Foundations - Year 1 (Fall/Spring)
This course is an in-depth study of the mechanism of Mendelian and non-Mendelian inheritance of diseases and disorders. Topics include gene structure and function, cellular processes, single-gene and complex inheritance, molecular defects that lead to various classes of genetic disease, and how theories of human genetics can be applied to populations. As part of the course, students will rotate through clinical laboratories at Columbia in order to understand various diagnostic genetic tests and how they are used.
This course is designed to teach students the basic and specialized skills necessary for effective counseling in a professional helping relationship. Through didactic training the course will build students’ knowledge and understanding of fundamental counseling skills, and through experiential learning the course will develop students' facility with applying these skills in helping relationships.
In this course, students examine the normal development and physiological function of organ systems, the mechanisms for the maintenance of health, and the pathophysiological alterations in body function that lead to disease. Each class will focus on a specific physiologic process or organ system. This course will focus on diseases with genetic contributions that occur across the life span, examining common genetic mutations, pathogenic mechanisms, clinical manifestations, and common treatments of each.
This course explores the significance of family history and risk in genetic counseling. Students will learn pedigree construction and how to elicit pertinent information when taking a family history. Students will understand how to use family history as a tool in risk assessment and will be able to interpret pedigree information and identify inheritance patterns. Bayes’ Theorem and conditional probability will be covered, as well as introduction to risk communication and risk perception.
This course provides students with medical and counseling information unique to the provision of reproductive genetic counseling services. This will include the technical information regarding screening and diagnostic testing modalities, the sociological perspectives of the geneticization/medicalization of pregnancy, and the specific counseling issues facing the perinatal client and genetic counselor.
Beginning with the basic principles of bioethics, this course will explore ethical dilemmas that may emerge in genetic counseling settings. Readings and class discussions will concentrate on case histories that demonstrate issues that can arise during preconception, prenatal, pediatric, and adult sessions, including wrongful life and wrongful death, unequal access to care, resource allocation, duty to warn, communication of genetic information, predictive testing, testing children for adult-onset diseases, conflict of interest, genetic discrimination, and many others.
This course uses a small-group format to process the clinical experiences in the first year and will provide a backbone of clinical supervision for casework. Each small group will be led by a genetic counselor faculty member who will facilitate discussion and provide support. Students will bring case material to the group to process together.
This course explores typical components of a clinical genetics/genetic counseling session and provides students with a practical approach to case management. Topics include history-taking, medical-record review, components of a physical exam, understanding of dysmorphology and syndromology, creation of a differential diagnosis, identification of referrals and resources, and writing both medical and counseling notes. Students will become familiar with available genetic and genomic tests, the process of identifying appropriate testing and selecting a reputable lab, coordinating and ordering testing, receiving and interpreting results, communicating these results to clients, and integrating test results into clinical care.
This course provides an introduction to clinical study design, including development of a study question, types of studies, and types of variables. Each week the course meets will include a lecture to allow for discussion of the outlined topics, and a lab learning workshop. The lab will provide students with the tools to apply the knowledge learned in lectures as well as provide them the foundation to collect, manage, and analyze data. Students will apply knowledge learned in the course to develop their scholarly project, such as conducting a literature review and producing an annotated bibliography.
As a basis for working with clients across the life span, this course addresses the physical, cognitive, and psychological changes human beings encounter as we pass through life, from infancy to death. Students taking this course will explore, discuss, and learn about important developmental psychological principles and how to apply them in understanding their work with clients of various ages and life stages.
Knowledge of the genetic and biochemical basis of inherited disease is expanding rapidly. As new genes are identified and biochemical functions are unraveled, increased information will be available to clinicians who care for individuals with inborn errors of metabolism (IEMs). This course will provide an overview of the basic principles of the pathophysiology, diagnosis, and management of IEMs, as well as prepare students to keep pace with new discoveries as they apply to clinical management.
This course explores the basic principles of genetics and their application to public health practice and research. Students will explore the history of genetics and public health, learn to apply principles of effective written and oral communication to public health genetics topics, incorporate genetic information into assessment and policy development, and assess the ethical, legal, social, and financial implications of the use of genetic principles and technologies in public health.
