How do I become a geneticist?

[Nontraddoc00081]

Do I get a PhD or MD/DO? How long does it take?

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[Tangerine123]

Geneticist (IMG) here! 🙂

Short answer: it depends on your Goals

Research? Clinic?
Are you interested in Genetics as a general topic? Or a specific field (Neurogenetics for example)

You can always go the MD/DO path. You have to graduate medical school and then usually continue training in a "base" field such as pediatrics/IM and then you can apply to a genetics fellowship.

I'll share my "non-traditional" experience, to show that there are many paths to choose from.

After medical school I decided to pursue a masters in Genetics. It was both lab and patient/clinic based. After that, I worked as a liason between a private genetics lab and public hospitals. Working together with attendings (mostly from peds) to discuss cases, evaluate patients, run DDxs, decide what diagnostic tests to order and I would interpret the results.

It was here were I decided that, while I did like genetics as a field, I disliked the clinical practice of a geneticist. I felt that you depended too much on others. They just consult you but you don't have a direct desicion making impact. I missed having my own cases to diagnose, treat and follow. It was also too broad. I wanted to focus on a specific field (Psych). Also, something important is that, most cases were "palliative". We would diagnose a patient just to inform them or their family that there was nothing we could do because there isn't a cure available. This is even more true in pediatrics. It became really hard to have " The talk" All the time with parents to explain that their son/daughter had a life expectancy of a few months or years and all we could offer was counceling and some quality of life improvements, but not a curative treatment.

This changed. Now i'm doing my residency in Psych combined with a PhD, focusing on neurogenetics and imaging genetics. I lead the genetics part of our clinical trials. Since genetics is really broad I have a lot of freedom, while also practicing the specialty I liked the most (Psych).

So you can follow your desidered specialty and do extensive genetics-focused research there. Perhaps an MD/PhD and then Residency and Fellowship in your desired field. Or you can go with the more traditional route and pursue a Residency/Fellowship in genetics to practice exclusively that.

This is all asumming that you want contact with patients. You can always go directly to a PhD without a medical degree if you are interested in basic research/industry. People that follow this route are the real deal. They work with the coolest toys and (usually) know more about the field than medical doctors. In a medical research setting they work together with MD/DOs and are a big backbone of the field. I can't stress enough how important they are. They are the ones that save you when your bioinformatics/stats knowledge falters and you have no clue how to proceed with the data. Now that i'm doing GWAS and Polygenic Scores I tend to rely on them often, and they deliver!

The cool thing about genetics is that you can apply it to any medical branch. So at the end of the day, all paths lead to Rome 🙂

 

[TelemarketingEnigma]

the post above has a great summary of MD/DO vs. PhD options, I'll also throw out that Genetic Counseling is it's own training path that can be a great option for some people depending on what you like about the field! that would be masters-level training, usually clinical but can also be involved in research

 

[futureapppsy2]

Also, something important is that, most cases were "palliative". We would diagnose a patient just to inform them or their family that there was nothing we could do because there isn't a cure available. This is even more true in pediatrics. It became really hard to have " The talk" All the time with parents to explain that their son/daughter had a life expectancy of a few months or years and all we could offer was counceling and some quality of life improvements, but not a curative treatment.

I rotated in peds/AYA genetic clinic and wanted to second this. There was a lot of saying “well, these things may improve QOL but won’t have a direct impact on the condition or lifespan” and even some “no one else has been recorded as having this particular deletion before, so we don’t really know how it will play out clinically.” Also, the geneticists were really bugged by a lot of the patients who came in looking for an EDS dx, so even extremely niche specialties have their “problem patient” archetypes, I guess.

 

[confused_doc]

Geneticist (IMG) here! 🙂

Short answer: it depends on your Goals

Research? Clinic?
Are you interested in Genetics as a general topic? Or a specific field (Neurogenetics for example)

You can always go the MD/DO path. You have to graduate medical school and then usually continue training in a "base" field such as pediatrics/IM and then you can apply to a genetics fellowship.

I'll share my "non-traditional" experience, to show that there are many paths to choose from.

After medical school I decided to pursue a masters in Genetics. It was both lab and patient/clinic based. After that, I worked as a liason between a private genetics lab and public hospitals. Working together with attendings (mostly from peds) to discuss cases, evaluate patients, run DDxs, decide what diagnostic tests to order and I would interpret the results.

It was here were I decided that, while I did like genetics as a field, I disliked the clinical practice of a geneticist. I felt that you depended too much on others. They just consult you but you don't have a direct desicion making impact. I missed having my own cases to diagnose, treat and follow. It was also too broad. I wanted to focus on a specific field (Psych). Also, something important is that, most cases were "palliative". We would diagnose a patient just to inform them or their family that there was nothing we could do because there isn't a cure available. This is even more true in pediatrics. It became really hard to have " The talk" All the time with parents to explain that their son/daughter had a life expectancy of a few months or years and all we could offer was counceling and some quality of life improvements, but not a curative treatment.

This changed. Now i'm doing my residency in Psych combined with a PhD, focusing on neurogenetics and imaging genetics. I lead the genetics part of our clinical trials. Since genetics is really broad I have a lot of freedom, while also practicing the specialty I liked the most (Psych).

So you can follow your desidered specialty and do extensive genetics-focused research there. Perhaps an MD/PhD and then Residency and Fellowship in your desired field. Or you can go with the more traditional route and pursue a Residency/Fellowship in genetics to practice exclusively that.

This is all asumming that you want contact with patients. You can always go directly to a PhD without a medical degree if you are interested in basic research/industry. People that follow this route are the real deal. They work with the coolest toys and (usually) know more about the field than medical doctors. In a medical research setting they work together with MD/DOs and are a big backbone of the field. I can't stress enough how important they are. They are the ones that save you when your bioinformatics/stats knowledge falters and you have no clue how to proceed with the data. Now that i'm doing GWAS and Polygenic Scores I tend to rely on them often, and they deliver!

