Genetics & Genomics Curriculum Director: Katherine Hyland, PhD | [email protected]
SOM Bridges Curriculum

The UCSF Medical Genetics and Genomics curriculum is integrated throughout the Foundations 1 and Foundations 2 phases of the four year UCSF SOM Bridges Curriculum.

Here is a summary of the Genetics and Genomics content in the SOM Bridges curriculum.

YEAR 1 (F1)

Students develop a framework of foundational principles in fall of the first year, including genetic variation, Mendelian inheritance and human disease, and pharmacogenetics in the ABC (Airways, Blood and Circulation) block, and principles of genetic association and complex, multifactorial inheritance of common disease, and epigenetics in the H&I (Health and the Individual) block. In the winter/spring, the molecular genetic basis of cancer and Inborn errors of metabolism are introduced in the REGN (REGulatioN) block, and principles of clinical genetic and genomic testing and key elements of the Genetic Information Nondiscrimination Act (GINA) are discussed in H&S (Health and Society).

YEAR 2 (F1)

Clinical application of genetic and genomic tests are presented in Life Stages with Prenatal genetic screening and diagnostic tests, and cell-free DNA testing; and Pediatric genetic evaluation of intellectual disability/development delay. Neurogenetics and repeat expansion diseases are covered in the BMB (Brain, Mind, Behavior) block.

YEAR 3 (F2)

Pertinent genetics topics are Integrated with clinical core clerkship didactics, including Prenatal Genetics in OBGYN and newborn screening, inborn errors of metabolism, and applications of genetic and genomic testing in Pediatrics.

Clinical Immersive Experience (CIEx) Elective in Clinical Genetics and Genomics: Pediatrics and Cancer

In this elective, students spend one week in Pediatrics Genetics and one week in Cancer Genetics. In Pediatrics Genetics, students experience various genetics clinics (general pediatrics genetics, metabolic, craniofacial, exome/personalized genetics), sit in on the weekly exome sign out meeting and genetics case conference, and learn about next-generation sequencing technologies and interpretation of genomic sequencing results in the Genomic Medicine lab.

In the 2nd week, students experience the Cancer Genetics and Prevention Program clinics, the Clinical Genomics Lab, the Molecular Tumor Board (using the UCSF500 Cancer Gene Panel), Hereditary Cancer Tumor Board, and other case discussions.

Figure Legend

GS = Ground School
ABC = Airways, Blood & Circulation
H&I = Health & the Individual
II = Inquiry Immersion
REGN = Renal, Endocrine, GI, & Nutrition
H&S = Health & Society
PHD = Pathogens & Host Defense
LS =  Life Stages
BMB= Brain, Mind, & Behavior
DR = Diagnostic Reasoning

Faculty Advisor: Katherine Hyland, PhD
Student Leaders: An interprofessional team of student leaders rotates annually.
GGSIG Student Organization

MISSION
The genetics and genomics student interest group (GGSIG) is an interprofessional student-run organization founded to:

• Provide resources and opportunities for students to explore their interest in genetics and genomics
• Educate students about the impact of genetics and genomics on current and future clinical medicine
• Connect medical students with local experts in genetics and genomics from clinical medicine and basic science
• Provide career guidance and mentorship for students interested in pursuing careers in genetics and genomics

EVENTS are scheduled regularly throughout the school year, and are publicized through fliers, email and online communications.

UCSF Contact: Joyce So, MD PhD | [email protected]
Program Website

The ACMG Foundation for Genetic and Genomic Medicine offers this program to medical students in good standing who are between their first and second years of medical school.

Applications
The deadline for applications is mid-January.

Director: Jessica Tenney, MD | [email protected]
Program Website

The UCSF Medical Genetics & Genomics Residency program aims to provide trainees with supervised clinical experience, didactic teaching, and professionalism skills that are essential for the successful practice of medical genetics and genomics. The focus of the program is to train physicians in the diagnosis, testing, and management of patients and families with a wide range of genetic conditions. We welcome trainees from diverse backgrounds. In alignment with the mission of the sponsoring institution, the residency program promotes caring, healing, teaching and discovery in genetics and genomics. The program supports UCSF’s larger vision of advancing health worldwide, as well as in our local communities and promotes lifelong learning.

