Pediatric Genetics

Goals and Objectives for Training

The primary objective is to train a physician in medical genetics so that he/she can function independently as a subspecialist in this field. At the end of the training the resident trainee should have acquired enough training, expertise, and experience to pursue an academic or clinical career. Two basic necessities emphasized for this training program are clinical care and research. Each of these components is given equal importance during the two years of training.

Clinical
Outpatient and inpatient care is an integral part of medical genetics training. In both years 1 and 2, the resident will be assigned to six months of inpatient and outpatient pediatric medical genetics primarily based at Children's Wisconsin. There will also be a 2-month rotation that includes Prenatal, Fetal Concerns, and Adult Cancer Genetics. Residents will present the patients after they have made their own independent assessment and developed a plan of action. Residents will also be responsible to present their patients at the weekly patient care conference.

Research – Clinical or Laboratory
The resident’s research experience begins in the first year and continues to progress in a meaningful way. Residents will learn how to select a research project and a mentor. A Research Methods Workshop is offered and those interested in clinical research are encouraged to take the course. Residents will meet biannually with the oversight committee to review the progress of their research project. Residents will spend six months in the laboratory of their choosing during the second year of their medical genetics residency.

Weekly Conferences

• Small group discussions with faculty, fellows, residents and students
• Patient care conferences with multidisciplinary teams
• Clinical Case Conference
• Metabolic Staffing

Monthly Conferences

• NF/RASopathy Staffing and Radiology Rounds
• Genetics Radiology Rounds
• Lab Case Conference
• Maternal Fetal Medicine
• Neurooncology
• Tumor Board
• Joint Fellows Curriculum
• Journal Club

Evaluations

Residents
In addition to self-evaluations, performance is evaluated after each learning experience by the Program Director as well as other members of the medical genetics section. Twice annually a summary evaluation is conducted based upon compiled data received from faculty and staff evaluations.

Program
Residents meet annually and participate in a confidential group interview where strengths of program as well as areas for improvement are gathered and disseminated to the Program Director.

During the regular daytime hours, residents are notified of each request for consult. The resident is the first to respond to the consult.

On call genetic faculty call residents during the off-hours anytime there is a consult for a rare condition or if it has significant educational value for other reasons.

Goals and Objectives of Rotations:

1. To see at least 100 patients annually.
2. To be exposed to the greatest possible variety of genetic disorders.
3. To have the opportunity to appreciate the phenotypic variability of these disorders.
4. To gain competency for diagnosing genetic diseases, including the recognition of the physical features, clinical variability and natural history, all of which will help to formulate a differential diagnosis.
5. To understand the benefits and limitations of diagnostic tests; indications for ordering the tests and interpretation of test results.
6. To gain competency to understand management choices for the patients, including medical as well as ethical and psychosocial considerations.
7. To develop counseling skills allowing them to interact with the family and provide genetic counseling in a sensitive, individualized, professional manner.
8. To be comfortable communicating the impressions and recommendations from patient evaluations to other health professionals.

The residents are assigned a 2-month rotation encompassing the following clinical diagnostic genetic laboratories:

1. Cytogenetics Laboratory
2. Molecular Genetics Laboratory
3. Biochemical Genetics Laboratory

Sequencing and Bioinformatics

Introduction to laboratory technique, bioinformatic resources, databases and molecular clinical tools needed for research rotation.

Goals and Education Objectives

1. To understand the diagnostic techniques used at the laboratory.
2. To learn the advantages and limitations of each test.
3. To learn what specimens are used for each test.
4. To interpret the clinical significance of the test results, the need for further testing to clarify any ambiguity or further define an abnormality.

Note: The objective is NOT to be proficient in performing the tests.

Each resident will be involved in a clinical or bench research project resulting in some form of peer review project ( i.e. meeting poster, abstract or case report). The chosen project has to have a realistic chance to produce publishable results before the completion of residency.

Goals and Educational Objectives

1. To learn research methodology.
2. To learn an approach to a clinical research study.
3. To learn about Informed Consent and IRB approval process.
4. To learn how to evaluate the results, including the utilization of statistical methods.
5. To experience writing and the submission of an abstract to a national meeting.
6. To experience writing and submitting a manuscript.

Immediately upon entering the program, the resident will be expected to complete a short self-study online module that will allow them to learn or review basic biology, Mendelian genetics, and molecular genetics. This will ensure that the resident possesses sufficient background knowledge to be successful in the "Translational Genetics" course that the resident will complete during the fall semester. This course will provide an overview of clinical genetics, current genetics technologies available in research and clinical practice, and will encourage the resident, through a course-long final project, to work to utilize new technologies in developing new tests and therapies.

The second semester "Clinical Genetics" course will be entirely based on patient care and will focus on practical, psychosocial, and ethical issues in the field of clinical genetics. This course will be given in alternate years so it will be completed during the second semester of either their first or second year.

