Clinical Rotations

Clinical experience is integral to overall graduate training in genetic counseling. At Northwestern, students become involved with the clinical practice early in their training so that they gain as much experience as possible during the program. We pride ourselves on the breadth and diversity of our clinical rotation sites, both in terms of clinical specialty and patient population. For those who wish to develop fluency in medical Spanish, emphasis can be placed on clinical rotations where Spanish is the predominant language.

Over the summer, students have the opportunity to complete full-time rotations in or outside of Chicago, and several students have even had summer internships abroad.

"It was great to know that Northwestern gave me the flexibility to seek a summer rotation in the city of my choosing. I was able to split my summer between Chicago and Hawaii." (from our 2008 Alumni Survey)

The first quarter of the program focuses on preparing students for rotations through classes, participation in patient review and journal club, role-playing, and observation of genetic counseling sessions. Beginning in the second quarter, students rotate through six five-week rotations at hospitals and clinics in the Chicagoland area. All students will have 1-2 rotations in each of the following areas:

• Prenatal counseling: Students learn to counsel patients in high-risk obstetrics clinics for a wide variety of preconception and prenatal indications, including amniocentesis, chorionic villus sampling, ultrasound abnormalities, maternal serum screening, carrier screening, and family history. Students facilitate decision-making regarding pregnancy options and provide patients with psychosocial support and resources.
• Cancer and adult genetic counseling: Students learn to elicit comprehensive cancer family histories, perform cancer risk assessment using a variety of statistical models, and counsel patients regarding cancer family history. Students also see patients with other adult-onset conditions, like Huntington disease. They become familiar with ordering genetic tests and interpreting results. Students may also attend tumor board conferences and present cases to oncologists and other specialists.
• Pediatric and general genetic counseling: Students learn to apply clinical dysmorphology skills, medical history-taking, and evaluation of developmental delay in general pediatric genetics clinics. They also participate in specialty clinics for children with genetic conditions such as 22q11.2 deletions, neurofibromatosis, skeletal dysplasias, Marfan syndrome, and metabolic disorders. Students are frequently involved in state newborn screening follow-up.

In addition to the rotations above, each student will have the opportunity to participate in one or more specialty genetics clinics:

• Cardiology: Students counsel families with all inherited forms of cardiovascular disease, including familial dilated cardiomyopathy and hypertrophic cardiomyopathy, sudden cardiac death, Marfan syndrome, and Long QT syndrome. Students will also see patients with muscular dystrophies with cardiac involvement, such as Duchenne muscular dystrophy. In addition, students consult patients in-house as necessary and participate in consenting patients for ongoing research projects.
• Neurogenetics: Students participate in a multidisciplinary adult neuromuscular clinic, working closely with neurologists, physical therapists, speech therapists, and cardiologists. Students also counsel adults at risk for inherited dementias, such as early-onset Alzheimer disease and Huntington disease. Students learn the role of genetic counselors in large research studies as they help recruit patients with familial amyotrophic lateral sclerosis.
• Pediatric hematology/oncology: Students counsel families regarding a wide range of hematological conditions, including sickle cell anemia, thalassemias, hemophilia, and other hematological genetic conditions. The clinic also provides exposure to childhood cancers like retinoblastoma, and students gain experience with newborn screening for sickle cell disease.
• Research and molecular techniques: Students gain exposure to a wide variety of molecular and cytogenetic laboratory techniques through the University of Chicago Laboratory. Students learn how to intepret genetic test results and apply them to clinical cases. The rotation helps students appreciate the complexities and ambiguities inherent in genetic testing.
• Teratology: Students research and respond to inquiries regarding exposure to medications, chemicals, or infections during pregnancy. This rotation gives students the opportunity to independently research rare exposures and provide information and advice based on their own findings.

Local clinical rotation sites include:

Advocate Christ Hospital
Advocate Illinois Masonic Hospital
Loyola University Medical Center
NorthShore University HealthSystem
Northwestern Medical Faculty Foundation
Rush University Hospital
Stroger Cook County Hospital
University of Chicago Hospitals
University of Illinois at Chicago