Medical Genetics?

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pillowhead

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Is there such a specialty or even a subspecialty?

yes. the medical geneticists I have seen have always done a pediatrics residency first and work in children's hospitals.
 

Haemulon

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Yes, MedGen became a full fledged specialty in 1993 I believe, although you technically get board certification in Clinical Genetics. It requires 2 preliminary years followed by 2-3 years of Med Gen. Dual residencies exist for Peds/MedGen and IM/MedGen, each of which is a combined 5 years of training. In some places you can do MedGen as a fellowship for 2-3 years after completing a residency in another area. There are also MedGen fellowships leading to board eligibility in fields such as cytogenetics and molecular genetics. These are more laboratory/research focused.
 
W

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Yes, but actual docs are few and far between. You pretty much have to be at an academic center, and I think that before a hospital can claim to be a "Children's Hospital," you have to have one hanging around.

It's not very competative though. I can't see them billing out for procedures, and treatment options will be referred out to whatever disease the patient has if they have one (pulm for CF, endocrine for weird metabolic disease, neuro for NTD's, etc.). Overall, I think you're just a diagnostician who usually runs necessary research program on the side.

It's definitely one of those specialties that premeds think is cool only to find out "not so much" after they get a taste of real medicine. Infectious disease is the same way.
 

Slitherin

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The medical geneticist that lectured at our school was a pathologist, if I remember correctly, that ran a lab at a major academic hospital where they ran the routine screening tests, as well as some not so routine diagnostic tests, while working on new tests and improving the ones currently available. An agreement such as this where the hospital profits from the lab by attracting patients for workups indicated by the lab tests, and the geneticist is able to bill for some of the testing, and generate grant money, could be a potential goldmine, aside from being a rewarding career.
 

Haemulon

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The medical geneticist that lectured at our school was a pathologist, if I remember correctly, that ran a lab at a major academic hospital where they ran the routine screening tests, as well as some not so routine diagnostic tests, while working on new tests and improving the ones currently available. An agreement such as this where the hospital profits from the lab by attracting patients for workups indicated by the lab tests, and the geneticist is able to bill for some of the testing, and generate grant money, could be a potential goldmine, aside from being a rewarding career.

I can see that working. One could potentially direct several labs ranging from cytogenetics to molecular diagnostics and do all kinda of lucrative tests. However this is the life more of a researcher/academian than of a clinician. I had envisaged a career as a Pediatrician/Clinical geneticist that would diagnose and manage the treatment for unusual cases and those with genetic conditions. Since then though, I have read more and more about the field and it seems virtually everyone in Med Gen goes into research and academics, and just dabbles in clinical management of patients. Plus, most residencies in med gen emphasize bench research for at least a year, and I have had my fill of that already, at least for a while.
 

Haemulon

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Yes, but actual docs are few and far between. You pretty much have to be at an academic center, and I think that before a hospital can claim to be a "Children's Hospital," you have to have one hanging around.

It's not very competative though. I can't see them billing out for procedures, and treatment options will be referred out to whatever disease the patient has if they have one (pulm for CF, endocrine for weird metabolic disease, neuro for NTD's, etc.). Overall, I think you're just a diagnostician who usually runs necessary research program on the side.

It's definitely one of those specialties that premeds think is cool only to find out "not so much" after they get a taste of real medicine. Infectious disease is the same way.

I am falling into this category, as I learn more about how people actually practice in that specialty ... its not looking as cool as I thought it would be. Your points are certainly valid. I'll still keep my eye on it for a while though, just out of curiosity.
 

Haemulon

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We have a Genetics Forum here on SDN. I'm sure they could use the traffic. ;)

Your point is taken, but virtually every thread there is started/dominated by a certain banned individual and talks more about genetic counseling than medical specialties or clinical rotations.
 

jonathon

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Your point is taken, but virtually every thread there is started/dominated by a certain banned individual and talks more about genetic counseling than medical specialties or clinical rotations.

Feel free to come and post in the Genetics Forum. There really isn't any talk in that forum about clinical genetics because there has been no need to so far. We can start some posts about clinical genetics if you want? I could pull up some articles that describe the field of clinical genetics and make a listing of what a person in clinical genetics does/can do. :)
 

DropkickMurphy

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Feel free to come and post in the Genetics Forum. There really isn't any talk in that forum about clinical genetics because there has been no need to so far. We can start some posts about clinical genetics if you want? I could pull up some articles that describe the field of clinical genetics and make a listing of what a person in clinical genetics does/can do. :)
Wow.....apparently two bans is not enough to stop this posting powerhouse. :laugh:
 
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acedens

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Overall, I think you're just a diagnostician who usually runs necessary research program on the side.