Educational Objectives

1. To acquire the basic science knowledge in all areas of genetics and learn to apply it to specific clinical situations.
2. To be exposed to presentations given by local and nationally known scientists; to gain the most current scientific information; to learn how to/not to structure a presentation; to establish professional contacts with nationally known scientists for possible future scientific collaboration.

Metabolic Clinic/PKU

• to recognize the symptoms of inherited metabolic disorders (IMD) and PKU in medical emergency situations
• to know what screening/testing a PCP should order for IMD patients in emergency situations
• to interpret results of biochemical and metabolic testing

Prenatal Diagnosis Clinic

• to learn the differential diagnosis of abnormalities detected by prenatal ultrasound
• to understand the implications of maternal serum screening tests results and indications for further testing
• to learn what prenatal techniques and at what gestational age are appropriate to address the parents' concerns
• to be able to accept and support all parental decisions regarding the management of an abnormal fetus

Cancer and Adult Genetic Clinic

• to understand the hereditary bases of familial cancers and adult genetic, cardiac and endocrine disorders
• to learn the clinical variability of cancer syndromes
• to gain the current knowledge regarding diagnostic and pre-symptomatic molecular testing in hereditary cancer families, including the psychosocial considerations
• to understand the indications, benefits and potential harm of testing

Hemophilia Clinic

• to learn the genetic mechanisms involved in bleeding disorders
• to understand the burden of these disorders, the natural histories and treatment modalities
• to be able to provide genetic counseling and order carrier testing

Neurofibromatosis/RASopathy:

• approved Children’s Tumor Foundation Center clinic
• to learn the current diagnostic criteria for NF and TSC
• to understand the natural history and indications for available interventions
• to know the status of molecular testing for these conditions

Muscular Dystrophy Clinic

• to recognize the phenotypes of the hereditary neuromuscular disorders
• to understand the genetic bases of these disorders
• to become familiar with the available molecular and other diagnostic and carrier testing

Cleft Palate Clinic

• to differentiate isolated facial cleft from syndromes associates with clefts

Sickle Cell Clinic

• to learn the phenotypes and genetic bases of hemoglobinopathies

Velocardiofacial Clinic

• to learn the spectrum of concerns for this disorder

Cystic Fibrosis Clinic

• to learn about the burden of the disorder and prevention of complications and treatment modalities

Learn More

The Medical Genetics & Genomics Fellowship Program has many strengths it offers trainees. One major strength afforded to fellows in this program is the independence and autonomy fostered in its trainees’ practice. While supervision is always available and accessible, the faculty and staff support you as you develop an efficient and effective personal workflow.

A typical day on your pediatric genetics rotation is divided between fascinating pediatric and adult inpatient consults, managing your scheduled outpatient clinic patients, and organizing and responding to abnormal newborn screen results.  You are immediately integrated into the department and attend all department meetings and case conferences, including a weekly fetal concerns multidisciplinary meeting and regular conferences with the Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine.  There is a strong emphasis on scholarly work and research and opportunities are boundless.  I was impressed by the faculty support to participate in and take advantage of initiatives and continuing education within Children’s Wisconsin-Milwaukee Hospital and the Medical College of Wisconsin community at large.

-Emily Slutsky, MD, MS 

Meet Our Faculty

About the Medical College of Wisconsin

With a history dating back to 1893, the Medical College of Wisconsin is dedicated to leadership and excellence in education, patient care, research and community engagement. More than 1,400 students are enrolled in MCW’s medical school and graduate school programs in Milwaukee, Green Bay and Central Wisconsin. MCW’s School of Pharmacy opened in 2017. A major national research center, MCW is the largest research institution in the Milwaukee metro area and second largest in Wisconsin. In the last ten years, faculty received more than $1.5 billion in external support for research, teaching, training and related purposes. This total includes highly competitive research and training awards from the National Institutes of Health (NIH). Annually, MCW faculty direct or collaborate on more than 3,100 research studies, including clinical trials. Additionally, more than 1,600 physicians provide care in virtually every specialty of medicine for more than 4.0 million patients annually.

About Children’s Wisconsin

Children’s Wisconsin is the region’s only independent health care system dedicated solely to the health and well-being of children. The hospital, with locations in Milwaukee and Neenah, Wisconsin, is recognized as one of the leading pediatric health care centers in the United States. It is ranked in nine specialty areas in U.S. News & World Report’s 2019-20 Best Children’s Hospitals report. Children’s provides primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. In 2019, Children’s invested more than $130 million in the community to improve the health status of children through medical care, advocacy, education and pediatric medical research. Children’s achieves its mission in part through donations from individuals, corporations and foundations and is proud to be a member of Children’s Miracle Network Hospitals.

At MCW and within the Department of Pediatrics, we have several programs and resources focused on fostering a diverse and inclusive environment. Our departmental and institutional focus is confronting negative perceptions and welcoming our community. Below is just a sampling of the efforts across our institutions to embed the principles of diversity and inclusion into our culture.

