Curious about a residency in genetic medicine

[transhuman]

I am pre-med right now. My goal is to become an MD/PhD with a residency in genetic medicine. I want to perform gene therapy in order to augment the human condition, as well as do research into advancing the field of gene therapy. For those of you who aren't aware, there are currently clinical trials going on for a gene therapy technique that has cured numerous individuals of blood cancer. The first gene therapy to be approved in the US and EU is known as Glybera, which was approved in 2012. Another gene therapy can preserve the eyesight of those who are going blind, simply by squirting a genetic concoction onto their retina. I feel that this technology eventually will completely replace medicine as we know it. Gene therapy in the future will make modem medical practices seem like homeopathy in comparison. Gene therapy curing cancer is great, but it doesn't end there. Imagine regrowing severed limbs, growing new designer cranial lobes to gain a massive IQ, or adopting an ideal immune system that defeats any unwanted virus/bacteria. The ability to edit your genome has limitless possibilities.

This is a cause that I have dedicated my life to. I will do anything in my power to achieve my vision of the future. I am just curious if anyone else is interested in the same residency and could share their opinion. I know I am a bit eccentric in my thinking, but I am content with my worldview. I am also wondering, would it be beneficial for me to share the truth of my aspirations during a medical school interview? Would the person interviewing me be impressed by my enthusiasm or would they be set in their ways and reject me for being forward thinking? I suspect the latter might be true. I assume that the type of people they are looking to accept into medical school are normal-minded individuals who are overflowing with empathy and want to travel to the developing world to help cure impoverished people of tuberculosis or something cheesy like that. If I have to lie to their face and tell them all that trite nonsense that they love to hear, I will. However, I would prefer to be honest and upfront because I feel that anyone who isn't looking toward the future is irrelevant.

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[allantois]

If you are a pre-med right now, you are years away from applying to residency. Are you at all involved with research? You should be honest on your interviews with your aspirations. Right now you need to be doing well in your classes and involving yourself with research as well as doing other things that are expected by medical schools.

 

[transhuman]

If you are a pre-med right now, you are years away from applying to residency. Are you at all involved with research? You should be honest on your interviews with your aspirations. Right now you need to be doing well in your classes and involving yourself with research as well as doing other things that are expected by medical schools.

You underestimate my dedication to this. I am not neglecting my pre-med responsibilities. I have a 4.0 gpa and am working on my extra-curriculars as well. I am a member of the first generation with a legitimate possibility of attaining immortality through life extension medicine, and I intend on achieving it. Gone will be the days of living to the ripe old age of 90 while taking a cocktail of prescription pain killers. Within my lifetime, I expect that genetic modification techniques will allow humans to halt the aging process and live indefinitely. You say that I should be honest during my interviews, but you give no explanation why. I will say and do whatever I must, to achieve my goal. I want to have the best odds of getting accepted, therefore, I will act in a manner that the adcoms respect.

 

[SpacemanSpifff]

I am pre-med right now. My goal is to become an MD/PhD with a residency in genetic medicine. I want to perform gene therapy in order to augment the human condition, as well as do research into advancing the field of gene therapy...

This is a cause that I have dedicated my life to. I will do anything in my power to achieve my vision of the future. I am just curious if anyone else is interested in the same residency and could share their opinion. I know I am a bit eccentric in my thinking, but I am content with my worldview. I am also wondering, would it be beneficial for me to share the truth of my aspirations during a medical school interview? Would the person interviewing me be impressed by my enthusiasm or would they be set in their ways and reject me for being forward thinking? I suspect the latter might be true. I assume that the type of people they are looking to accept into medical school are normal-minded individuals who are overflowing with empathy and want to travel to the developing world to help cure impoverished people of tuberculosis or something cheesy like that. If I have to lie to their face and tell them all that trite nonsense that they love to hear, I will. However, I would prefer to be honest and upfront because I feel that anyone who isn't looking toward the future is irrelevant.

