Canadian
College of Medical Geneticists
Over the past 25 years, advances in medical genetics that are directly ap¬ plicable to medical practice have developed dramatically. Evidence to support this statement is not difficult to find. Cytogenetic investigation of children with a variety of developmen¬ tal disorders is standard procedure in most large hospitals, and because of progress in biochemical genetics a large number of genetically determined me¬ tabolic diseases can now be screened for, diagnosed and treated. The field of prenatal diagnosis of genetic disease has developed rapidly, and most large centres in Canada provide this service to high-risk patients. The medical facul¬ ties of all universities in this country include one or more geneticists; in some universities there are divisions of medical genetics and in two there are full departments. The medical geneti¬ cists are responsible for, in addition to teaching and research, carrying out some of the activities mentioned above and providing genetic counselling. The advances have touched upon al¬ most every specialty area in medicine and, although most genetics programs in Canada had their beginning in* pedi¬ atrics departments (and are still largely based in these departments or make major contributions to them), there is now increasing contact with other specialties such as internal medicine (chronic disease of the adult), obstetrics (prenatal diagnosis and genetically de¬ termined reproductive problems), psy¬ chiatry (mental retardation and some behavioural disorders) and ophthalmol¬ ogy (gene-determined eye disorders). The four editions of McKusick's "Men¬ delian Inheritance in Man: Catalogs of Autosomal Dominant, Autosomal Recessive, and X-Linked Phenotypes" il¬ lustrate the recent rapid increase in
genetic knowledge: the fourth edition, published in May 1975, contains 2336 entries, whereas the first edition (1966) contains 1487 entries, the second (1968) 1545 and the third (1971) 1876. Only single-gene disorders are listed,
not the many
variants of chromo¬
358 CMA JOURNAL/SEPTEMBER 6,
somal aberrations known in man nor the increasingly large number of chronic disorders and congenital mal¬ formations suspected of having a multifactorial basis. The extent of these advances and their importance in medical practice have fostered the growing belief that medical genetics should now be con¬ sidered a distinct medical discipline. However, "Despite these developments, the necessary skills and knowledge of a properly trained medical geneticist are not as yet encompassed by any formal professional program, and there are no standardized procedures for en¬ suring the quality of laboratory or counseling services". This quotation is from the recently released document "A Proposal for the Formation of a Canadian College of Medical Geneti¬ cists". The proposal was formulated at a meeting held in Toronto Nov. 25 to 27, 1974 to consider the needs men¬ tioned in the quotation and recom¬ mend how they could best be met. The meeting was attended by 33 individuals providing medical genetics services in Canada and was made possible by a grant from The Hospital for Sick Chil¬ dren Foundation of Toronto. The meet¬ ing recommended the following: 1. A corporation shall be formed, known as the Canadian College of Medical Geneticists. 2. It shall consist of and represent properly qualified PhDs and MDs pro¬ viding medical genetics services in
Canada.
3. Its role shall be to establish and maintain professional standards of health care delivery in the field of medical genetics, and specifically: (a) To define the characteristics of medical genetics centres and their re¬ sponsibilities in health care. (b) To accredit medical genetics centres providing health care services. (c) To inform appropriate levels of government on the role of medical geneticists in health care. (d) To advise provincial governments on the nature and extent of medical
1975/VOL. 113
genetics services that should be pro¬ vided for the province. (e) To aid in negotiations with ap¬ propriate levels of government on methods of funding (when requested). (f) To issue certificates of accredita¬ tion in medical genetics to MDs and PhDs who possess the necessary qualifications. The proposal has been widely dis¬ tributed and valuable comments on it have been received. (Copies of the pro¬ posal may be obtained from the de¬ partment of medical genetics, Univer¬ sity of British Columbia, Vancouver, BC V6T 1W5.) To expedite the initial steps a steering committee of seven members (L. Dallaire, F.C. Fraser, J.L. Hamerton, EJ. Ives, C. Laberge, J.R. Miller and M.W. Thompson) was elected at the Toronto meeting, and the committee
has chosen an additional 17 individuals. Committees have been formed to make recommendations on the following is¬ sues: interaction with the Royal Col¬ lege of Physicians and Surgeons of Canada (chairman, E.J. Ives, Saska¬ toon), constitution and incorporation
(chairman, L. Dallaire, Montreal), geneticists (chairman, J.R. Miller, Vancouver), ac¬ creditation of medical genetics centres (chairman, J.L. Hamerton, Winnipeg) and accreditation of training programs (chairman, M.W. Thompson, Toronto). Establishment of a new professional accreditation of medical
accrediting group in the health sciences may seem unnecessary to some in view of the plethora of such bodies. If an organization already existed that would accept medical geneticists (both MDs and PhDs) a new group would be unnecessary, but since none exists, and in view of the rapid developments out¬ lined above, it seems desirable that some type of organization be estab¬
lished promptly to guarantee a high professional standard in the provision of medical genetics services in Canada. James R. Miller, ph d Department of medical genetics University of British Columbia Vancouver, BC