The cool thing about genetics is that you can apply it to any medical branch. So at the end of the day, all paths lead to Rome 🙂

How did you manage to combine your psych residency with a Phd? Does this mean it will extend your psych training? How long will it be altogether to complete?

 

[Redpancreas]

How did you manage to combine your psych residency with a Phd? Does this mean it will extend your psych training? How long will it be altogether to complete?

I'm not who you asked, but that person you quoted posted last here in February so I'll try to speculate in the meantime. They mention completion of a Masters in Genetics that included lab, (likely classroom), and clinical components prior to residency. I don't think residencies would allow you to split clinical duties with PhD stuff within a given day/week for the sake of continuity/patient care, but I do know that residencies give their residents research years. ACGME surgery residencies can oftentimes block off 1-2 years for dedicated research on top of the 5 year requirement. Masters coursework can often translate to PhD coursework so OP may have been able to transfer credits from their Masters and finish off the PhD (i.e. thesis, a few more courses, etc.) with just 1-2 research years added to their general training like the gen surg resident example so it wasn't like the did the full equivalent of a PhD during residency, but rather completed it in residency.

@Tangerine123 feel free to correct me.

 

[Dave1980]

Geneticist (IMG) here! 🙂

Short answer: it depends on your Goals

Research? Clinic?
Are you interested in Genetics as a general topic? Or a specific field (Neurogenetics for example)

You can always go the MD/DO path. You have to graduate medical school and then usually continue training in a "base" field such as pediatrics/IM and then you can apply to a genetics fellowship.

I'll share my "non-traditional" experience, to show that there are many paths to choose from.

After medical school I decided to pursue a masters in Genetics. It was both lab and patient/clinic based. After that, I worked as a liason between a private genetics lab and public hospitals. Working together with attendings (mostly from peds) to discuss cases, evaluate patients, run DDxs, decide what diagnostic tests to order and I would interpret the results.

It was here were I decided that, while I did like genetics as a field, I disliked the clinical practice of a geneticist. I felt that you depended too much on others. They just consult you but you don't have a direct desicion making impact. I missed having my own cases to diagnose, treat and follow. It was also too broad. I wanted to focus on a specific field (Psych). Also, something important is that, most cases were "palliative". We would diagnose a patient just to inform them or their family that there was nothing we could do because there isn't a cure available. This is even more true in pediatrics. It became really hard to have " The talk" All the time with parents to explain that their son/daughter had a life expectancy of a few months or years and all we could offer was counceling and some quality of life improvements, but not a curative treatment.

This changed. Now i'm doing my residency in Psych combined with a PhD, focusing on neurogenetics and imaging genetics. I lead the genetics part of our clinical trials. Since genetics is really broad I have a lot of freedom, while also practicing the specialty I liked the most (Psych).

So you can follow your desidered specialty and do extensive genetics-focused research there. Perhaps an MD/PhD and then Residency and Fellowship in your desired field. Or you can go with the more traditional route and pursue a Residency/Fellowship in genetics to practice exclusively that.

This is all asumming that you want contact with patients. You can always go directly to a PhD without a medical degree if you are interested in basic research/industry. People that follow this route are the real deal. They work with the coolest toys and (usually) know more about the field than medical doctors. In a medical research setting they work together with MD/DOs and are a big backbone of the field. I can't stress enough how important they are. They are the ones that save you when your bioinformatics/stats knowledge falters and you have no clue how to proceed with the data. Now that i'm doing GWAS and Polygenic Scores I tend to rely on them often, and they deliver!

The cool thing about genetics is that you can apply it to any medical branch. So at the end of the day, all paths lead to Rome 🙂

Wow that is a lot of training. Med school, Masters, Psych residency, Phd. At what age will you actually become an Attending if you don't mind me asking?

 

[Tangerine123]

How did you manage to combine your psych residency with a Phd? Does this mean it will extend your psych training? How long will it be altogether to complete?

I'm not who you asked, but that person you quoted posted last here in February so I'll try to speculate in the meantime. They mention completion of a Masters in Genetics that included lab, (likely classroom), and clinical components prior to residency. I don't think residencies would allow you to split clinical duties with PhD stuff within a given day/week for the sake of continuity/patient care, but I do know that residencies give their residents research years. ACGME surgery residencies can oftentimes block off 1-2 years for dedicated research on top of the 5 year requirement. Masters coursework can often translate to PhD coursework so OP may have been able to transfer credits from their Masters and finish off the PhD (i.e. thesis, a few more courses, etc.) with just 1-2 research years added to their general training like the gen surg resident example so it wasn't like the did the full equivalent of a PhD during residency, but rather completed it in residency.

@Tangerine123 feel free to correct me.

Wow that is a lot of training. Med school, Masters, Psych residency, Phd. At what age will you actually become an Attending if you don't mind me asking?

Sorry, I've been AFK for a while.

An important note. It's a European program designed to combine both. You have 3 funded years of protected research time that you can use up whenever you want to during your residency. Most people in the program switch sides every 6 months or so, depending on the progress of your research. Some decide to do 50/50 by having clinical duties only half of the day, but it's a hassle. People that do it at the same time say that it tends to be 75/50 rsther than 50/50, so it's overwhelming. The MDs working with cell cultures and animal models have a harder time to do it simultaneously than the MDs working in computational projects or clinical trials.

@Redpancreas is right about the MSc. And we do need credits for the PhD(30 ECTS) , but it's doable. Things like Workshops or conferences ammount to something like 0.5 ECTS for every 2 days of participation

@Dave1980 If everything goes as planned... I should be 32 *crosses fingers*