The logbook is a critical component of the Laboratory Genetics and Genomics (LGG) fellowship program. It serves as a record of your practical training, helping ensure that you meet the required competencies and gain exposure to a variety of cases, technologies, and methods. This seemingly daunting process is crucial for achieving board certification through the American Board of Medical Genetics and Genomics (ABMGG).
One of the most hardest thing but most critical thing you need to complete during the LGG fellowship program is the logbook. Completing the logbook effectively is crucial not only for program compliance but also for your board qualification and your professional development as a clinical geneticist. Here’s a guide on how to approach this task efficiently:
1. Understand the Requirements
Before you start filling out your logbook, familiarize yourself with the specific guidelines provided by the American Board of Medical Genetics and Genomics (ABMGG). This will give you a clear idea of what needs to be documented, including:
Number of cases to be logged for each testing methodology (e.g., karyotyping, FISH, microarray, NGS)
Range of testing category to cover (e.g., prenatal, oncology, diagnostic, carrier)
Your roles in each case (e.g., observation, analysis, interpretation, sign-out)
Make sure to have this checklist handy so you can plan how to meet each requirement throughout your fellowship. Please checkout the logbook requirement from the following website:
**New update in 2025 logbook requirement: Compared to 2023 logbook requirements, now it is recommended at least one WGS analysis and 5 WES analyses.
2. Start Early and Stay Consistent
One common mistake fellows make is delaying logbook completion until later stages of the fellowship. Avoid this by starting early and logging cases as you go. Each time you complete a significant case or activity, take a few minutes to update your logbook. Consistency is key to preventing backlog, which can make it harder to recall details accurately.
3. Know the Required Minimum and Maximum Number of Cases
For each category in the logbook, there are minimum and maximum case numbers to keep in mind. For example, certain categories may specify that you need to log "at least XX cases" but "no more than XX cases."
If a category doesn't have a minimum case number listed, this means it’s acceptable to log zero cases in that category without affecting your overall completion.
This flexibility can help when your exposure to certain types of cases, such as rare conditions or specific technologies, may be limited in your lab setting.
4. Use the 90% Rule for Case Involvement
A common challenge in logbook completion is collecting the minimum number of cases while being involved in at least three roles (e.g., observation, analysis, interpretation). However, the ABMGG logbook requirement allows some flexibility through the 90% rule. According to this rule, only 90% of the total required cases (typically 180) must involve at least three roles, but up to 10% (20 cases) can involve only one or two roles.
For example, if your lab does not perform many prenatal cases or does not offer cfDNA testing, you could attend prenatal clinic sessions to work with clinicians. By reviewing test results and participating in clinic discussions, you can log these cases even if you’re not involved in all three roles. This flexibility ensures that you can still meet the prenatal case requirement despite limited lab exposure.
5. Pay Attention to Check Minimum Case Numbers for Both Category and Methodology
It can be complicated to meet the minimum case requirements across both testing categories (e.g., prenatal, postnatal, oncology) and testing methodologies (e.g., karyotyping, FISH, microarray, NGS), especially in cytogenetics. To simplify this process, it’s helpful to create a table where testing categories are listed in rows and testing methodologies are listed in columns like below.
As you log each case, enter it into the appropriate number in the table. This will help you track your progress and quickly determine which areas need more attention.
6. Keep Two Logbooks
One strategy that many fellows find helpful is maintaining two logbooks:
Master Logbook: This is where you document every case you’ve worked on, regardless of testing category, methodology, or your level of involvement. You can be as comprehensive as you like here, logging every exposure.
Selective Logbook: This logbook is more focused and includes only the cases that meet the official logbook requirements. This logbook will be reviewed by your program director or Clinical Competency Committee (CCC) for approval.
Even if you think you’ve completed the logbook, your program director might ask you to replace some cases. If you maintain a comprehensive master logbook, it will be easier to swap cases and ensure you meet all the requirements.
7. Detail Each Case Thoroughly
For each case you log, make sure to include:
Type of case: The type of genetic test performed (e.g., prenatal, oncology, diagnostic, carrier).
Clinical Diagnosis: Briefly note clinical diagnosis (disease name).
Methods used: Specify the laboratory methods, tools, or assays involved in the analysis (e.g., chromosomal analysis, FISH, NGS).
Your role: Clearly mark your role (bench work, analysis, or interpretation).
Test result with nomenclature: Record test result with appropriate nomenclature (ISCN or HGVS nomenclature system).
Sign-out director: Date and sign-out director.
8. Review Progress Regularly
Periodically review your logbook with your program director or mentor. (Annual review is good and additional review in 3 months before the final submission would be appropriate) This will ensure you’re on track and meeting the fellowship’s educational goals. They can provide feedback on whether your documented cases meet the standards and suggest areas for improvement if needed. Also, make sure to give enough time ahead to your program director for reviewing your logbook.
9. Prepare for Final Submission
In the final stages of your fellowship, ensure that your logbook is complete and meets all program and ABMGG requirements. Some programs require specific sign-offs from supervisors, so make sure you leave enough time to obtain these signatures.
Conclusion
Completing the LGG fellowship logbook is essential for your certification and professional growth. By starting early, staying organized, and using strategies like the 90% rule and keeping two logbooks, you can efficiently meet the program requirements. Remember, your logbook is not just a documentation requirement; it’s a valuable resource that reflects your breadth of experience and will be an asset as you advance in your genetics career.
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