Why MD/PhD specifically? I'm wondering if you might be happier by avoiding all the "trite nonsense" that physicians are expected to embody. I've been investigating medical genetics as a potential career path and your expectations might be a little unrealistic (not saying the whole immortality/limb regeneration thing is unrealisitc, just that you might be better off pursuing these interests in another career path). Here are some sources you might want to consider before drawing up your life plan:


https://www.acmg.net/ACMG/Resources...rces/Genetics_Frequently_Asked_Questions.aspx

As an aside, I think you'd get along really well with this guy: http://www.kurzweilai.net/ray-kurzweil-biography

 

[WedgeDawg]

You underestimate my dedication to this. I am not neglecting my pre-med responsibilities. I have a 4.0 gpa and am working on my extra-curriculars as well. I am a member of the first generation with a legitimate possibility of attaining immortality through life extension medicine, and I intend on achieving it. Gone will be the days of living to the ripe old age of 90 while taking a cocktail of prescription pain killers. Within my lifetime, I expect that genetic modification techniques will allow humans to halt the aging process and live indefinitely. You say that I should be honest during my interviews, but you give no explanation why. I will say and do whatever I must, to achieve my goal. I want to have the best odds of getting accepted, therefore, I will act in a manner that the adcoms respect.

You ask his/her advice and then discount it.

Do genetic research, both clinical and basic.

Also (s)he said to be honest and you question why, but isn't the why pretty self-evident?

 

[transhuman]

Why MD/PhD specifically? I'm wondering if you might be happier by avoiding all the "trite nonsense" thatw physicians are expected to embody. I've been investigating medical genetics as a potential career path and your expectations might be a little unrealistic (not saying the whole immortality/limb regeneration thing is unrealisitc, just that you might be better off pursuing these interests in another career path). Here are some sources you might want to consider before drawing up your life plan:


https://www.acmg.net/ACMG/Resources...rces/Genetics_Frequently_Asked_Questions.aspx

As an aside, I think you'd get along really well with this guy: http://www.kurzweilai.net/ray-kurzweil-biography

MD/PhD because I am interested in both sides of genetics, medical and research. This field is in its infancy and I want to help foster it in every way I can. I don't think my expectations are unrealistic. Look at the progress we have made in a single decade. This progress will compound exponentially. Kurzweil doesn't particularly tickle my fancy.

You ask his/her advice and then discount it.

Do genetic research, both clinical and basic.

Also (s)he said to be honest and you question why, but isn't the why pretty self-evident?

I didn't discount the advice, I merely questioned its founding in logic because it was not backed up with any explanation. Always being honest for honesty's sake is not self-evident at all. Appeal to tradition is a logical fallacy. If you think that every single medical student at a top 10 medical school didn't embellish heavily during their interview in order to stand out and impress, you're mistaken. Of course, cynically admitting this fact is a bit distasteful, but I prefer frankness. Here's my point of view. Most of these adcoms are going to be baby boomers with a very primitive world view. Their narrow minds can't comprehend the changes that will occur in the 21st century. They want to preserve an antiquated status quo that will quickly become obsolete. My generation will forge a new world with new morals and achieve heights never before fathomed. If I tell these adcoms my dream they might think I am some autistic loser that spends too much time watching the movie Gattaca.

 

[WedgeDawg]

MD/PhD because I am interested in both sides of genetics, medical and research. This field is in its infancy and I want to help foster it in every way I can. I don't think my expectations are unrealistic. Look at the progress we have made in a single decade. This progress will compound exponentially. Kurzweil doesn't particularly tickle my fancy.

I didn't discount the advice, I merely questioned its founding in logic because it was not backed up with any explanation. Always being honest for honesty's sake is not self-evident at all. Appeal to tradition is a logical fallacy. If you think that every single medical student at a top 10 medical school didn't embellish heavily during their interview in order to stand out and impress, you're mistaken. Of course, cynically admitting this fact is a bit distasteful, but I prefer frankness. Here's my point of view. Most of these adcoms are going to be baby boomers with a very primitive world view. Their narrow minds can't comprehend the changes that will occur in the 21st century. They want to preserve an antiquated status quo that will quickly become obsolete. My generation will forge a new world with new morals and achieve heights never before fathomed. If I tell these adcoms my dream they might think I am some autistic loser that spends too much time watching the movie Gattaca.

I'm not going to try and argue with you. I respectfully disagree that people at top 10s all embellish. Do what you think is right.

 

[coldpheet]

Here's my point of view. Most of these adcoms are going to be baby boomers with a very primitive world view. Their narrow minds can't comprehend the changes that will occur in the 21st century. They want to preserve an antiquated status quo that will quickly become obsolete. My generation will forge a new world with new morals and achieve heights never before fathomed.

I am also interested in genetic medicine, and I shared my aspirations and opinions with many adcoms during many interviews. You will be pleased to know that your current point of view is wrong.

 

[coldpheet]

If I tell these adcoms my dream they might think I am some autistic loser that spends too much time watching the movie Gattaca.

If you phrase it how you currently have it then you are probably right.