To achieve the overall mission, the UCSF medical genetics and genomics program combines broad clinical experience, didactic teaching, mentorship, and scholarly activity. The residency has also added a specific focus on genomic medicine and genetic testing in keeping with technological advances in this field. The program aims to provide:

1. Clinical experience in patient care, including the evaluation of patients with multi-system and diverse genetic conditions, the implementation and interpretation of genetic and genomic testing, and the development and application of clinical management skills based on genetic information. The patient population encountered in training includes all age groups, diverse ethnicities, and individuals who are pregnant or planning families. Health conditions in genetics training include a range of conditions that include undiagnosed diseases, intellectual disability, malformations, cancer and acutely presenting and chronic health conditions. Counseling and treatment of health conditions are important skills that are acquired and refined in training.
2. Skills for medical knowledge acquisition regarding genetic health conditions are taught through case conferences, lectures, rounds, journal clubs and didactic sessions. Scholarly activities, such as attendance at conferences, abstract presentations and publications, are strongly encouraged.
3. Practice-based learning and improvement in the context of the health system are also important. The training program emphasizes safety and improvement in practice based on feedback, technology tools, and information from the literature. Trainees also focus on quality improvement.
4. Interpersonal communication skills are emphasized through teamwork and interaction with faculty and inter-disciplinary colleagues throughout the program. Communication with patients and families is also stressed, given the diverse population and wide range of patient situations encountered.
5. The training program fosters and provides training in professionalism, particularly in relation to diverse populations. The program also provides training in ethical principals in medicine and accountability.
6. The program emphasizes systems-based practice using technology and cost-effective medicine within the context of the health system.

Director: Elena Flowers, PhD, RN | [email protected]
School of Nursing — Genomics Concentration

The Human Genome Project, an international quest to understand the genomes of humans and other organisms, is leading to unprecedented advances in science and healthcare. Individual variations in the human genome can have a major impact on risk for disease and responses to the environmental, behaviors, drugs, and other therapies.­­­

The growing momentum of genomics (the study of genes and their function) is revolutionizing our understanding of the molecular mechanisms of disease, including the complex interplay of genetic and environmental factors.

Nurses are called upon by patients and families to answer questions about genetic information, testing, and treatments. Technology is advancing so rapidly in genetics that health care delivery is already affected. For example, screening for pharmacogenetic profiles can predict if an individual is likely to benefit from a medicine and/or if they will be likely to experience serious side effects.

Given the changing nature of healthcare as a result of the human genome project and subsequent scientific advances, a number of essential genetic and genomic competencies for nurses have been established.

The special focus area on Genomics at the UC San Francisco School of Nursing provides a spectrum of content related to human genomics and clinical implications for nurses. There are 3 required courses for the focus area. Additional clinical practicum and/or laboratory experience is available on a case-by-case basis.

CURRICULUM
Students from all Master’s program specialties and the doctoral program are welcome to register for these courses. Courses must be taken in sequence and may be taken during the first or second year of the Master’s program. N294C is the only course that may be taken without pre-requisites. N294A (Fall) and N294B (Winter) meet approximately 4-5 times each quarter on Tuesday evenings from 5:30-7. The format for and is a lecture (~45 minutes), and discussion (~45 minutes). Other weeks consist of online content. N294C in Spring quarter is entirely online.

REQUIRED COURSES

• N294A, Introduction to Human Genomics (2 units, Fall)
  Genetic structure and function, patterns of inheritance, lab methods, epigenetics, human genome project, Genetic Information Non-Discrimination Act.
• N294B, Implications of Genomics for Nursing Practice (2 units, Winter)
  Genomic competencies for nurses, ethical, legal, and social issues, family history and pedigree assessment, direct to consumer testing, whole genome sequencing in research and practice, Precision Medicine Initiative.
• N294C, Clinical Genomics (1 unit, Spring)
  Clinical applications across the lifespan – prenatal testing, newborn screening, pharmacogenetics, screening, cancer, complex diseases, aging, microbiome.

OPTIONAL COURSES

• 414.27A, Genomics Clinical Practicum (1 – 3 units, Varies)
  Supervised experience using skills of genomics assessment, interventions, and/or management.
• 301.27A, Genomics Skills Lab (1 unit, Varies)
  Supervised experience in a molecular laboratory.

