Duke University Hospital Program

The Duke Laboratory Genetics and Genomics Fellowship program is designed to equip postdoctoral fellows who hold either a PhD or an MD with expansive training experiences in the fields of cytogenetics and molecular diagnostics. This dual laboratory-based approach merges both disciplines in a shared space within the Duke Hospital campus, guided by faculty members who are board certified by the American Board of Medical Genetics and Genomics (ABMGG) in cytogenetics and molecular genetics. The fellowship emphasizes an integrated learning approach, combining constitutional/germline testing, hematologic malignancy testing, and solid tumor testing, thereby providing fellows with a comprehensive understanding of laboratory genetic processes in clinical contexts 1.

Throughout the fellowship, trainees are exposed to an array of advanced laboratory techniques, encompassing:

• Chromosome analysis, including prenatal, postnatal, and bone marrow evaluations
• Fluorescence in situ hybridization (FISH) applications across various contexts
• Microarray analysis
• Next-generation sequencing (NGS) and Sanger sequencing techniques
• Methylation assays relevant to genetic disorders
• Carrier screening methodologies
• Quantitative PCR (qPCR) techniques for mutation detection and quantification
• Analysis for somatic mutations and bone marrow engraftment via Short Tandem Repeat (STR) profiling

In addition to laboratory work, fellows rotate through diverse medical genetics clinics that cover a spectrum from general medical genetics to specialized clinics focusing on Down syndrome, exome sequencing, and metabolic disorders. They will also gain exposure to the Duke Biochemical Genetics Laboratory, enhancing their hands-on training in biochemical genetics 2.

Clinical Biochemical Genetics Fellowship

The Clinical Biochemical Genetics Fellowship at Duke provides a two-year immersive training targeting the development of expertise in biochemical genetics, including responsibilities as directors of clinical laboratories. This program is anchored in the Duke University Health System (DUHS) Biochemical Genetics Laboratory. The lab has an extensive background in diagnosing inborn errors of metabolism and fosters innovation in testing methodologies. During training, fellows participate in comprehensive diagnostic work including amino acid, organic acid, acylcarnitine analysis, and enzyme activity measurements 2.

Training Structure

The majority of the training occurs in the integrated facilities which are equipped with cutting-edge analytical instrumentation for biochemical assessments. Trainees engage in the new test development processes, quality management initiatives, and familiarize themselves with regulatory requirements like CAP and CLIA standards. They will also rotate through the DUHS Molecular Diagnostics Laboratory, ensuring they cover fundamental domains within genetics and genomics 3.

Visa Support and Competitiveness

The program is structured to support International Medical Graduates (IMGs) and offers sponsorship for J-1 visas, accommodating a wide array of applicants including those from diverse educational backgrounds. The competitiveness of the program is notably high, yet it maintains a welcoming stance towards DO and IMG candidates, ensuring that applicants from various routes into medicine can find equal footing in the selection process 1.

Special Application Requirements

To apply for the Laboratory Genetics and Genomics Fellowship, prospective individuals must provide evidence of prior training and meet supplementary qualifications as outlined, which may include a maximum of failed STEP exams and specific requirements pertinent to recent graduates. For the Clinical Biochemical Genetics Fellowship, candidates must have completed an ACGME accredited residency program in Medical Genetics, enabling applicants to focus their expertise within biochemical genetics 4.

Research Opportunities and Faculty

The program affords fellows ample opportunities to participate in research projects across multiple domains of medical genetics. Duke's Division of Medical Genetics is recognized for its innovative contributions such as enzyme replacement therapies, gene therapy, and translational research through facilities like the Undiagnosed Disease Network (UDN). Faculty members are not only distinguished educators but also leaders in their respective research areas, providing a rich mentoring environment 5.

Diversity and Inclusion

Duke’s Department of Pediatrics is committed to fostering a culture of diversity and inclusion, recognizing these as vital components for institutional excellence and innovation. The program actively seeks to create a welcoming and inclusive environment for students, faculty, and staff from diverse backgrounds 6.