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Vocational Training
Clinical
Genetics (Australia) (cont.)
Components
of Training (cont.)
Subspecialty/Non
Core Training
Trainees intending to subspecialise in areas such as
cancer genetics, genetic metabolic medicine or
neurogenetics should spend at least a year training in core general clinical
genetics and at least 2 years in the subspecialty area, which may include 6 months
of relevant elective training in a related discipline.
New guidelines commencing 2008
Trainees intending to subspecialise should spend at least a year training in
core general clinical genetics and at least 2 years in the subspecialty area,which
may include 6 months of relevant elective training in a related discipline (see
below). There are specific guidelines for training in cancer genetics and genetic
metabolic medicine. A minimum of 6 months of general clinical genetics is required
in genetic metabolic medicine; this is the only field in which less than 12 months
of core clinical genetics is acceptable.
Up to 6 months
of advanced training may be spent in a related field, other than clinical genetics
or subspeciality genetics. This could include up to 6 months of full time research
or clinical training. Appropriate fields of clinical training may include, but
are not restricted to, neurology, developmental paediatrics and endocrinology.
Trainees wishing to do an elective period in a field other than genetics must
obtain prospective approval from the SAC. Approval would not be automatic even
for training in the areas listed above - the specifics of the 6 month period
would be important and it is possible that some neurology rotations (for example)
would not be suitable. This means that it is important to discuss plans to do
an elective term with the Coordinator of Advanced Training well in advance of
the proposed start date.
Clinical Cancer Genetics
Two years of prospectively
approved supervised advanced training in cancer genetics' will be accredited by
the SAC if undertaken:- in a centre with access to a clinical genetics'
service;
- with continuing involvement in a clinical genetics training
program;
- with joint supervision by a clinical geneticist.
A
detailed curriculum for cancer genetics' training is available from the Training
Section of the College office in Australia.
 Subspecialty training requirements in Clinical Cancer Genetics
Project or Case Reports
From January 2005 all Clinical Genetics trainees have to comply with a word
limit of between 1500 - 2000 words for each case report, not including references.
This does NOT apply if the trainee is submitting a publication (either already
accepted/published
or submitted to a journal) with appended counselling discussion.
- Five
per year in each of the 3 years (3 copies of each case report must be submitted
to the College
by 15 September).
- At
least 5 case reports must be submitted before the end of the first year of training
in order to progress to the second year. At least 10 case reports must be submitted,
and at least 5 of these passed as satisfactory, before the end of the second
year in order to progress to the third year.
- If fewer than 5 cases have been
received by the end of the first year, but there are specific circumstances
which have made it difficult for the trainee to comply
with this requirement, an extension until February 28th of the following year
may be granted, at the discretion of the Coordinator of Advanced Training.
If this deadline is not met, the Application to Commence or Continue Training
for
that year will not be considered. The Trainee would then have until 31st August
to submit the cases in order for the second half of the year to be considered
for approval. The same deadlines apply for trainees who have not submitted
10 cases or had 5 approved by the end of the second year.
- Trainees whose first
6 months of training are in research positions may apply to the Coordinator
of Advanced Training for a variation of this rule for their
first year (usually a reduction of the requirement to 3 cases by the end
of the first year), although the requirements for the second year will remain
the same.
Submission of case reports
is intended to show trainees' accumulation of experience in the complete
management of families, so they should contain more than reports of new
research, posters
or grant applications.
- Publications may be submitted as case reports:
trainee should be first author. Counselling issues' section should be appended
to publications submitted as case reports. No more than 2 publications per year
should be submitted as case reports where it is not possible to include counselling
issues (e.g. review articles).
- The total of 15 case reports over the
3 years should include at least 2 dealing with clinical problems in each of these
areas:
- Cytogenetics
- Dysmorphology/clinical diagnosis
-
Molecular genetic testing/clinical correlation
- Biochemical genetics
-
Prenatal diagnosis
- Mendelian genetic problems, e.g. cystic fibrosis,
Huntington disease myotonic dystrophy
- Headings should include:
-
Summary
- Referral details
- Clinical section including:
-
History
- Pedigree
- Clinical examination
- Investigations
-
Discussion
- Differential diagnosis
- Literature review
-
Counselling issues: should not just address diagnostic problems or recurrence
risk. Topics should include:
- Reasons for seeking assessment
-
Dilemmas faced by consult
- Emotions: fear, grieving, guilt, anger,
psychological defence mechanisms
Consultant's understanding of discussion
of testing, penetrance/occurrence risk, recurrence risk, natural history, variability,
prenatal and/or diagnostic testing - Benefits/limitations of testing,
uncertainty
- Offer of plans for counselling to relatives at risk
-
Outcome
- Follow-up: management
- Bibliography/reference
list
- Examples of representative reports will be provided on request.
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