College of Medical Geneticists
Over the past 25 years, advances in medical genetics that are directly ap¬ plicable to medical practice have developed dramatically. Evidence to support this statement is not difficult to find. Cytogenetic investigation of children with a variety of developmen¬ tal disorders is standard procedure in most large hospitals, and because of progress in biochemical genetics a large number of genetically determined me¬ tabolic diseases can now be screened for, diagnosed and treated. The field of prenatal diagnosis of genetic disease has developed rapidly, and most large centres in Canada provide this service to high-risk patients. The medical facul¬ ties of all universities in this country include one or more geneticists; in some universities there are divisions of medical genetics and in two there are full departments. The medical geneti¬ cists are responsible for, in addition to teaching and research, carrying out some of the activities mentioned above and providing genetic counselling. The advances have touched upon al¬ most every specialty area in medicine and, although most genetics programs in Canada had their beginning in* pedi¬ atrics departments (and are still largely based in these departments or make major contributions to them), there is now increasing contact with other specialties such as internal medicine (chronic disease of the adult), obstetrics (prenatal diagnosis and genetically de¬ termined reproductive problems), psy¬ chiatry (mental retardation and some behavioural disorders) and ophthalmol¬ ogy (gene-determined eye disorders). The four editions of McKusick's "Men¬ delian Inheritance in Man: Catalogs of Autosomal Dominant, Autosomal Recessive, and X-Linked Phenotypes" il¬ lustrate the recent rapid increase in
genetic knowledge: the fourth edition, published in May 1975, contains 2336 entries, whereas the first edition (1966) contains 1487 entries, the second (1968) 1545 and the third (1971) 1876. Only single-gene disorders are listed,
not the many
variants of chromo¬
358 CMA JOURNAL/SEPTEMBER 6,
somal aberrations known in man nor the increasingly large number of chronic disorders and congenital mal¬ formations suspected of having a multifactorial basis. The extent of these advances and their importance in medical practice have fostered the growing belief that medical genetics should now be con¬ sidered a distinct medical discipline. However, "Despite these developments, the necessary skills and knowledge of a properly trained medical geneticist are not as yet encompassed by any formal professional program, and there are no standardized procedures for en¬ suring the quality of laboratory or counseling services". This quotation is from the recently released document "A Proposal for the Formation of a Canadian College of Medical Geneti¬ cists". The proposal was formulated at a meeting held in Toronto Nov. 25 to 27, 1974 to consider the needs men¬ tioned in the quotation and recom¬ mend how they could best be met. The meeting was attended by 33 individuals providing medical genetics services in Canada and was made possible by a grant from The Hospital for Sick Chil¬ dren Foundation of Toronto. The meet¬ ing recommended the following: 1. A corporation shall be formed, known as the Canadian College of Medical Geneticists. 2. It shall consist of and represent properly qualified PhDs and MDs pro¬ viding medical genetics services in
Canada.
3. Its role shall be to establish and maintain professional standards of health care delivery in the field of medical genetics, and specifically: (a) To define the characteristics of medical genetics centres and their re¬ sponsibilities in health care. (b) To accredit medical genetics centres providing health care services. (c) To inform appropriate levels of government on the role of medical geneticists in health care. (d) To advise provincial governments on the nature and extent of medical
1975/VOL. 113
genetics services that should be pro¬ vided for the province. (e) To aid in negotiations with ap¬ propriate levels of government on methods of funding (when requested). (f) To issue certificates of accredita¬ tion in medical genetics to MDs and PhDs who possess the necessary qualifications. The proposal has been widely dis¬ tributed and valuable comments on it have been received. (Copies of the pro¬ posal may be obtained from the de¬ partment of medical genetics, Univer¬ sity of British Columbia, Vancouver, BC V6T 1W5.) To expedite the initial steps a steering committee of seven members (L. Dallaire, F.C. Fraser, J.L. Hamerton, EJ. Ives, C. Laberge, J.R. Miller and M.W. Thompson) was elected at the Toronto meeting, and the committee
has chosen an additional 17 individuals. Committees have been formed to make recommendations on the following is¬ sues: interaction with the Royal Col¬ lege of Physicians and Surgeons of Canada (chairman, E.J. Ives, Saska¬ toon), constitution and incorporation
(chairman, L. Dallaire, Montreal), geneticists (chairman, J.R. Miller, Vancouver), ac¬ creditation of medical genetics centres (chairman, J.L. Hamerton, Winnipeg) and accreditation of training programs (chairman, M.W. Thompson, Toronto). Establishment of a new professional accreditation of medical
accrediting group in the health sciences may seem unnecessary to some in view of the plethora of such bodies. If an organization already existed that would accept medical geneticists (both MDs and PhDs) a new group would be unnecessary, but since none exists, and in view of the rapid developments out¬ lined above, it seems desirable that some type of organization be estab¬
lished promptly to guarantee a high professional standard in the provision of medical genetics services in Canada. James R. Miller, ph d Department of medical genetics University of British Columbia Vancouver, BC
