Medical Genetics

[hedera916]

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Anyone interested in Medical Genetics? I find this fast-paced field very interesting and fulfilling. I don't know much about my chances though, since I'm not in an MD-PhD/physician-scientist program or in the NIH Training programs. But I'm thinking of going into Pediatrics or Psychiatry first as my pre-genetics...unless of course I get into any of the combined programs...they look like very competitive programs though.

 

[agp4]

We just finished up our med gen unit last week. I think the field's really interesting, but I don't think I could spend all my time looking at those sad babies. It was depressing enough having to cycle through the pictures to learn the genetic disorders.

 

[G0S2]

Anyone interested in Medical Genetics? I find this fast-paced field very interesting and fulfilling. I don't know much about my chances though, since I'm not in an MD-PhD/physician-scientist program or in the NIH Training programs. But I'm thinking of going into Pediatrics or Psychiatry first as my pre-genetics...unless of course I get into any of the combined programs...they look like very competitive programs though.

Do you have some research experience? I think the key to the med gen fellowship is to have some solid research experience and there is plenty of time to get that during med school and residency.

 

[hedera916]

Not in the field of genetics, no. I'm hoping to get more research experience during my residency...I know I really need it for a med gen fellowship. Actually I'm thinking also of getting a med gen residency as well, after I finish Peds or Psych, because I know I'll be needing it...

 

[G0S2]

Not in the field of genetics, no. I'm hoping to get more research experience during my residency...I know I really need it for a med gen fellowship. Actually I'm thinking also of getting a med gen residency as well, after I finish Peds or Psych, because I know I'll be needing it...

It doesn't have to be hard core med gen, just basic research at the bench. If after your residency you want a med/gen fellowship, you can get one with some basic research experience under your belt from residency. Believe me, you will be highly sought after if you complete your residency with research and want to be a med/gen fellow to be a physician scientist. They love that. Your fellowship can go almost as long as you want. One or two years is never enough to really develop a research project and get solid meaningful data. I know many who run labs and see patients.

 

[hedera916]

Thanks so much for the insight! Whew, I was worried that I'd have to be very experienced with hardcore med gen. Yes, I think my ideal setting would be that I would like to have my own research lab, and still see patients. I think I would also be happy to teach or give lectures if given the chance. I feel that I'm very much more a research-oriented person than a "pure" clinician...I'm happiest when I work on research projects (just for school, nothing major) now in medschool, and even back during pre-med.

 

[G0S2]

Thanks so much for the insight! Whew, I was worried that I'd have to be very experienced with hardcore med gen. Yes, I think my ideal setting would be that I would like to have my own research lab, and still see patients. I think I would also be happy to teach or give lectures if given the chance. I feel that I'm very much more a research-oriented person than a "pure" clinician...I'm happiest when I work on research projects (just for school, nothing major) now in medschool, and even back during pre-med.

Well it is refreshing to hear a med student say that he/she likes research. I am finishing up a PhD and will start med school in 2005 (I deferred for a year). My plan is to enter internal med followed by hem/onc. I would ultimately love to see patients and have a lab to follow through with some ideas. Best of luck to you!!!

 

[Gene Queen]

Hi! I'm a first year resident in Medical Genetics in Ontario, Canada. I'm not sure how the training works in the States... here you can either do a fellowship (2 years) after peds or other residency, or you can do what I'm doing, which is enter directly into a residency in medical genetics from med school. My program is 5 years - one year of adult medicine, one year of peds, one year of research and lab rotations, and 2 years of clinical genetics.

I love this field! I decided to go into medicine for the express purpose of becoming an MD geneticist. I did a Masters in Molecular Biology and then went to med school. If you are already in med school, try approaching one of the clinical geneticists at your institution and see if you can write up a case report or two for publication, if you don't have time to do bench work. More important than hard-core research is showing a genuine interest in the specialty!

I'd love to talk more about it if you have anymore questions... also I'd love to hear more about how the training works in the States. In Canada they're talking about phasing out the fellowships and making the 5-year residency the only route for training MD geneticists.

Gene Queen

 

[hedera916]

Gene Queen I sent you a private message.

I wouldn't be surprised if the 5 year residency route would eventually be the sole route for Med Gen in maybe 10 years or so, or even less. In both the US and Canada.

 

[Fermata]

Wow. There has always been a shortage of information about this field on SDN and suddenly this pops up.

Would any of you mind expounding on what you like about the new and ever growing field/specialty?

Thanks in advance.

