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Clinical Rotations

Clinical Rotations and Fieldwork

Q610 Medical Genetics Clinic Practicum

 Students take this practicum twice for a total of two semesters of experience with pediatric and general genetics. Students will see a 40 or more patients with an extraordinary variety of genetic conditions. The Medical Genetics Clinic is held every Friday morning at Riley Hospital for Children. Students see one to two patients per week in this clinic as well as discuss their cases with the medical genetics faculty in pre-clinic conferences. Also during this practicum, students will see patients in the Bone Dysplasia Clinic, as well as several outreach clinics located in Bloomington, Madison, and Terre Haute.  During five weeks of the second semester of this rotation, students work with our neurogeneticist and neurogenetics counselor to focus on Neurogenetics referrals; this sub-rotation provides students the opportunity to counsel patients in the Neurogenetics Clinic, Muscular Dystrophy Clinic and Neurofibromatosis Clinic. 

The geneticists involved with the Medical Genetics and Neurogenetics clinics come from diverse backgrounds with expertise in pediatrics, obstetrics and pediatric neurology. Three genetic counselors also provide patient services and student supervision. Several times a month, students will participate with the geneticists on in-patient consultations at any of four local hospitals. These patients are presented during weekly genetics rounds. A lecture series covering many aspects of clinical skills and medical genetics issues also accompanies this clinic practicum. Students attend these one-hour lectures every Friday morning.

Q615 Prenatal Diagnosis Clinic Practicum
Students will spend five weeks in the University Hospital Prenatal Diagnosis Clinic as well as an additional five weeks at one of the following sites: Center for Prenatal Diagnosis, St. Vincent Maternal Fetal Medicine and Genetics Center, and Community Hospital Maternal Fetal Medicine. During the University Hospital rotation, students will attend a prenatal clinic with a large Hispanic population where they will participate in bilingual provision of services; participate in the evaluation of a case through the KateCares Stillbirth Assessment Program and present to materal fetal medicine specialists, residents and prenatal staff about a prenatal genetics-related topic. Students will participate in the care of an average of 50 patients during the prenatal practicum. Referral indications include advanced maternal age, abnormal maternal serum screening or cell free fetal DNA screening results, teratogenic exposures, abnormal ultrasound findings, and a variety of other issues. Students will observe prenatal procedures including amniocentesis, chorionic villus sampling, ultrasound, and others when available. Nine genetic counselors provide supervision at these four centers.

Q616 Specialty Clinics and Services Practicum
This rotation provides students with exposure to a variety of specialty clinic services and multidisciplinary clinics in cancer genetics, cardiovascular genetics and biochemical/metabolic genetics.  During this rotation, students spend five weeks in each of two cancer genetic counseling clinics from among the Indiana Familial Cancer Clinic at IU Health and three other local cancer risk assessment clinics.  Seven board-certified counselors provide supervision at these sites where students will counsel about a variety of familial cancers and genetic testing options as well as attend tumor board and other oncology meetings.  While completing their month-long Metabolism Clinic rotation, students will participate in and observe the care of individuals with PKU, galactosemia, storage disorders and other metabolic diseases in both outpatient and inpatient settings.  During the five-week cardiovascular genetics rotation, students will work with medical geneticists, cardiologists and two cardiovascular genetic counselors to provide genetic counseling and offer genetic testing to individuals and families affected by cardiomyopathies, arrhythmias, aortopathies and congenital heart defects in both adult and pediatric settings.

Q617 Genetic Counseling Clinic Practicum
During this five-week advanced rotation, students are the primary genetic counselors, responsible for all aspects of patient counseling and care. Supervision is provided by two genetic counselors and two clinical geneticists. Students will focus on refining their genetic counseling skills and further developing their competency with psychosocial assessment and counseling. Students will see approximately 10 patients with indications that may include abnormal chromosomal microarray or whole exome sequencing results, a recent diagnosis or family history of a genetic condition, consenting for whole exome sequencing, and pregnancy loss among others.

Fieldwork
Over the course of the program, students will be responsible for identifying and completing a series of fieldwork experiences designed to broaden their exposure to a variety of health care providers, educators and other individuals who are important in the lives of their patients.  Students will observe in a variety of multidisciplinary clinics staffed by developmental pediatricians, neurologists, plastic surgeons, nurses, therapists and social workers to appreciate the expertise that diverse specialists contribute to their patients’ care. These clinics include the Down Syndrome Clinic, Myelomeningocele Clinic, Developmental Pediatrics Clinic, Huntington Disease Clinic, and Assisted Reproductive Technology/Infertility Clinic among others. Through the Mother To Baby Indiana service, students will assist with taking calls from physicians and pregnant women regarding prenatal exposures, research the medications or chemicals in question, and provide a summary of this information to callers. To further their experience with non-clinical genetic counseling roles, students will meet with genetic counselors employed in a variety of industry and non-clinical settings and will have the opportunity to shadow such counselors to gain an understanding of their day-to-day responsibilities.  In addition to exploring these specialty clinics and non-clinical genetic counselor roles , students will tailor their fieldwork to their own interests by choosing from among a variety of options including attending support groups; speaking to high school, undergraduate or community groups about genetic counseling; writing articles to contribute to Perspectives in Genetic Counseling and other NSGC or other professional publications; observing in a special education class or physical, occupational or speech therapy session; shadowing an inpatient perinatal bereavement nurse; and visiting a group home, assisted living facility or vocational training organization that provides services to individuals with special needs, among other opportunities. 

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