Training Programs

Residency in M.D. Clinical Genetics and Post-Doctoral Fellowship Programs

The Greenwood Genetic Center operates South Carolina's only Medical Genetics training program and is one of 43 accredited programs in the nation to offer training in four or more specialty areas. The Center's Postdoctoral Genetics Training Program is designed for individuals with an M.D. or Ph.D. degree seeking academic, clinical, and research careers in human and medical genetics. The programs are accredited by the Accreditation Council for Graduate Medical Education (for M.D. Clinical Genetics) and the American Board of Medical Genetics (Clinical Cytogenetics, Clinical Molecular Genetics, and Clinical Biochemical Genetics). Training programs last two to three years. Clinical, as well as research, competence is stressed with opportunities available for the trainee in all areas of genetics.

Residency in M.D. Clinical Genetics

The clinical genetics residency at the Greenwood Genetic Center is designed to provide intensive postgraduate clinical experience with heritable or potentially heritable conditions. Residents are required to have completed a primary care residency program (family practice, internal medicine, OB/GYN or pediatrics) in the United States. Clinical training includes exposure to prenatal, pediatric and adult genetics and counseling (2,500 new families per year). Specifically, the resident will see a wide range of heritable disorders, reviewing the evaluation and management of each patient with their preceptor. The student will learn principles of heredity through conferences, internal graduate courses and clinical experience. Moreover they will study the nature of genetic disorders and their impact on the individual, family, and society.

The writing of case reports and reviews, utilization of genetic literature and the preparation of lectures will be integral parts in the residency learning process. All residents are required to take a core course in Advanced Human Genetics through the Center.

While many heritable disorders have medical impact, the content and focus of the clinical residency at the Greenwood Genetic Center will be weighted toward birth defects and mental retardation. Comprehensive prenatal, pediatric and adult patient genetic evaluations are provided to the upstate region of South Carolina through offices in Greenwood and Greenville. Experience with individuals and families having mental retardation will be largely gained through patients of the South Carolina Department of Disabilities and Special Needs in statewide outreach clinics. Experience in dysmorphology will be obtained in the multiple regional and statewide outreach clinics. Additionally, the resident will have in-patient consults through Self Regional Healthcare and prenatal experience through the Greenville Maternal-Fetal Medicine Program, Greenville and Greenwood Ob/Gyn, to gain experience in prenatal and neonatal diagnostics, and the care and management of genetic disease.

The resident will also obtain laboratory and fetal pathology experience in the Anatomical Studies Section of the J. C. Self Research Institute of Human Genetics. Rotation in fetal pathology is designed to improve the residents ability to recognize and evaluate malformations and other abnormalities of human development. The student will gain practical experience in gross and microscopic study of specific fetal cases, for the purpose of diagnosis, understanding of cause and management of recurrence risk issues and counseling. Monthly Fetal Boards take place through Greenville Memorial Hospital.

After successful completion of the residency program, the physician resident should be qualified for independent clinical practice in medical genetics or an academic position in clinical genetics. The resident will be prepared to sit for the examination given by the American Board of Medical Genetics for certification as a clinical geneticist.

Lab Rotations: Residents who will pursue the two-year genetic residency tract will arrange three 3-week rotations in each of our diagnostic laboratories: molecular, biochemical and cytogenetics. The purpose of these rotations is to gain a more complete understanding of the diagnostic and research functions of these laboratories in relation to clinical practice. The student will be expected to meet specific goals and objectives for each laboratory rotation. For those residents choosing the three-year tract, the additional year can be spent as an elective in the research laboratories.

Research Elective: The J. C. Self Research Institute of Human Genetics, a division of the Greenwood Genetic Center, offers the resident an opportunity for extensive research and training on molecular and anatomical approaches to birth defects and mental retardation. Current research activities of the faculty of the Research Institute include: localization, isolation, and characterization of genes responsible for X-linked mental retardation; mutation analysis of patients with X-linked hydrocephalus, Aarskog syndrome, EDA (ectodermal dysplasia); identification and characterization of genes involved in lissencephaly, ectrodactyly and the BOR (branchial-oto-renal) syndrome; identification of candidate genes for neural tube defects and autism.

Library Access: The Center's extensive English language library holdings contain over 1,000 monographs and pertinent genetics textbooks, including rare and historical book collections in the area of birth defects. Over 60 current major Medical and Medical Genetics journals are in circulation as well as a substantial number of back volumes for another 50 titles. The library also provides a comprehensive collection of patient photos, slides, and radiographs from our clinical and research studies. A full-time librarian is on staff to assist in searches and interlibrary loans.

Didactic Teaching: Residents are required to participate in a regular set of conferences and lectures throughout the period of training. In addition, residents have the opportunity to attend other seminars and lectures given through the Center. Required conferences are:

Application Procedure: Candidates for residency are expected to have completed a primary care residency program (family practice, internal medicine, OB/GYN or pediatrics) in the United States. The candidate must also be licensed to practice medicine in the United States. Applicants must complete an application form and send this along with a letter of intent and a current curriculum vitae. Arrangements should also be made for three letters of reference to be sent.

