Opportunities for fellowship education: the first year of the Medical Biochemical Genetics Clinical Core Seminar Series

ABSTRACT

Background: The Medical Biochemical Genetics (MBG) Fellowship is an Accreditation Council of Graduate Medical Education (ACGME) subspecialty,one-year training program designed to prepare ClinicalMedical Genetics and Genomics graduates for practice in the diagnosis and treatment of inborn errors of metabolism (IEM). The ACGMErequires each program to provide “structured education, includingformal coursework in the basic sciences and clinical areas pertinent tobiochemical genetics”. There are currently 19 programs around theUnited States (US). Most have only one fellow per year. An average of18 MBG fellows every two years sit for the board examination. Eachprogram has a separate, individual curriculum. This puts a potentiallylarge burden on faculty to generate and teach didactic lectures for asingle fellow per year, and limits the fellow to learn in isolation,without interaction with the greater US IEM community. In 2020,amidst the COVID-19 pandemic, faculty at the University of Coloradoapproached the program directors of the individual MBG programsacross the US to establish a unified MBG curriculum to meet the“formal coursework” requirement. Twelve MBG programs opted totake part.Methods: A curriculum, designated as the MBG Clinical Core SeminarSeries (CCSS),was established to included 13 lectures covering contentfrom the American Board of Medical Genetics and GenomicsBiochemical Genetics Blueprint. Sessions were held weekly fromAugust through November of 2020 using a virtual platform (https//zoom.us/). Each session was designated to be 90 minutes 75 min fordidactic teaching and 15 min for questions/interaction with the facultyspeaker and one another. Lectures were taught by expert faculty,boarded in Medical/Clinical Biochemical Genetics and well-known inthe field for the lecture subject matter. Invitations were sent out toMBG programs nationwide, and responding participants were addedto an email listserv that was kept through the MBG program at theUniversity of Colorado. Attendance was not limited to MBG fellows,but faculty were instructed to focus on MBG fellows as the primaryaudience. After each lecture, opportunity was given to all participantsto engage in a brief survey to evaluate the class using 3 generalquestions (see below) and response both by free text and using a Likertscale (5 = Strongly Agree to 1 = Strongly Disagree). Lectures wererecorded on ZOOM, and recordings with accompanying referencematerialwere distributed to the entire listserv using a Dropbox link, aswell as uploaded and stored on the Society for Inherited MetabolicDisease website.Results: The number of participants on the listservwas 217 by the endof the lecture series. Synchronous participation included an average of75 participants per session. In total, there were 98 responses to thethree questions in the survey. Respondents include both MBG andClinical Biochemical Genetics (CBG) fellows (22 responses), as well asattending physicians, genetics/pediatrics residents, genetic counselors,advanced practice providers, and nurses. Participants scored thethree questions as follows “This session will improve my ability todiagnose and manage metabolic patients” (4.60 ± 0.59);“This sessionmade me feel more connected to the larger metabolic community”(4.62 ± 0.65);and “This session was high-yield given breadth anddepth of content and time allotted” (4.61 ± 0.65). Of note, MBG andCBG fellow responses to the three questions were 4.73 ± 0.54,4.36 ± 0.83, and 4.77 ± 0.41, respectively. Free text comments weregenerally positive, with the major critiques being the large amount ofcontent for time allotted and the desire for board-related practicequestions.Conclusions: The MBG-CCSS endeavored to create a unique opportunityfor trainees to network, facilitate teaching by nationallyrecognized experts, and minimize duplication of effort in individualtraining programs. These goals were all achieved with great success.An unexpected finding was the level of interest from a much largernumber of individuals than expected, far more than th US cohort ofMBG fellows. This points to a significant unmet demand for IEMfocusededucation at all levels around the country. Evaluation scoresfrom fellows, as well as comments, indicate several areas forimprovement including 1) less content per session 2) more participantinteraction 3) incorporated board practice questions and 4) formalassessment of knowledge using a written final exam. We will alsostrive to improve fellow-fellow and fellow-faculty dialogue through interactive questions and smaller fellow-faculty-only discussions.Moving forward, we will continue to build on the success of the firstyear, to prepare and inspire IEM providers for independent clinicalpractice