• DOP Diversity, Equity and Inclusion Council | Our Diversity Council, led by Dr. Mike Levas, the DOP Vice Chair for Diversity and Inclusion, and comprised of faculty, staff, administration, and trainees, is focused on connecting with partners across our system and within the community to ensure the DOP is a diverse, equitable and inclusive employer.
• DOP Fellowship and Residency Diversity and Inclusion Committees | In a city filled with its own diversity and rich cultural history, our fellows and residents recognize the importance of addressing diversity, health equity, and inclusion within our programs. As such, the program is proud to recognize the presence and work of its Committee for Diversity, Equity, and Inclusion.
• DOP Unconscious Bias Training | The AAMC has partnered with Cook Ross, Inc., a leading consulting firm, to create training focused on the science behind unconscious bias to help academic medical staff and faculty mitigate disparities. Seven members of our team have earned a certification as unconscious bias trainers through Cook Ross. These trainers have translated what they’ve learned into a two-hour training for our faculty and staff. By learning how to identify and confront unconscious bias, it is possible to mitigate the impact and promote respect for all groups.
• Trauma-Informed Workplace Training | This committee has undertaken actions including a department-wide survey and the creation of four online training modules sharing the principles of trauma-informed approach and how to recognize signs and symptoms of trauma in ourselves and others. This group started as part of Fostering Futures, a state-wide initiative aimed at infusing a trauma-informed approach into all the systems and organizations that touch the lives of Wisconsin citizens with the goal of expanding across the state to make Wisconsin the first trauma-informed state in the nation.
• Office of Diversity and Inclusion | Established in March 2016, the MCW Office of Diversity and Inclusion (ODI) partners within MCW and with community partners to foster and drive inclusion excellence as an effective, empowering enabler of MCW mission and strategic goals.
• Spring Festival of Cultures | The annual Spring Festival of Cultures encourages an increased awareness and celebration of the visible and non-visible identities among our MCW community. This three-day event is an opportunity to promote the fostering of diversity, inclusion and unity at MCW.
• President’s Diversity and Inclusion Award | MCW’s President's Diversity and Inclusion Award recognizes the accomplishments of faculty, staff, students, residents, trainees, and community members in contributing to diversity and inclusion through exemplary leadership.
• Institute of Health and Equity | The Institute for Health & Equity is focused on researching the root causes of health disparities in our communities, and advancing the best ideas to foster health equity throughout the world. We target populations with abnormally high rates of disease and injury – urban and rural alike – and then we find out why. Partnering with community health collaborators who live and work closest to the most vulnerable populations, we are making an impact on reducing those disparities, one community at a time.
• GMF-MCW Partnership | Through their overall partnership, MCW and GMF will bring complementary expertise on a range of strategies to invest in the health, equity and economic well-being of people across Milwaukee, beginning with the neighborhoods adjacent to the new development. Guided by community priorities and data, the GMF-MCW Partnership will be a catalyst for additional investment and community impact. Together, the partners will:
  • Engage resident and community partnerships
  • Improve social determinants of health
  • Catalyze change that leverages resources and investment

Learn about MCW's Office of Diversity and Inclusion

“Children’s Wisconsin gets the most diverse and complex cases from over the state allowing for broad patient exposure during training.”

-Gabrielle Geddes, a graduated fellow

“Medical Genetics at Children’s Wisconsin provides excellent learning opportunities for complex and rare genetic clinical cases. Great training with experienced and dedicated team of genetics counselors and geneticists.”

-Randeep Brar

Milwaukee is one of the Midwest’s best-kept secrets and a prime location for the Medical College of Wisconsin’s main campus. A one-of-a-kind city with a vibrant and diverse culture, this charming, yet metropolitan must-see is just 90 minutes north of Chicago and nestled on the coast of Lake Michigan. Whether you’re catching a show at Summerfest, the world’s largest music festival, immersing yourself in the old world charm of the Historic Third Ward or taking in the sights and sounds of one of the many cafés, beer gardens or restaurants that line the city’s riverbank and shoreline, Milwaukee never disappoints. Find out why MCW students, faculty and employees take pride in calling Milwaukee home.

Learn about housing and rental options.

More about Milwaukee

Our 3-year fellowship program is ACGME accredited and begins on July 1 each year. We accept one fellow every other year through the National Resident Matching Program (NRMP). Applicants must have completed a US-accredited residency program. Applications from prospective applicants are accepted from July through October via the Electronic Residency Application Service (ERAS). We will access your application and contact you to make interview arrangements.

Complete applications should include the following:

• ERAS application form
• At least 3 letters of reference including Program Director letter
• Medical Student Performance Evaluation/Dean's Letter
• Curriculum Vitae
• Personal statement
• MD Applicants: USMLE scores - Steps 1, 2, and 3 or
• DO Applicants: COMLEX scores – Levels 1, 2 and 3
• ECFMG certificate for foreign medical school graduates (see visa information below)

Our program currently accepts the following visas:

• Permanent Resident Visa
• Visitor Exchange Visa sponsored by ECFMG (J-1)
• Temporary Professional Workers (H-1B)

For additional visa information please visit MCW’s office of Graduate Medical Education.

Apply on ERAS