All materials should be addressed to: Robert A. Saul, M.D., Greenwood Genetic Center, 101 Gregor Mendel Circle, Greenwood, SC 29646.

Application to the residency program should be completed by January 1st for July 1st appointment. Interviews are arranged and final decisions will be made as soon as possible. Greenwood Genetic Center is an Equal Opportunity Employer. Women and interested minorities are encouraged to apply.

Post-Doctoral Fellowship Programs

Clinical Cytogenetics

The clinical cytogenetic fellowship program allows the trainee to gain competence in performing and interpreting cytogenetic analysis relevant to the diagnosis and management of chromosome disorders. The trainee will also gain research experience by participating in on-going research projects and by conducting independent research.

The cytogenetic laboratory at the Greenwood Genetic Center processes approximately 2500 samples per year for chromosome analysis. The sample load includes about 1500 peripheral bloods, 400 amniotic fluids, 50 chorionic villus samples, 500 bone marrows, 350 solid tissues, and 1500 FISH analyses. The trainee will rotate through each of the cytogenetic laboratory sections: peripheral blood/bone marrow, prenatal diagnosis (amniotic fluid/CVS), and solid tissue.

The purpose of these laboratory rotations is to gain expertise in culturing and analyzing each specimen type and to gain experience in interpreting test results. Within each laboratory section, the trainee will perform routine G-banded analysis and will perform special staining such as C-banding, silver staining, R-banding, and Q-banding, when indicated. The trainee will also perform fluorescence in situ hybridization (FISH) and array CGH for the diagnosis of microdeletion and microduplication syndromes, the detection of aneuploidy in uncultured cells, and the identification of marker chromosomes.

During the rotations within the cytogenetic laboratory, the trainee will follow specimens from set-up to completion. This experience will allow the trainee to accumulate an adequate case load to complete the logbook required for the ABMG certification examination.

By attending weekly clinic conference, weekly laboratory conference, and monthly state-wide case review, the trainee will interact with clinical geneticists, genetic counselors and others who refer patients for cytogenetic testing. This interaction will allow discussion of pertinent clinical features corresponding with laboratory findings and will permit the opportunity for discussion of counseling issues such as long term prognosis, family studies, recurrence risks, and additional laboratory testing. In addition, the trainee is required to participate in a core course in Advanced Human Genetics by attending all lectures and by limited teaching responsibilities. An individual completing the the fellowship program will possess the skills required for certification by the ABMG, including:

The ability to supervise and direct a diagnostic cytogenetic laboratory.
The understanding of the heterogeneity, variability, and natural history of chromosome disorders.
The capacity to diagnose and interpret a wide range of cytogenetic problems.
The competence to communicate results as a consultant to other clinicians, genetic counselors, and to patients in cooperation with a clinical staff.

Clinical Molecular Genetics

Candidates with an M.D. or a Ph.D. degree in one of the basic sciences may enter this program. The molecular genetics fellowship program allows the trainee to gain competence in all molecular analyses relevant to the diagnosis of genetic disorders at the gene level. The DNA Diagnostic Laboratory handles blood, amniocytes and CVS tissue samples for molecular analysis. The trainee will gain expertise in PCR, Southern hybridization, SSCP, FISH, linkage analysis, DNA sequencing. At completion of the program, Clinical Molecular Fellows will possess the skills required for certification by the ABMG, including competence in:

The ability to supervise and direct the operations of a clinical molecular genetics diagnostic laboratory.
The ability to perform a variety of diagnostic assays.
A broad knowledge of
- basic molecular biology and genetics
- the application of recombinant DNA techniques and linkage analysis to diagnosis of genetic diseases
- the etiology, pathogenesis, clinical manifestations/management of genetic disorders.
The ability to appropriately interpret and communicate molecular diagnostic laboratory results in the capacity of a consultant to other clinicians or directly to patients in concert with other clinicians or genetic counselors.

Clinical Biochemical Genetics

The clinical biochemical genetics fellowship program will allow the trainee to gain competence to perform and interpret biochemical analyses and diagnostic techniques relevant to the diagnosis and management of human biochemical genetic diseases, and will act as a consultant regarding the laboratory diagnosis of a broad range of biochemical/metabolic conditions. An individual completing the fellowship program will possess the skills required for certification by the ABMG including:

The ability to supervise and direct the operations of a clinical biochemical genetic diagnostic laboratory.
A broad knowledge of
- basic biochemistry and biology
- the application of biochemical techniques to the diagnosis and management of genetic biochemical/metabolic diseases
- the etiology, pathogenesis, clinical manifestations, and management of human inherited biochemical conditions.
The ability to appropriately interpret and communicate biochemical laboratory results as a consultant to other clinicians, genetic counselors, or directly to patients in cooperation with a clinical staff.