Molecular Genetic Pathology Fellowship
 
Program description: The McLendon Clinical Laboratories of UNC Hospitals offer a one-year fellowship in molecular genetic pathology. The fellow gains a working knowledge of molecular procedures including DNA and RNA extraction, Southern blot, in situ hybridization/FISH, sequencing, and amplification methods. Trainees are exposed to tissue microdissection and array technologies. These technologies are applied in a wide spectrum of clinical settings including cancer, inherited disease, infectious disease, HLA-typing, and identification. The fellow learns to analyze and interpret molecular data from clinical cases, and to compose diagnostic reports. Results are correlated with clinical, morphologic, immunophenotypic, and cytogenetic findings. The fellow learns to design and carry out research projects aimed at understanding the molecular basis of disease or translating such basic discoveries into improved patient care. Fellows may apply for an optional second year of full time research. Ethical issues, quality assurance, and lab administration are discussed as they relate to clinical practice and research in molecular pathology. UNC Hospitals is among the first molecular fellowship programs in the country to be accredited by the ACGME, thus allowing our trainees to apply for subspecialty certification in molecular genetic pathology.
 
Program requirements: Candidates must have an MD degree. AP/CP board eligibility/certification is preferred.
 
Stipends: Fellowship stipends are based on the trainee's number of years of postdoctoral training and the current UNC Hospitals' Housestaff salary scale.
 
Program director: Margaret L. Gulley, MD, Director of Molecular Genetics Laboratory
 

Applications: Applications should be submitted no later than October 1 prior to the intended fellowship start date of July 1. UNC Hospitals' Housestaff Contract and Policies are available online for review.

To apply, please send a cover letter, curriculum vitae, and the names of three references to the Program Director at the address below.

 
For additional information, please contact

Margaret L. Gulley MD
Department of Pathology and Laboratory Medicine
CB# 7525
Chapel Hill, NC 27599-7525

   
E-mail: margaret_gulley@med.unc.edu
Telephone: 919-843-4595
   
 

 
DESCRIPTION OF THE PROGRAM
 

The goal of the MGP fellowship is to produce physicians with special expertise in molecular pathology who are competent clinical consultants on issues related to the application of DNA/RNA technology in a wide variety of clinical settings. The trainees are made ready to direct clinical or research laboratories by applying the knowledge and skills that they have acquired in molecular diagnostics, in research, and in laboratory administration. Their fundamental understanding of genomics and of hybridization technologies prepares them to continue to read the literature, understand new molecular methods that are introduced in future years, apply those methods to solve practical clinical problems, and become lifelong learners.

Training in Molecular Genetic Pathology is provided through didactic seminars; hands-on experience with laboratory techniques; preparation of clinical cases for sign out under the supervision of qualified faculty; interaction with clinicians, counselors, and laboratory scientists; and research projects.

Specific Objectives of the Molecular Genetic Pathology Fellowship are:

 
1. Gain a working knowledge of molecular genetic procedures including DNA and RNA extraction, Southern blot, in situ hybridization/FISH, sequencing, and amplification methods (PCR, rtPCR, real-time PCR, NASBA, LCR, SDA, and bDNA).
2. Learn diagnostic applications of molecular technologies in a wide spectrum of clinical settings including cancer, inherited disease, infectious disease, HLA-typing, and identification.
3. Learn to analyze and interpret molecular data from clinical cases, and compose diagnostic reports.
4. Correlate results of genetic testing with clinical, morphologic, immunophenotypic, cytogenetic findings, and other clinicopathologic information.
5. Learn how to design and carry out research projects aimed at understanding the molecular basis of disease.
6. Perform translational research aimed at applying basic research findings and molecular technologies towards a goal of improving patient care.
7. Discuss issues of ethics, quality assurance, and lab administration as they relate to clinical practice and research in molecular pathology.
 
 
TYPICAL EDUCATIONAL EXPERIENCE OF MGP FELLOWS
 
Displayed below is a block diagram of a typical fellow's rotations and assignments. Fellows learn the fundamentals of molecular pathology during mandatory rotations in the three clinical laboratories where molecular methods are commonly applied, namely the Molecular Genetics Laboratory, the Cytogenetics/FISH laboratory, and the Microbiology/ Virology/ HLA laboratory. These clinical lab rotations, along with a month-long structured course in molecular diagnostics, comprise the first half of the fellowship year. Research is performed throughout the year, and the research experience is further enhanced by at least 3 months of protected time for studies in the latter half of the year. An optional second year of full time research is available to qualified fellows.
 
  July/Aug September October Nov/Dec Jan-Mar Apr-June
First year in program Molecular Lab (inherited disease, cancer, identity) Molecular Diagnostics/ Cytogenetics Course Cytogenetics & FISH Lab (congenital disease, cancer) Microbiology/ Virology/ HLA Lab (infectious disease, HLA) Clinical Electives with case accrual Mentored Research Electives
Second year in program (optional) Experimental Pathology Fellowship (Mentored Research)
 
 
Elective Rotations on Anatomic and Clinical Pathology Services:
 

Following 6 months of structured training, the schedule becomes more flexible in order to accommodate the fellow’s previous training, experience, and career goals. Clinical elective rotations may be chosen in any of the three core molecular laboratories or in services where molecular assays are applied to only a small proportion of cases, such as autopsy, forensics, toxicology, cytopathology, surgical pathology, neuropathology, dermatopathology, hematology, coagulation, blood bank/transfusion medicine, immunopathology, chemistry, biochemical laboratory, newborn screening lab, prenatal triple testing lab, prenatal clinic, and medical genetics clinic. These rotations build upon existing clinical rotations for our AP/CP and genetics residents and subspecialty fellows, with the caveat that the MGP fellow is expected to emphasize the role of molecular diagnostics in medical practice and in understanding disease pathogenesis in the area. This emphasis is demonstrated through active case acquisitions and through conference presentations.

To demonstrate their clinical experience, the fellow must maintain a logbook of molecular cases in which they were substantially involved. A case is defined as the complete evaluation of a patient or a specimen, including oversight of laboratory testing, interpretation of results, preparation of report for signout, and clinical consultation. Also included is direct participation in clinic/inpatient visits with laboratory consultation regarding indications for testing or transmission of lab results. A minimum of 150 cases must be acquired to meet the requirement for MGP board certification. These cases should reflect a breadth of experience with regard to molecular technologies (PCR, rtPCR, LCR, Southern blot, PTT, sequencing), and disease types (inherited, cancer, infectious, HLA, and identity).

 
 
Research Experience:
 
Research experience is mandatory for MGP fellows, and the goal of this experience is to make our fellows ready to become creative leaders of future basic and applied research efforts. To this end, our program promotes acquisition of a foundation of knowledge, accumulation of laboratory skills, and formulation of experimental approaches to problem solving in a modern molecular laboratory setting. Research electives provide the fellow with a solid block of time in which to complete their studies. The topic of research should be chosen, under guidance of the Program Director and pertinent faculty, early in the year and at least one month prior to the start of any research elective rotation. Study is conducted under the guidance of the preceptor who is published and nationally recognized in the chosen area of research. Progress is monitored by monthly 2-way evaluations along with monthly meetings with the Program Director. A second year of full-time research is available to those trainees who successfully compete for departmental or external funding. In this regard, the Department of Pathology offers a mentored year-long Experimental Pathology Fellowship which pays the full stipend for the trainee and provides a bench research fund. Presentation of research findings at local and national meetings is strongly encouraged.
 
For more information on molecular pathology at UNC, check out Dr. Gulley's Molecular Diagnostics Web Page.