 

[deleted436726]

:troll:

 

[SpacemanSpifff]

MD/PhD because I am interested in both sides of genetics, medical and research. This field is in its infancy and I want to help foster it in every way I can. I don't think my expectations are unrealistic. Look at the progress we have made in a single decade. This progress will compound exponentially. Kurzweil doesn't particularly tickle my fancy.

Bolded 1: Being interested in the "medical side" of genetics doesn't exclude the PhD as a possible route. Look through any medical school's medgen department and you'll see plenty of PhD's. Look over the ACMG's site and you should learn a bit about what a clinical geneticist deals with on a daily basis.

Are you sure you aren't into Kurzweil? Cuz bolded #2 is basically his tagline.

And addressing one of your initial questions: being frank in an interview about your aspirations will yield varied results, depending on your presentation. Telling a member of an admissions committee that their world view is antiquated, narrow-minded and primitive is unlikely to get you far.

 

[Serous Demilune]

I hate to break it to you but your generation is at best mildly ******ed. You look into the future and see progress, I see decline. I'm not sure giving these selfie-taking beliebers immortality is the best way to go.

 

[transhuman]

I hate to break it to you but your generation is at best mildly ******ed. You look into the future and see progress, I see decline. I'm not sure giving these selfie-taking beliebers immortality is the best way to go.

You can thank the boomers for the decline. It is due to their profound guidance that we have developed our idiosyncrasies. The coming genetic revolution will correct these mistakes.

 

[tmn]

This is a cause that I have dedicated my life to. I will do anything in my power to achieve my vision of the future.

My generation will forge a new world with new morals and achieve heights never before fathomed.

Dude you sound like a freaking psychopath.

 

[tmn]

 

[Reckoner]

If I tell these adcoms my dream they might think I am some autistic loser that spends too much time watching the movie Gattaca.

Well, are you?

 

[Reckoner]

I hate to break it to you but your generation is at best mildly ******ed. You look into the future and see progress, I see decline. I'm not sure giving these selfie-taking beliebers immortality is the best way to go.

And get off my lawn!

 

[transhuman]

Dude you sound like a freaking psychopath.

Typical baby boomer, using ad hominem attacks to stifle the voice of progression. "How dare anyone want the world to be better? It should stay exactly the same! Anyone who disagrees must be mentally ill!" Can you no longer dream? The universe is ours for the taking. All we must do is reach out and grab it.

 

[tmn]

Typical baby boomer, using ad hominem attacks to stifle the voice of progression. "How dare anyone want the world to be better? It should stay exactly the same! Anyone who disagrees must be mentally ill!" Can you no longer dream? The universe is ours for the taking. All we must do is reach out and grab it.

Seriously dude, take your meds. I'm not a baby boomer, and I'm not "stifling the voice of progression." You ranting like a crazy person on an internet forum isn't "the voice of progression."

 

[SynBio]

Back to the main topic...

I am also interested in gene therapy/genetic medicine/synthetic biology.

Here is a link to medical genetics residencies including combined residencies. From your post, the combined IM/MG program may fit your interest. It is five years total, followed by fellowship if you choose to do so. There are currently only six programs including UAB, JHU, HMS, Mount Sinao, Case Western, and UPenn, but this will most likely expand.

Also, I think talking about your enthusiasm for gene therapy/genetic medicine would be productive to interviews if you are invited for one (or several), but I would perhaps talk about your aspirations for the next 5 years. For example, we need to first achieve optimal delivery of gene therapy before we can ever achieve supplementing the human body, so maybe talk about something that is more likely to be achieved in the short term (i.e. raising transfection efficiency/delivery of Cas9/CRISPR or TALENs or whatever DNA editing technology into human cells).

It is healthy to have career long aspirations, but for these programs I feel they are seeking students who can first achieve short term research goals. Since most (if not all) of the people interviewing you will not be geneticists, if the question(s) come up, you need to show them/tell them what is feasible over the next few years during your combined degrees. If field specific goals come up (which they probably won't, it would more likely be career long goals such as: in 15 years I hope to be finishing my fellowship and applying for a junior faculty position...), then maybe talk about long term (~25-30 years) aims of gene therapy that may be feasible (i.e. using gene therapy to eradicate all mono-genetic diseases). Just my opinion.

 

[MrLogan13]

Pretty sure the OP is trololololololo-ing.

 

[transhuman]

Back to the main topic...

I am also interested in gene therapy/genetic medicine/synthetic biology.

Here is a link to medical genetics residencies including combined residencies. From your post, the combined IM/MG program may fit your interest. It is five years total, followed by fellowship if you choose to do so. There are currently only six programs including UAB, JHU, HMS, Mount Sinao, Case Western, and UPenn, but this will most likely expand.

