Cytogenetics Rotation

Cytogenetics Rotation Goals and Objectives

The goal of the Anatomic and Clinical Pathology Residency Program Cytogenetics rotation in the clinical genetics' laboratory is to provide the resident with an understanding of and an appreciation for the laboratory techniques and tests used in the clinical cytogenetics, clinical molecular genetics and prenatal screening laboratories. Clinical and research applications of genetic laboratory techniques and protocols are discussed, as are the limitations of these procedures. At the end of the rotation, the resident will have completed training in the following competencies and evaluation of specific components of the program:

Cytogenetics Patient Care Aspects

Residents will recognize how results from cytogenetics and molecular genetics diagnostic tests and from prenatal screening tests can be integrated with results from pathology and laboratory medicine to provide the referring physician a more comprehensive clinical picture of the patient.

Cytogenetics Medical Knowledge

  • Be familiar with PCR and other DNA-based procedures used in the molecular genetics' laboratory and their utility in a variety of clinical and research applications
  • Be familiar with routine procedures used in routine clinical cytogenetics, clinical molecular genetics and prenatal screening tests
  • Be familiar with the specialized technique of fluorescence in situ hybridization (FISH), as well as its utility in a variety of clinical and research applications

Practice-Based Learning and Improvement

  • Demonstrate an investigatory and analytical thinking approach to the delineation of chromosomal abnormalities (both constitutional and acquired); the resident should be familiar with the FISH and/or molecular techniques used in delineating a chromosome abnormality identified during a routine cytogenetic analysis
  • Utilize current scientific literature to determine the clinical significance of a chromosome abnormality (either constitutional or acquired)

Interpersonal and Communication Skills

  • Communicate to appropriate genetics laboratory staff, including interpretation, the pathology review, flow cytometry and/or immunohistochemistry results from patient samples that are found by the genetics laboratory to have an unusual cytogenetic and/or molecular genetic result

Professionalism

  • Recognize that the frequencies of a gene's disease-causing mutations can vary widely between ethnic populations
  • Recognize the ethical considerations that are inherent in providing genetic information to a patient, due to the familial nature of genetic test results

Cytogenetics System-Based Practice

  • Learn about the different types of genetic laboratories, how these differ from one another and how using different laboratories as reference laboratories will affect the quality of care and the costs of that care

Cytogenetics Rotation Duration

The rotation in Clinical Cytogenetics lasts for one month in conjunction with the rotation in Molecular Diagnostics and the Prenatal Screening Laboratory.


Duties and Responsibilities of Residents by Year

  • Attend the Center for Human Genetics weekly clinic conference
  • Attend the laboratory's weekly abnormal meeting and discuss abnormal patient results, both cytogenetic and molecular
  • Attend the weekly interdisciplinary leukemia/lymphoma malignancies tumor board conference
  • Attend biweekly cytogenetics/molecular laboratory meeting
  • Compare cytogenetic findings in cancer patients with pathology/morphology review, flow cytometry and immunohistochemistry results
  • Present a 30-minute seminar on a topic related to cytogenetics, prenatal screening or molecular diagnostics (topic to be mutually agreed upon between the teaching staff and the resident)

Cytogenetics Rotation Teaching Staff

Shulin Zhang, PhD, Rotation Director
Shashirekha Shetty, PhD
Shahla Vahabi, Manager, Molecular Diagnostic and Cytogenetics Lab


Cytogenetics Rotation Supervision and Evaluation

  • Be assessed by the laboratory genetic counselor who will report to the director on the resident's sensitivity for the ethical considerations that are inherent in providing genetic information to a patient as well as their family (using a scale of one to 10)
  • Be evaluated by the laboratory director (on a scale of one to 10) on his/her utilization of the current scientific literature in determining the clinical significance and prognosis of a chromosome abnormality identified by the cytogenetics laboratory
  • Be evaluated by the laboratory director (on a scale of one to 10) on his/her communication and interpretation of pathology review, flow cytometry and/or immunohistochemistry results from patient samples that are found to have an unusual cytogenetic and/or molecular genetic result
  • Be evaluated by the laboratory director (on a scale of one to 10) on their understanding of different types of genetic laboratories, how these differ from one another and how using different laboratories as reference laboratories will affect the quality of care and the costs of that care
  • Be evaluated on a monthly basis with regard to medical ability, work habits, educational initiative and personal attributes. Evaluations are forwarded to the residency program director, where they are available for review
  • Be reviewed by the cytogenetic and molecular diagnostic supervisors who will report to the director on the resident's understanding of laboratory test protocols, as well as both routine and specialized laboratory techniques (using a scale of one to 10)
  • Meet on a regular basis with the director of the rotation and with the lead technologists for supervision, instruction and review of cases
  • Meet with the laboratory director who will evaluate (on a scale of one to 10) the resident's proposed FISH and/or molecular approach to studying an unusual chromosome abnormality encountered in the lab; The evaluation will be based on the efficiency of the approach (time to complete) and the amount and significance of clinical information gained using this approach.
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