 

[Gene Queen]

Would any of you mind expounding on what you like about the new and ever growing field/specialty?

Not at all!!!

I guess the first thing is, I love studying genetics. I found this out in high school. I find it so fascinating how such minute changes in DNA can cause such dramatic health conditions and malformation of human form.

As for genetics as a field of medicine, I should let you know that I applied to med school for the express purpose of going into clinical genetics. So I was never a hard-core "I want to be a doctor" person. That being said, I really enjoyed med school, although some parts more than others! I don't like taking care of really sick patients (eg, ICU, ER) and I don't particularly like doing procedures either. I don't want a high-stress, fast-paced job. I want to have an office and see patients in consultation and spend a lot of time with each patient. That being said, I did consider psychiatry for a brief time.

I like the academic side of medicine, and I definitely want to be at an academic center. I really want to teach and do research too. People usually assume that in clinical genetics you work in a lab. Not so. You need to understand the principles behind the tests you order but you don't actually do the lab work. As for research, some MD geneticists have their own research lab with grad students and techs, but most don't. Most MD geneticists do clinical research, like publishing case reports and the like.

Lifestyle is great. On par with radiology and pathology I would say. But even less call! The pay is less though. I suppose it depends where you are, but most Canadian geneticists are on salary. I've been told by several female geneticists that med gen is a great career for women who want families.

As for the daily work in med gen, the patients are always so interesting! Unlike many medical specialties where you see the same problems all the time (eg, CAD for cardiologists, asthma for respirologists, etc), every case is unique in genetics. The range of patient problems is also very wide. In one day you might see a child with developmental delay, a middle-aged person with a neurodegenerative disease, a pregnant couple with a prenatally diagnosed chromosome abnormality in the fetus, and a young woman concerned about breast cancer in the family.

There is a lot of counselling involved. You have to have great communication skills to be a good geneticists.

Sometimes you have to deliver very bad news. Also, there is not much you can do for your patients in terms of treatment or cure. Some sticky ethical issues can come up. These are some of the downsides of med gen. But there are difficult situations in every area of medicine.

These are the main things I love about med gen. I'd be happy to elaborate on anything about the field!
Gene Queen

 

[Fermata]

Thank you for the information.

 

[carrigallen]

I have a question: what does a medical genetics physician do, if they are shut out of research?

I knew several MD medical geneticists who strongly discouraged me from that route. One doctor had literally failed; his last grant expired and he was forced out of the medical school (OHSU). Last I heard, he was job-hunting in the Midwest. This was an experienced research physician in his forties, and his funding completely dried up because he could not compete with his Phd peers for grant money.

From what they said, it doesn't sound like an inviting job. Many researchers have told me that nowadays you are inadequately trained as an MD to get grants or succeed in research. Also, although some people manage it, the time balance is difficult and unwieldy.

Also, as a medical geneticist, another physician said that you are severely hampered by human research protocols and a mileu of bureucracy for what should be simple genetic studies. This slows down progress and bogs you down in extra paperwork.

I have heard that you also encounter the problem of genetic orphan research - competing for tiny pools of money for rare genetic diseases. They complain that you rarely have the chance to see or treat these patients; instead you are flooded with mundane cases which have little to do with your field of expertise.

I realize this is a pessimistic view - I just wanted to present it to see what current medical geneticists thought about this.

 

[sambo]

We need more genetics MDs, and I'm glad there are people interested in the field, but good gawd, I have med. genetics at the moment and it sucks ass!!! Hundreds of rare diseases that all look alike (Crouzon, Pfeiffer, Smith-Lemli-Opitz, blah, blah, blah) and you are expected to know ALL the symptoms of every one of them.

I could NEVER EVER do medical genetics. Different strokes for different folks, I guess.

 

[Shredder]

I guess the first thing is, I love studying genetics. I found this out in high school. I find it so fascinating how such minute changes in DNA can cause such dramatic health conditions and malformation of human form.

As for genetics as a field of medicine, I should let you know that I applied to med school for the express purpose of going into clinical genetics. So I was never a hard-core "I want to be a doctor" person.

this is a good little thread, old though. im bumping--just a premed here thats interested in the field. im a lot like gene queen, based on these comments she made. the pessimistic comments a little above mine here are good; balanced views are important to know what one is going into and make informed decisions. seems fascinating though. any schools with particularly strong programs? whats the current status basically

 

[evade]

Wow, there are other people on here who want to do med gen! Here I thought I was totally out there. I, too, am shooting to be an MD geneticist. I'm also going to put out a call for any info on how the field is doing as well, because I honestly don't know much about residency programs at this point (but hey, I'm just a lowly first year). I also don't know how much involvement in research I'm going to have, because right now I have zip in the way of bench research. I'm interested in clinical research to be sure, but am uncertain as to how to get involved. I guess I'd just like to hear from others how they're heading down this path.

