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What Kind of Training Does the ABMGG LGG Fellowship Program Provide? A Typical Training Structure of the ABMGG LGG Fellowship Program

What kind of training the LGG fellow get? What is typical training structure of the training program? What can be expected from this LGG fellowship program?



The ABMGG-accredited Laboratory Genetics and Genomics (LGG) fellowship isn't just a standardized two-year program; it's a transformative journey into the exciting world of clinical genetics. While the core curriculum provides a solid foundation, the specific training format can vary depending on the program, institution, and the passionate program director who designed it.


 Let's delve into the exciting possibilities that await you: 


Core Genetics Laboratory Training of Molecular Genetics and Cytogenetics:


Despite standardized two-year training programs accredited by ACGME, the format varies depending on the institution and program director. Typically, fellows undergo one year of molecular training and one year of cytogenetics training. For molecular training, most of programs provide at least two big technologies, one with non-sequencing technology such as triplet primed PCR, MLPA, methylation PCR, allele specific PCR, PCR fragment analysis, quantitative PCR, Taqman probe assay genotyping and sequencing technology (Sanger Sequencing and Next-Generation Sequencing).


Since molecular cytogenetic technology (SNP microarray or Chromosomal microarray (CMA)) has been developed and implemented in the clinical lab for the genetic testing purpose, it could be part of either molecular training or cytogenetic testing depends on which lab performed the array testing. For cytogenetic training, most of program provides chromosome analysis (karyotyping), FISH analysis.



Various Training Structure: Program Requirements and Focus


As it was mentioned before, program structure can vary. Beyond the logbook, some programs may have its own requirement to complete the fellowship. Also, some programs emphasize technical skills and most of time you will spend time for the benchwork, while others focus on analysis and interpretation rather than technical skills. Therefore, you should communicate with your program director regarding the training program, milestone, requirement, expectation, etc.



Example of Training Curriculum:


For an insight into a training curriculum, the Baylor College of Medicine shares its program structure openly on its website, offering a valuable reference point for prospective trainees.



Also, University of Washington LGG felloship program shares it program rotation block diagram and typical weekly schedule.




Beyond the Core Genetics Lab Training: Expanding Your Horizons with Non-Specialty Rotations


Some programs offer a strictly lab-based curriculum, but many incorporate rotational experiences to broaden your skillset and expose you to different aspects of clinical genetics. Even though non-specialty rotation is a critical for your future work, some of them are mandatory for some fellowship requirement. Especially, Genetic Clinic and Prenatal Clinic participation is required for the program graduation.


Also, molecular pathology lab rotation or cytogenetic testing for oncology/hematology neoplastic disorders are required for the log book completion. However, some of institution does not have on-site genetics clinic, prenatal clinic, molecular pathology lab or biochemical genetics lab and in this case, the trainees can take outside rotation from other medical institution or lab.


Imagine spending 2 weeks to a month rotating through stimulating areas like:


  • Genetics Clinic Rotation: Witness firsthand how genetic testing translates into real-world patient care in a dynamic clinical setting.

  • Biochemical Genetics Lab Rotation: Deepen your understanding of how biochemical markers work hand-in-hand with genetic testing for a more comprehensive clinical picture.

  • Molecular Pathology Lab Rotation: Explore the exciting world of molecular testing within the context of pathology workflows, gaining valuable insights into integrated diagnostics.

  • Prenatal Clinic Rotation: Immerse yourself in the world of prenatal diagnosis and counseling, learning about the crucial role of genetic testing in ensuring healthy pregnancies.

  • Cancer Genetics Rotation: Gain valuable knowledge about the use of genetic testing in cancer diagnosis and treatment, a rapidly evolving field at the forefront of personalized medicine.


Sharpening Your Theoretical Edge: Didactic Courses and Lectures


The majority of programs provide comprehensive didactic courses to solidify your theoretical knowledge base. Most of program offers didactic courses like:


  • Human Genetics: Learn about the scientific fundamentals of human genetics and biochemical and molecular mechanism.

  • Clinical Genetics: Explore the various type of genetic diseases, disease mechanism and treatment options.

  • Genetics Laboratory Science for Genetic Counseling: Designed for genetic counseling students who need to understand the technical aspects of genetic testing and interpret the genetic testing result and deliver it to clinicians or patients.



Essential Communication and Lab Management: Presentation Skills and Lab QC/QA/QI Skills 


The majority of programs provide multiple presentation opportunities such as grand rounds or tumor boards, provide valuable experiences to improve communication/presentation skills. Teaching fellow trainees, residents, or medical students further develops your ability to convey complex information effectively. Also, lab management is a critical part of the fellowship program. An understanding of laboratory management and quality assurance (QA/QC) is vital for future lab directors. Many programs offer CAP inspection experiences, allowing fellows to engage in QA/QC-related activities and prepare for leadership roles.



Building Your Competitive Edge: Research Opportunities


While dedicated research time may not be formally included, there are ways to get involved and showcase your research prowess:


  • Research on Your Time: Consider pursuing research projects outside of regular training hours. This could involve collaborating on new test assay development, writing compelling case reports, participating in quality improvement projects, or developing valuable lab SOPs/manuals.

  • Presentations and Publications: Having at least two research projects under your belt strengthens your job application and allows you to present your findings at prestigious national conferences like ACMG or ASHG, boosting your boosting your profile and demonstrating your passion for scientific discovery. Publishing your research in peer-reviewed journals further enhances your credibility and establishes you as an emerging expert in the field.



Taking Ownership of Your Learning: Beyond Program Requirements


Regardless of the program structure, you have the power to take an active role in your learning and future-proof your career. Here's how:


  • Think Like a Future Lab Director: Consider your long-term goals. If you aspire to be an independent clinical lab geneticist, actively sharpening your case analysis and interpretation skills. Imagine yourself analyzing real clinical cases, putting yourself in the director's shoes, and making pre-decisions about analyzing results, interpreting data, and reporting findings to clinicians and patients.

  • Practice Makes Perfect: Even if your program doesn't heavily emphasize case interpretation, find ways to get practice before graduation. Seek opportunities to analyze cases, make pre-decisions, and compare your approach to the lab director's. Embrace constructive feedback and use it as a springboard for continuous improvement.

  • Embrace the Challenge: Don't shy away from rare and complex cases. Working through these challenging scenarios will enhance your problem-solving abilities and prepare you for the diverse situations you might encounter in your future career.


Aim High Whatever You Expect From LGG Fellowship


Beginning the ABMGG LGG fellowship marks the start of a transformative journey that offers unparalleled opportunities for growth and specialization in the field of clinical genetics. As you navigate through the program, remember to seize every opportunity to enhance your skills, broaden your knowledge base, and contribute to scientific discovery and patient care. By actively engaging in rotations, taking ownership of your learning, and pursuing research opportunities, you'll emerge from the fellowship with a competitive edge and the confidence to excel as a clinical lab geneticist.


Also, proactively participated in research work, refining presentation and teaching skills, and gaining management and QA/QC training, you can maximize your training experience and pave the way for a successful career in medical genetics. So, fully immerse yourself in the journey, dive deep into the world of clinical genetics, and let your passion for the field drive your success.

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