C. S. Mott Children's Hospital

University of Michigan Health System

Genetics: Goals and Objectives

Pediatric Clinics

Residents will rotate in clinics and provide inpatient consultation services as well as participate in Outreach Clinics in the State of Michigan through a state grant to the Division of Pediatric Genetics. The goals of this rotation are to train the resident in the diagnosis, management, and provision of genetic counseling for the broad spectrum of newborn multifactorial birth defects, multiple congenital anomalies, developmental delay, mental retardation, clinical syndromes and single gene disorders, chromosome anomalies, neurological diseases, teratogenic effects, deformations and disruptions in the Pediatric population. The Pediatric Genetics and Adult Medical Genetics clinics meet separately. A Medical Genetics Conference is shared once each month on the third Thursday of each month at 1:30 p.m. Residents rotate through both clinics at separate times in the schedule to access the varied clinical spectrum cared for by each division.

Inpatient and Outpatient Service

Inpatient and outpatient genetics services are provided within the University of Michigan Hospitals as well as within Outreach Clinics in three different cities in Michigan. For the Pediatric outpatient clinical genetics activities, the patients are evaluated in the Taubman Outpatient clinical center. Six outpatient rooms, an outpatient staff meeting room which includes computers, library, video equipment, a copy machine, and access to a fax machine, and telephones for dictation, or outside hospital communication are available. Within the Pediatric Genetics Divisional offices in the Medical Professional Building adjacent to the Taubman Outpatient Clinic Center, adequate meeting room space is available for review of patient information prior to visits. This includes five office spaces, 3 computers (all with Internet access), a library with Clinical Genetics textbooks and journals, computerized diagnostic tools, and audiovisual records of patients seen in clinic. The outpatient clinical program also includes the Pediatric Genetics Outreach Clinics in Marquette, Traverse City, and Gaylord, Michigan. Eight separate clinics are held throughout the year. Genetics physicians, including residents and fellows, travel to these cities and evaluate approximately 15-35 patients over the course of one or two days.

Adult Neurogenetics

Residents rotate through Adult Neurogenetics clinic to gain experience with neurometabolic and neurologic disorders. The resident in this rotation will evaluate and manage adult neurogenetic disease such as CMT, inherited ataxias, myotonic dystrophy, Niemann-Pick disease, and muscular dystrophies.

Adult Medical Genetics

The goals of the rotation in Adult Medical Genetics are to train the resident in the diagnosis, management, and genetic counseling of individuals with adult-onset genetic disease, cancer, mental retardation and single gene disorders of the adult population. Therefore the resident is exposed to a broad group of patients spanning the age spectrum.

Within the Division of Medical Genetics in the Department of Internal Medicine, clinical genetics activities are also carried out in the Taubman clinical building. Clinic conferences for that division are held within meeting facilities at the University of Michigan Hospitals. Five rooms are available within the clinical genetics space for Internal Medicine. Adequate office and meeting room space is available for pre- and post-clinic conference discussions. In addition, there is a fully-equipped conference room in MSRB III (medical school space), a clinical genetics office suite that houses a genetic counselor office, desk space for residents and students, access to computers, FAX and copy machines and a digital video display terminal.

Cancer Genetics

Cancer Genetics clinic rotation offers outstanding training in the application of contemporary genetics to cancer syndromes and sporadic cancer genetics evaluation and counseling. A syllabus is provided at the start of the program. The University of Michigan Cancer Genetics Tumor Board offers residents the ability to review cases on a wide variety of clinical situations.

Prenatal Genetics

Residents rotate in Prenatal Genetics in the Department of Obstetrics and Gynecology in an outpatient setting but do not take inpatient consults. This experience is combined with a rotation in Teratologic Genetics and Fetal Pathology coordinated by the Division of Pediatric Genetics. The goals of this rotation are to expose the resident to the evaluation and management of in utero genetic disease and birth defects and to give the resident direct experience in fetal/newborn pathology and malformations. Within the Maternal/Fetal Medicine Division of the Department of OB/GYN, approximately 700 amniocentesis and 100 CVS procedures are performed each year. Of these, 35 abnormal cytogenetic results were obtained and genetic counseling was provided. The Fetal Diagnostic Clinic also evaluates referrals for fetal malformation and performed multiple molecular and biochemical analyses.

Within the Department of Obstetrics and Gynecology, patient care activities are performed in the Mott Children's Hospital extension branch, which is composed of numerous clinical care rooms. Patients are also evaluated in radiology facilities in the Taubman Outpatient clinical center and there is ample space for counseling and discussion of cases as well as library facilities and computers.

Laboratory Rotations

Each resident rotates in the cytogenetics, molecular, and biochemical laboratories to become familiar with performing and interpreting karyotypes, metabolic screens, and contemporary molecular genetic/diagnostic analyses.

Didactic Coursework

The Department of Human Genetics offers basic science genetics instruction through two courses, HG541 and HG542. Residents are expected to attend lectures in these courses. The curriculum covers all of contemporary molecular and population/statistical genetics. HG803 and HG804 are advanced genetics methods courses that are also available to Medical Genetics trainees.