Discovery Group Director: Bani Tamraz, PharmD, PhD | [email protected]
PharmD Program Website

Genomics, with emphasis on pharmacogenomics, is integrated throughout the new UCSF School of Pharmacy (SOP) Curriculum.

Here is a summary of this content in the SOP Curriculum.

YEAR 1

UCSF PharmD degree curriculum is a science-based, competency based, integrated, experiential course of study that prepares our students for diverse and dynamic careers in pharmacy and beyond. The entering class in Foundations I receives a 3-hour introductory lecture to pharmacogenomics (PharmIS 110). The lecture is also associated with a 2-hour workshop (APCS 170) on applying the concepts of pharmacogenomics to practice. The curriculum includes inquiry sessions that are threaded through each of the seven themes. These sessions are evolving to engage the students in controversial areas of care or treatment and genetics is the subject of discussion in some of these sessions. The first integrated theme in year 1 is cardiology. In this theme, the students have a 2-hour debate in one of their inquiry sessions on pros and cons of pharmacogenetic testing for clopidogrel (PharmIS 111).

One of the requirements of the curriculum is participation and completion of a discovery project. The goal of the discovery project is for the student to assess open questions associated with biomedical problems and apply their training in research design to evaluate a specific question identified for this project. Pharmacogenomics is one of the seven themes in discovery. Students interested in pharmacogenomics, can further explore this science in their discovery projects. Students rank the themes in the order of their interest and assignments are made. The current pharmacogenomics group in discovery has 12 students.

YEAR 2

Students in pharmacogenomics discovery group identify a specific project and mentor in fall. These students participate in six 3-hour workshops in fall and winter blocks dedicated to pharmacogenomics theme with a focus on developing their research question and necessary skills to successfully conduct their pharmacogenomics project. Starting spring, all students have a 5-weeks block to complete a significant portion of their discovery project.

In the oncology block, students are taught key concepts regarding the molecular basis of cancer and mechanisms for oncogenesis.  This includes learning how alterations in the general structure of DNA and pathways related to DNA synthesis or repair can lead to both malignant or non-malignant genetic diseases, along with the application of clinical pharmacogenomics for selecting genetic-based drug therapy (e.g. tyrosine kinase inhibitors or monoclonal antibodies). There is a sub-content focus on examples of rare diseases that can be corrected through hematopoietic cell transplantation (HCT), gene therapy, and immunotherapy.  This includes inquiry sessions (PharmIS 118) on (1) gene therapy/HCT for correction of x-linked severe combined immunodeficiency, (2) the UCSF 500 panel for diagnosis and treatment of pediatric brain tumors (MATCH trial), and (3) CAR-T therapy for potential curelative treatment of pediatric acute lymphoblastic leukemia.

YEAR 3

Students continue working on their discovery projects and present their results in a seminar organized in spring.

In addition to the specific courses and activities mentioned related to genetics in the Curriculum, students encounter pharmacogenetics throughout their clinical courses, Introductory Pharmacy Practice Experiences (IPPEs) and Advanced Pharmacy Practice Experiences (APPEs) as appropriate. For example, during neurology/psychiatric block students learn about the importance of HLA testing prior to initiating carbamazepine or in cardiology while learning about warfarin and clopidogrel they encounter CYP2C9 and CYP2C19 effect on these drugs, respectively.

Director: Cynthia Morgan | [email protected]
Genetic Counseling Program

UCSF has established a new Genetic Counseling Program that is scheduled to admit the first cohort of 12 students September 2021.

The vision of the Genetic Counseling Program is to train genetic counselors that are able to meet the demands of the rapidly expanding field of contemporary genetic medicine and successfully practice in a wide variety of settings.

CURRICULUM

The curriculum emphasizes three primary areas:

• Foundational Didactic Education
  A rigorous academic curriculum draws upon the expertise of UCSF genetics professionals and spans subjects such as molecular and cytogenetics, bioethics, medical genetics, research methods, genomic technologies, and humanistic counseling theory.
• Clinical Training
  Rich clinical experiences illustrating the application of genomic medicine are available throughout UCSF’s diverse laboratories and genetics clinics; with additional opportunities in regional Bay Area genetics centers and biotechnology companies.
• Research
  As a premiere research institution, UCSF offers a broad spectrum of research opportunities that support the development of genetic counseling scholars and the advancement of the field of genetic counseling.