A major challenge raised by the Human Genome Project is how to translate its extraordinary information content into health benefits. An impediment to achieving this goal relates to the shortage of physicians who are well trained in both medicine and genetics. The BWH Combined Residency in Genetics, a component of the BWH Internal Medicine Residency Program, aims to address this problem by training carefully selected BWH Internal Medicine Housestaff in both Internal Medicine and Medical Genetics. The primary goal of these two Programs is to train physicians and physician-scientists who will become leaders in Genomics, and who will help catalyze the introduction of genetics into the care of adult patients.
We believe that the integration of genetics and genomics into contemporary Internal Medicine training requires faculty with a broad range of clinical expertise who can precept and mentor residents in ambulatory settings where patients with genetically-based diseases can be evaluated and managed. In addition to ambulatory experiences, there are also opportunities for inpatient genetics consultation at BWH, MGH and Children’s Hospital. There are also clinical laboratory experiences across the range of diagnostic technologies in cytogenetics, biochemical genetics and molecular genetics.
While the Internal Medicine portion of the program is centered at BWH, the Medical Genetics training component takes advantage of the tremendous clinical expertise in genetics that is located throughout the Mass General Brigham System and the Harvard-affiliated Hospitals. The key feature of this combined residency program is the integration of genetics training into the Internal Medicine Residency starting in PGY2. Other key features are the emphasis on genetic diseases of direct interest to internists, and flexibility during the last two years so that residents may pursue additional electives or post-doctoral research in the genetic basis of disease.
During PGY2 and 3, residents pursue alternating 3 month blocks of Internal Medicine and Genetic Medicine rotations. Candidates in this program can choose from research mentors who span a very wide spectrum of research endeavors. This Program’s flexibility will allow candidates to use PGY4 and PGY5 to tailor their training toward careers which include clinical research, basic research, or translational research. At the end of the five-year training program, residents are active candidates for certification examinations in both Internal Medicine (ABIM) and Medical Genetics (ABMG), and will in most circumstances have completed a year or more of post-doctoral research training.
The overall program structure is summarized below:
12 months of categorical Internal Medicine rotations
6 months of Medical Genetics rotations; 6 months of Internal Medicine rotations; 10 months of Advanced Human Genetics course; Longitudinal Genetics Clinic begins, continues through PGY5.
6 months of Medical Genetics rotations; 6 months of Internal Medicine rotations
Clinical electives in Internal Medicine or Medical Genetics and Research
Clinical electives in Internal Medicine or Medical Genetics and Research
Numerous research opportunities are available to trainees during PGY4 and 5 of the Genetic Medicine Residency Program. We seek to promote rigorous investigation into the genetic basis of human disease, broadly defined. For those who elect basic research, a variety of world-class laboratories exist at Harvard Medical School and the Harvard-affiliated Hospitals. Program faculty will mentor residents and help direct them to the most appropriate laboratory.
For clinically oriented research projects that involve human studies or genetic epidemiology, patient cohorts may be identified during Genetics blocks in PGY2 and 3 that become the substrate for focused investigations during PGY4 or 5. Trainees may elect to pursue their research training with mentors who have served as their clinic preceptors during PGY2 and 3.
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