 

[Shredder]

ive always been annoyed when i tell ppl im interested in medical genetics and they look at me with skepticism, as if i should do a phd instead. applies to advisors, peers, even interviewers. they make it seem like every aspiring doc should want to be a surgeon, and everyone else can be a phd especially ppl like pathologists and geneticists. sucks

 

[evade]

ive always been annoyed when i tell ppl im interested in medical genetics and they look at me with skepticism, as if i should do a phd instead. applies to advisors, peers, even interviewers. they make it seem like every aspiring doc should want to be a surgeon, and everyone else can be a phd especially ppl like pathologists and geneticists. sucks

Or, when you say you're interested in medical genetics, people say, "oh, you mean like genetic counseling?" No, not like genetic counseling. Like diagnosing and treating (for such disorders you can treat. . .I spent a year at a metabolic clinic, and you can do remarkable things for a lot of those kids with meticulous dietary management). People have this impression that there's nothing you can do about someone's genes, so there's no purpose to clinical genetics. Such silliness.

 

[Shredder]

yeah thats a good point, i forgot to mention the counseling bit but they suggest that too. its pretty pejorative. and youre right on the other count too--its like ppl who get a bad genetic hand can just be left high and dry, theirs are completely lost causes. IMO genetics involves the most compassion out of perhaps all medical fields, bc its pretty hard to pin down any blame on victims, unlike lung cancer, cirrhosis or obesity. truly they just get screwed and ive always felt bad about that. ppl harp on and on about how many patients are just victims of circumstances...but for a lot of them come on

 

[knitwitty]

You may be interested in the discussion on medical genetics on Ian Wong's premed site (the Canadian counterpart of SDN) where a med gen resident gave us details of her training through first and second year of residency.

http://p090.ezboard.com/fpremed101frm52.showMessage?topicID=2.topic

Gene Queen, hello from a fellow Ontarian!!

It's great to see so many people interested... I was starting to think that in the US there was no residency in med gen because it's never mentioned on SDN

 

[marcus_aurelius]

i am also extremely interested in the field of medical genetics! i'm glad to know that i'm not alone!

when i say that i'm interested in a genetics fellowship, my friends look at me like i'm crazy and tell me i wont make any money.

but the field excites me. there is so much to be found and with an m.d. we have an opportunity to link research with clinical trials. i'm trying to decide wheter to enter a residency in internal med, peds or ob-gyn. i'm thinking the ob-gyn and peds have more of a potential.

i am particularly interested in cancer genetics and ivf. so i'm also considering heme-onc. i dont like ob-gyn a whole lot, so it is deterring me from entering ivf, but who knows, i might change my mind.

either way, we probably wont get to see big bucks bc i htink it will be a LONG time before these trials amount to anything real in patient treatments.

i still think that it is an exciting area to enter now. i have a genetic disease in my family and this field could be the answer, or at least an avenue of hope.

good luck. let me know if u find any new info. perhaps we can set up a seperate forum for medical genetics to get those of us interested in it to express our ideas and opinions. i think it would be fun

 

[marcus_aurelius]

one question though.....

when does one draw the line in medical genetics as to what is ethical or moral. it seems the more advanced this field gets, the greater the propensity for miraculous cures, as well as unimaginable atrocities.

and if the U.S. imposes restrictions (as they have on stem cells) how does this solve a problem.....bc the opportunity still exists abroad in nations where there is little to no supervision.

is pandora's box already open?

 

[Shredder]

regarding morals/ethics in science: proceed first, ask questions later. without this mentality progress ceases. even the television would not have been created. pandora's box never closes. restrictions in the US will not spread worldwide and we will inevitably fall behind. our morals have been one of our strengths historically, but i dont think where science is concerned. thats just my mentality though, im the gas pedal type.

 

[marcus_aurelius]

regarding morals/ethics in science: proceed first, ask questions later. without this mentality progress ceases. even the television would not have been created. pandora's box never closes. restrictions in the US will not spread worldwide and we will inevitably fall behind. our morals have been one of our strengths historically, but i dont think where science is concerned. thats just my mentality though, im the gas pedal type.

Do you like tennis?

 

[Shredder]

haha yeah...can you tell?