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Both the ACGME and ABMG maintain a list of approved programs that lead to certification as a clinical geneticist. Approved residency programs include clinical and academic components. Approved programs expose the resident to a patient population large enough to develop an understanding of the wide variety of medical genetic problems. They enable direct involvement in genetic research laboratories, where students learn to critically interpret laboratory data. They include graduate-level course work in basic, human, and medical genetics, as well as clinical teaching conferences, and they foster the development of the communication skills necessary to interact and sustain a long-term therapeutic relationship with patients and their families.

One need not necessarily decide upon the profession of clinical genetics prior to entering medical school or even upon receiving a medical degree or completing a full residency. Traditionally, the ABMG has accepted physicians into clinical genetics programs who come from approved residency programs in pediatrics, obstetrics-gynecology, and internal medicine. This is because the profession of clinical genetics originated from the treatment of inherited diseases that are initially observed in newborn infants and children. It is still within these disciplines that many physicians develop a secondary interest in clinical genetics, during residency or even later in their medical career. However, the field of medical genetics is rapidly changing, due to the recognition that many genetic disorders result in symptoms that are delayed until adulthood. As a consequence, clinical geneticists are now beginning to provide their services to adults as well.

The Human Genome Project has also brought the realization that clinical genetics involves more than single-gene and single-chromosome conditions. Genetic medicine is becoming applicable to many kinds of complex diseases and disorders such as cancer, heart disease, and asthma, to name a few well-known conditions.

The 1,100 certified clinical geneticists registered in the United States in the year 2000 were too few to keep up with an ever-increasing demand for their services. Students interested in pursuing clinical genetic careers can expect that the number of subspecialties will continue to grow, that both the ACGME and ABMG will continue to strive to provide new certification programs and career tracks, and that the concept of clinical genetics may become an integral component of "well" medical health care. see also Disease, Genetics of; Genetic Counselor; Genetic Testing; Genetic Testing: Ethical Issues; Prenatal Diagnosis.

Diane C. Rein

Bibliography internet Resources

Accreditation Council for Graduate Medical Education. <http://www.acgme.org>.

American Board of Medical Genetics. <http://www.abmg.org>.

Careers in Human Genetics. University of Kansas Medical Center's Genetics Education Center. <http://www.kumc.edu/gec/prof/career.html>.

Guide to North American Graduate and Postgraduate Training Programs in Human Genetics. American Board of Medical Genetics. <http://www.abmg.org/genetics/ashg/ tpguide/intro.htm>.

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National Coalition for Health Professional Education in Genetics. <http://www .nchpeg.org>.

Webliography for Clinical Geneticists. The Federation of American Societies for Experimental Biology. <http://www.faseb.org/genetics/webliog.htm>.

Cloning Genes

Gene cloning, or molecular cloning, has several different meanings to a molecular biologist. A clone is an exact copy, or replica, of something. In the literal sense, cloning a gene means to make many exact copies of a segment of a DNA molecule that encodes a gene. This is in marked contrast to cloning an entire organism—regenerating a genetically identical copy of the organism—which is technically much more difficult (with animals) and can involve ethical ramifications not associated with gene cloning. Molecular biologists exploit the replicative ability of cultured cells to clone genes.

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