Children's Hospital Boston (CHB) is an internationally recognized 300 bed pediatric hospital with a full range of medical and surgical specialties as well as a major research program. Training in medical genetics is provided through the Division of Genetics in the Department of Medicine. The division occupies 11,684 square feet of research space in the Enders Research Building, with clinical offices on the tenth floor of the Fegan Ambulatory Building. The Clinical Genetics Program provides services in genetic diagnosis of both postnatal and fetal patients, genetic counseling, and diagnosis and management of inborn errors of metabolism. The major emphasis of the program is on pediatric genetics, although residents participate in the care of families through all stages of life, including evaluation of the fetal patient through the Advanced Fetal Care Center, and genetic counseling and care of adults with genetic diseases. The Metabolism program in particular cares for a large number of adults with inborn errors of metabolism due to the fact that many children identified by newborn screening are now of adult age and the expertise needed for management of these rare conditions is not widely available.
The inpatient consultation service sees patients for diagnosis, counseling, or management of genetic and/or metabolic disease at the request of the attending physicians in the hospital. In addition, the medical genetics residents and attendings supervise the metabolic management of patients with inborn errors of metabolism admitted on the inpatient units. Approximately 30-40 inpatient consultations are seen per month and residents will follow 10-15 patients at any given time in the course of evaluation or treatment. The inpatient consult service consists of a resident and an attending physician who round together at least once per day.
Sources and types of consultations are:
While on the inpatient consultation service, the resident will be responsible for all calls to the service Monday through Friday, including Monday through Thursday nights. Weekend call from Friday night through Monday morning is provided by first and second year residents and an attending on a rotating basis.
Outpatient clinics are held every day. Wednesday mornings are reserved for teaching and morbidity and mortality conferences, and journal club. Residents participate in general genetics clinics on Monday and Wednesday afternoons, metabolism clinics on Tuesday and Thursday mornings, and subspecialty clinics on Monday and Friday mornings.