clinical Observations|
|Gene 529||Psychosocial Issues in Genetic Counseling|
|Gene 531||Cancer Genetic Counseling Seminar|
|SASS 517||Family Systems Interventions|
|Gene 532||Clinical Observations continue|
|Gene 651||Thesis - Research Thesis Seminar &Applied Biostatistics in Clinical Research Seminar Series|
|Gene 532||Clinical Rotation I|
|Gene 526||Advanced Medical Genetics:Molecular/Quantitative (even years)|
|Gene 527||Advanced Medical Genetics:Metabolic Disorders (odd years)|
|Gene 532||Clinical Rotations II|
|Gene 530||Ethical & Professional Issues in Genetic Counseling|
|Gene 532||Clinical Rotations III|
|GENE 524||Advanced Medical Genetics: Cytogenetics||2.0|
|Fundamental principles regarding clinical cytogenetics including discussion of autosomal numerical and structural abnormalities; sex chromosome abnormalities; population cytogenetics; mosaicism; uniparental disomy; X-chromosome inactivation; contiguous gene deletions, and clinical molecular laboratory testing approaches.|
|GENE 525||Advanced Medical Genetics: Clinical Genetics||2.0|
|Fundamental principles regarding congenital malformations, dysmorphology and syndromes. Discussion of a number of genetic disorders from a systems approach: CNS malformations, neurodegenerative disorders, craniofacial disorders, connective tissue disorders, skeletal dysplasias, hereditary deafness, cardiovascular genetics, etc. Discussions include diagnosis, etiology, genetics, prognosis and management.|
|GENE 526||Advanced Medical Genetics: Molecular Genetics/Quantitative Genetics||2.0|
|Molecular: Fundamental principles of gene structure; mechanisms, detection and effects of mutations; imprinting; triplet repeat disorders; mitochondrial disorders; animal models for genetic disease and gene therapy. Laboratory approaches (includes a clinical correlate) are discussed as well as direct to consumer genetic testing. Quantitative: Fundamental principles of pedigree analysis, segregation analysis, Bayes theorem; linkage analysis and disequilibrium; multifactorial inheritance; risk assessment; consanguinity and paternity testing.|
|GENE 527||Advanced Medical Genetics: Metabolic Disorders||2.0|
|Fundamental principles of metabolic testing; amino acid disorders; organic acid disorders; carbohydrate disorders; peroxisomal disorders; mitochondrial disorders; etc. Discussion of screening principles and newborn screening as well as therapy for metabolic diseases.|
|GENE 528||Principles and Practices of Genetic Counseling||3.0|
|Fundamental principles needed for the practicing genetic counselor. Topics include skills in obtaining histories (prenatal, perinatal, medical, developmental, psychosocial and family); pedigree construction and analysis, physical growth and development; the genetic evaluation; the physical examination and laboratory analyses; prenatal issues, prenatal screening and diagnosis; and teratogenicity.|
|GENE 529||Psychosocial Aspects of Genetic Counseling||3.0|
|Fundamental principles regarding the psychosocial aspect of birth defects and genetic disease, its psychological and social impact on the individual and family. Topics include the genetic counseling interview process, issues regarding pregnancy, chronicity, death and loss, as well as the impact of cultural issues. Resources for families are also explored. Basic interviewing skills are addressed. Students will have an opportunity for practice of skills through role play and actual interviewing situations.|
|GENE 531||Clinical Cancer Genetics||2.0|
|This seminar discusses basic concepts in cancer epidemiology, principles of cancer genetics, inherited cancer syndromes, cytogenetics of cancers, predigree analysis for familial cancer risk and approaches to the differential diagnosis of inherited and familial cancers. Additionally, topics of risk assessment, genetic testing, screening, management and psychosocial issues in providing genetic counseling to patients with familial and inherited cancers will be discussed.|
|GENE 530||Ethical and Professional Issues in Genetic Counseling||2.0|
|Professional issues inherent in medical genetics and genetic counseling are addressed including ethical, legal, religious and cultural concepts. Fundamental principles of ethics are explored in some depth as they relate to genetic issues such as confidentiality, privacy, discrimination, autonomy and informed consent. The course is centered on weekly cases that are presented for discussion.|
|SASS 517||Family Systems Theories||3.0|
|This course covers development of the family over the life span, with an emphasis on normal family stages and tasks. Life cycle stages include marriage, parenting young children, families with adolescents, launching children and moving on, and families in later life. Divorce, remarriage, and forming a stepfamily are considered. The course covers a range of family forms based on culture and socioeconomics as well as changes in the family life cycle over time. Families coping with various life stresses such as alcoholism or drug addiction, children with chronic illness or developmental disabilities, care of elderly family members, and living in impoverished conditions also are discussed.|
|Cancer Genetics Seminar|
|This required seminar during spring semester provides a foundation regarding the principles of cancer genetics and their application to individuals and families at risk for hereditary cancers. Material discussed includes basic concepts in cancer epidemiology, principles of cancer genetics, inherited cancer syndromes, approaches to differential diagnosis, risk assessment, genetic testing, screening and management of patients with familial or inherited cancer disorders and psychosocial issues. The course is taught from a case-based approach enabling students to recognize family histories and pedigrees at risk for familial and inherited cancers, apply the appropriate risk assessment strategies and to practice the necessary counseling skills needed for counseling these families.|
The Research Thesis Seminar provides students an opportunity to discuss the research process, to explore potential research projects and develop a research proposal. Starting in fall of the first year and continuing through spring semester, topics cover different research approaches including quantitative, qualitative and mixed research approaches, approaches to identifying projects, writing research questions and specific aims, human subjects’ protection (IRBs), and presentations from faculty about their research interests. Students discuss their projects and develop their proposals while getting feedback from their peers and faculty. Students register under Gene 651 thesis hours in spring semester.
To complement the Research Seminar students also attend the 9-week lecture series on Applied Biostatistics in Clinical Research given by the Clinical & Translational Science Collaborative faculty in spring semester. This lecture series focuses on the interpretation and understanding of what methods to use in different research designs as well as how to interpret results.
|On-line Clinical Embryology|
|This on-line course, developed by the faculties of the Genetic Counseling Program and Department of Anatomy at the University of Cincinnati, provides students with an in-depth review of normal human development and provides a basis for explaining the process of developmental anomalies. Moreover, the course provides an introduction to the treatment of patients with congenital anomalies as well as counseling options for families of affected individuals. Students are given access to the course prior to being classes of the first year. They are required to have completed the course by the end of September of the first year.|
|GENE 532||Clinical Rotations|
|There are five rotations; four in the clinical areas and one in the laboratory. These begin over the summer semester with a six-week General Genetics/Prenatal Diagnosis/Cancer Genetics/Specialty Clinic Rotation at Akron Children's Medical Center Hospital and a three-week Clinical Cytogenetics/Molecular Genetics Laboratory rotation. Rotations continue through the second year of the program with three ten-week rotations including General Genetics and Specialty Clinics rotation (includes children and adults); Prenatal Diagnosis Rotation; and Clinical Cancer Genetics. Students rotate at the Center for Human Genetics Case Medical Center, the Genomic Medicine Institute at the Cleveland Clinic and at MetroHealth Medical Center. In addition, student start observational experiences at these institutions early in the first year.|
|GENE 651||Thesis Requirement|
|The Program requires a thesis for the completion of the M.S. degree. This scholarly project may be literature-based, a clinical or counseling project, or laboratory-based project and must relate to some aspect of genetic counseling. There is a formal presentation of the thesis and an oral defense before the student's thesis committee. It is expected that students will complete a publishable project.|