This course will build upon developing counseling skills as students learn to perform psychosocial assessment during the genetic counseling session and determine when additional intervention is warranted. Students will work with giving bad news and providing support, as well as managing client guilt, shame, anger, and blame. This course will also assist students in learning to identify and address transference and countertransference in the genetic counseling setting and to understand various client coping and defense mechanisms.
Integration - Year 2 (Summer/Fall/Spring)
This course provides an overview of precision medicine with an emphasis on genomic health. Students will receive detailed instruction on how to interpret genomic variation and how to effectively communicate this information to patients in ways that are effective, efficient, and scalable. The course will cover big-data initiatives in systems biology and quantitative data analysis and how machine learning is being applied to individual patient care. Students will also explore questions of clinical implementation, including measuring cost effectiveness, and will address the ethical, legal, and social issues presented by precision medicine.
This course is designed to introduce students to a critical analysis of race, racism, and the social and political constructs of race through the lens of a sociohistorical framework. The course includes lectures and interactive seminars that explore racial oppression, the invention of race, structural violence, racial identity, and privilege from systematic and personal perspectives and examine how these constructs and feelings interact with and impact the healthcare system and healthcare professionals. The course will provide a safe space and a pedagogical model for community-centered, culturally inclusive, respectful, and sociohistorical dialogue for students. Students will be encouraged to critically analyze and engage in introspection regarding internalized assumptions, attitudes, and self-identity.
This case-based course integrates the genetic/genomic, medical, and counseling topics that students have been exposed to thus far in their training through application to clinical genetic counseling scenarios. Students will work through a variety of cases, including cancer, neurogenetics, cardiogenetics, prenatal genetics, renal genetics, and dermatology genetics. Practicing genetic counselors will bring case material from their clinics for students to work with. All aspects of case management and roles that genetic counselors might play based on the specifics of the case will be discussed.
This course will present the pertinent ethical, legal, and social issues raised by the use of genetics and genomics in the clinic and in research. Topics will include the shrinking distinction between clinical and research testing, return of results across an individual’s life span, models—and challenges—of consent and return of incidental findings, race and ethnic issues, equal access, privacy, public health and allocation of resources, use and storage of biological materials and genomics data, commercialization of genomic testing and research, and the use of genetic testing in legal settings.
Genomics and precision medicine research are quickly advancing and will be relevant for genetic counselors regardless of specialty. This course will provide students with an overview of current applications of precision medicine and will teach students the skills to stay up-to-date as research advances. Students will be prompted to consider the ethical implications of current technologies and future applications. Students will be presented with new developments in precision medicine and genomics research and will explore these topics through lectures, case-based class discussions, and student-led journal presentations.
This course provides a theoretical foundation for understanding the therapeutic potential of genetic counseling in various clinical settings. Students will further develop and practice skills to create an ongoing therapeutic/working alliance with clients and to capitalize on this relationship to provide support and education that can positively impact clients. Both theory and practice will be addressed, as well as an understanding of models stemming directly from the genetic counseling profession. Students will deepen their understanding of various topics relevant to the practice of genetic counseling, including grief/loss, family systems, nondirective and directive counseling, disability, meaning making, adaptation, adult education, decision-making, and working with uncertainty.
This course is conducted as small-group work, providing space for processing clinical case work within the model of leader-led peer supervision. Students will have increasing clinical responsibilities in their internships and can utilize this course to further process and develop their professional self. Each small group will be led by a genetic counselor faculty member who will facilitate discussion and provide support for the students’ ongoing professional development and increasing counseling skills.
This course will provide support to students as they prepare to transition into the professional community of genetic counselors in regard to board exam preparation, supervision of students, education of other healthcare providers, and the importance of self-care. Students will identify and review the key aspects to establishing and optimizing genetic services for any type of setting. Beyond employment, genetic counselors have a professional responsibility to stay actively engaged in the community, contribute to advancing the field, and maintain their own education beyond graduate training.
This course provides credit for the ongoing research that students participate in during their graduate studies. Students will prepare a written summary of their work in scientific format and orally present their work in both platform and poster format.