Also, I think talking about your enthusiasm for gene therapy/genetic medicine would be productive to interviews if you are invited for one (or several), but I would perhaps talk about your aspirations for the next 5 years. For example, we need to first achieve optimal delivery of gene therapy before we can ever achieve supplementing the human body, so maybe talk about something that is more likely to be achieved in the short term (i.e. raising transfection efficiency/delivery of Cas9/CRISPR or TALENs or whatever DNA editing technology into human cells).

It is healthy to have career long aspirations, but for these programs I feel they are seeking students who can first achieve short term research goals. Since most (if not all) of the people interviewing you will not be geneticists, if the question(s) come up, you need to show them/tell them what is feasible over the next few years during your combined degrees. If field specific goals come up (which they probably won't, it would more likely be career long goals such as: in 15 years I hope to be finishing my fellowship and applying for a junior faculty position...), then maybe talk about long term (~25-30 years) aims of gene therapy that may be feasible (i.e. using gene therapy to eradicate all mono-genetic diseases). Just my opinion.

Awesome, thanks, exactly the reply I was hoping for. What's the practicality of going into genetic medicine at this point? Are there very few positions available due to limited technology? Is the pay high or low? Does it involve performing the actual procedures/surgeries to deliver the genes, or would it only involve consultation and then relaying the patient to a normal surgeon to replace the GM marrow or whatever?

 

[SpacemanSpifff]

Awesome, thanks, exactly the reply I was hoping for. What's the practicality of going into genetic medicine at this point? Are there very few positions available due to limited technology? Is the pay high or low? Does it involve performing the actual procedures/surgeries to deliver the genes, or would it only involve consultation and then relaying the patient to a normal surgeon to replace the GM marrow or whatever?

Per the AAMC: "The job of the medical geneticist is to recognize genetic disorders and birth defects, to understand the significance of these with respect to the well-being of the patient, to arrange for proper treatment, and perhaps most important, to help the patient and/or the patient's family understand and cope with the disorder. This specialist uses modern cytogenetic, radiologic, and biochemical testing to assist in specialized genetic counseling, implements needed therapeutic interventions, and provides prevention through prenatal diagnosis. A medical geneticist plans and coordinates large scale screening programs for inborn errors of metabolism, hemoglobinopathies, chromosome abnormalities, and neural tube defects. Some medical geneticists work primarily with infants and children. Other medical geneticists, often those who are first trained as obstetricians, concentrate on the genetic problems of fetuses. Internists with training in medical genetics work with adult patients who may have familial forms of heart disease, cancer, or neurological disease. There are also opthalmologists, dermatologists, and pathologists who are medical geneticists.Great strides are being made in many areas of human genetics, leading to deeper understanding of the basic functions of genes. Such technologic advances also give rise to new methods of diagnosis and treatment. An increasingly important role of the medical geneticist is to act as the link between scientists who are making these technologic advances and patients who may benefit from them."

Here's a more in depth description: https://www.aamc.org/cim/choices/all2011/january2011/339984/medicalgenetics.html

Answering your other questions, again, per the AAMC:
1. The median salary for geneticists working at academic institutions is listed as $116,000 for an assistant professor and $188,000 for a full professor. No figures were provided for non-academic practices, possibly because they are fairly rare.
2. The competitiveness of MG was rated as "low", with the mean Step 1 of incoming residents being 212 (mean Step 2 was 215). Residency slots have gone unfilled in years past, so positions are there for those interested in pursuing them.

An MG practice can be combined with other specialties like oncology, pediatrics, or IM so you might be able to incorporate procedures into your practice. As an aside, a bone marrow transplant is not usually a surgical intervention.

 

[Optimus-Prime]

Sounds like a genetic counselor who writes scrips

 

[GeneRx]

Hi everyone,

To the OP. Gene therapy hasn't really made it into clinical medicine in the US but it is clearly on its way. Sadly the current practice of Clinical Genetics doesn't involve many procedures, and, except in research, no gene therapy yet.

Currently available therapies, however, include enzyme replacement therapy which is still kinda neat. And of course gene therapy is on its way. In fact some strategies for gene therapy in clinical trials involve also involve procedures including image guided injections, hydrostatic retrograde perfusion, and Ultrasound guided gene delivery, and many more.

Most clinical geneticists don't do many procedures other than skin biopsies, but there are exceptions. Some clinical geneticists do CVS and amniocentesis as well. Most of these geneticists are also OB/Gyn, and MFM trained but not all of them. MFM geneticists tend to do many other, non-genetic procedures as well. In the future it is certainly possible that geneticists will be doing more procedures, and indeed I recently heard a lecture in which interventional genetics was mentioned 4 or 5 times.

For further exploration, there are a variety of descriptions of careers in clinical genetics at the American College of Medical Genetics and Genomics website ( https://www.acmg.net/ ). But I would say that that gene therapy is not a current focus. It is a focus however, for the American Society of Gene and Cell therapy, which does count many clinical geneticists amongst its members (http://www.asgct.org/ ). I once asked a medical geneticists who is the director for the center for gene therapy at the University of Minnesota, what I should do if I was interested in Gene Therapy and he told me to join the American Society for Gene and Cell therapy. In terms of salary, there is a report available from the American College of Medical Genetics and Genomics ( https://www.acmg.net/StaticContent/Survey/2011ACMGSalarySurveyReportFINALMay2012.pdf ) It has private practice and academic practice numbers. Geneticists tend to be happy, and have good hours. There are exceptions, and there is a huge range in salary.

All of that said, if you are interested in transhumanism, you might also want to consider neurology, psychiatry, neurology or physiatry. All of those areas have more procedures (today anyway) and might be a path into connectomics and neural circuit dynamics which are pretty interesting too. Yes I know that psychiatry is on the list, and indeed some places, in addition do the occasional LP they to trans-cranial magnetic stimulation, and ECT.

In summary, I think clinical genetics and gene therapy are really cool, but the procedures and the gene therapy part is still somewhat aspirational.

I hope this is helpful.

GeneRx

 

[mimelim]

MD/PhD because I am interested in both sides of genetics, medical and research. This field is in its infancy and I want to help foster it in every way I can. I don't think my expectations are unrealistic. Look at the progress we have made in a single decade. This progress will compound exponentially. Kurzweil doesn't particularly tickle my fancy.

I didn't discount the advice, I merely questioned its founding in logic because it was not backed up with any explanation. Always being honest for honesty's sake is not self-evident at all. Appeal to tradition is a logical fallacy. If you think that every single medical student at a top 10 medical school didn't embellish heavily during their interview in order to stand out and impress, you're mistaken. Of course, cynically admitting this fact is a bit distasteful, but I prefer frankness. Here's my point of view. Most of these adcoms are going to be baby boomers with a very primitive world view. Their narrow minds can't comprehend the changes that will occur in the 21st century. They want to preserve an antiquated status quo that will quickly become obsolete. My generation will forge a new world with new morals and achieve heights never before fathomed. If I tell these adcoms my dream they might think I am some autistic loser that spends too much time watching the movie Gattaca.

#1 You don't need to do an MD/PhD in order to do clinical duties and research, especially in a field where the vast majority of clinicians are doing research, so it is an expected part of most of their jobs. You did not mention anywhere that you have any research experience. It is a hard sell to say that you want to commit so much time to research without a solid foundation on which to stand on. Many if not most people that do MD/PhDs have an extensive research backgrounds. At a minimum, several Summers, if not working during the school year. Publication certainly is NOT mandatory, but a fair few do and those that don't typically are productive in other ways and have strong LOR.

#2 Regarding the red section. What exactly is your foundation for making this kind of bold statement? I interviewed at every top 10 I applied to (ie all of those outside of California). Probably met a hundred or so people on the trail, know dozens of others from attending one of those schools. I hate to break it to you, but some people don't need to embellish. Now sitting on the other side of the table, I can tell you that people are far more transparent than they think they are. If you look beyond the words at their productivity, it is obvious who has actually accomplished something and who just likes to talk. There is clearly a world of academics that you have never seen nor do you even know exists.

#3 Regarding the blue section. Never mind all admissions committee members, but all baby boomers have a "very primitive world view"? Really? You are that much more intellectually, culturally and emotionally superior to people who went through on average 12 years of post-HS education, and tended to be at the tops of their classes? Hint: the people that actually CAN make sweeping statements like this because of their insight don't make such juvenile comments.

#4 My honest opinion? Grow up. Do research, get a job, get a girlfriend/boyfriend/whatever. I have no idea what your academic qualifications are. You may be suitable clay to work with. However, even if you are. This is about so much more. Medical school is long, hard and grueling. Enthusiasm goes a long way. People incapable of functioning with colleagues, underlings and bosses are going to flounder. People that assume that they know more than everyone above them are going to get ignored. The people that actually do know more get stuff done and rise because of their productivity, not their sense of entitlement.