I'm a genetic counseling student, and I am going to medical school this fall with plans to become a medical geneticist. I am in SC, and the only training program here is the Greenwood Genetics Center. They are great, though, and the have a lab which generates money, but they hire several medical geneticists to see patients in the clinic in pediatric and cancer settings, organize the fetal pathology division, and travel to clinics to provide genetic services to patients in the DDSN (Dept of Disabilities and Special Needs) network. They have several offices across the state, a also a traveling metabolic team. So, yes, they can do research if they need funding to "private practice," but there are certainly jobs for people who want to diagnose syndromes in newborns and children and coordinate a medical management plan for their long-term health needs. I don't know how many other places operate like GGC, though.
 

homeobox_genes

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There's enough variability in the programs that bench research is not necessarily mandatory, and you certainly get to see a vast number of clinical cases. When you think about the fact that multiple congenital anomalies are the commonest cause of perinatal mortality in the US, there's certainly a clinical need. Much of what I've read in these threads so far is bunk. You're hearing from the horse's mouth.
 

med_heidelberg

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Hi does anyone have any more specific information about medical genetics? I am considering going into this field. I have a background in genetics, and I'm an American citizen studying in Europe. Iserson's doesn't have too much information, but it does say that the field is 50% IMG. Therefore, it doesn't appear to be very competitive. Why is this? The average work week for residents is around 40 hours and there is little to no call. Do clinical geneticists not have a very high median income compared to other specialities, or are medical students turned off by genetics (most people I study with can't stand it actually). I've looked at the FRIEDA website and checked out the various programs. Most are at good universities in large cities. If there's anyone working in this field, I would love to hear from you.
 

gbwillner

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Hi does anyone have any more specific information about medical genetics? I am considering going into this field. I have a background in genetics, and I'm an American citizen studying in Europe. Iserson's doesn't have too much information, but it does say that the field is 50% IMG. Therefore, it doesn't appear to be very competitive. Why is this? The average work week for residents is around 40 hours and there is little to no call. Do clinical geneticists not have a very high median income compared to other specialities, or are medical students turned off by genetics (most people I study with can't stand it actually). I've looked at the FRIEDA website and checked out the various programs. Most are at good universities in large cities. If there's anyone working in this field, I would love to hear from you.

I have a PhD in genetics and I also looked into this field, but didn't really like what I saw. There are several reasons why it is not that competitive:

1: Relatively low income- you work hard in either a straight-up Clinical genetics residency (only a handful of academic centers have this specialty) or do peds/medicine first and then a fellowship... and you will earn equal to or less than someone who just did medicine. The reason is that you don't really do any procedures yourself and can only bill for your consult.

2: No one knows about it. There are several great fields out there that few people know about, like nuclear medicine. They may be exactly what you're looking for, but may not ever hear about it in medical school. As evidence of this (I believe), you'll find that the clinical genetics residency is outside the match.

3: There are very few positions available and all are in tertiary medical centers. You will spend much of your time doing research, and see rare and unique cases on call and run a specialty clinic. For example, if you are a skeletal dysplasia expert, how many patients will you really see? You need to be at a major medical center to have enough cases to keep you busy, and even then you may only do clinic once a week.

On the flip side, if you are really looking forward to doing research in developmental genetics or studying rare disease, this is an excellent opportunity. What really turned me off is only working with rare disease, and I wanted my research to be more broadly applicable.
 
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med_heidelberg

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I have a PhD in genetics and I also looked into this field, but didn't really like what I saw. There are several reasons why it is not that competitive:

1: Relatively low income- you work hard in either a straight-up Clinical genetics residency (only a handful of academic centers have this specialty) or do peds/medicine first and then a fellowship... and you will earn equal to or less than someone who just did medicine. The reason is that you don't really do any procedures yourself and can only bill for your consult.

2: No one knows about it. There are several great fields out there that few people know about, like nuclear medicine. They may be exactly what you're looking for, but may not ever hear about it in medical school. As evidence of this (I believe), you'll find that the clinical genetics residency is outside the match.

3: There are very few positions available and all are in tertiary medical centers. You will spend much of your time doing research, and see rare and unique cases on call and run a specialty clinic. For example, if you are a skeletal dysplasia expert, how many patients will you really see? You need to be at a major medical center to have enough cases to keep you busy, and even then you may only do clinic once a week.

On the flip side, if you are really looking forward to doing research in developmental genetics or studying rare disease, this is an excellent opportunity. What really turned me off is only working with rare disease, and I wanted my research to be more broadly applicable.

Hi gbwillner, thanks for your input, I appreciate it. I was kind of assuming that the pay is rather low for a doctor. On the other hand, if you arent doing many procedures, your chances of getting sued are lower. Maybe the lack of procedures you can do yourself could be balanced with applying new tests and molecular genetic techniques. I think desire to do research is a must for someone going into this field ... I would definitely like to get back into research but not be stuck as a postdoc (low pay, no job stability) doing it .. thats one reason why I switched over to medicine. As you mentioned, the question is, what kind of research and what kind of impact/applicability do you want it to have?

I will look more into it, and ask around. I may end up deciding against it as well, there is still time for me to decide, thankfully.
 

gbwillner

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Hi gbwillner, thanks for your input, I appreciate it. I was kind of assuming that the pay is rather low for a doctor. On the other hand, if you arent doing many procedures, your chances of getting sued are lower. Maybe the lack of procedures you can do yourself could be balanced with applying new tests and molecular genetic techniques. I think desire to do research is a must for someone going into this field ... I would definitely like to get back into research but not be stuck as a postdoc (low pay, no job stability) doing it .. thats one reason why I switched over to medicine. As you mentioned, the question is, what kind of research and what kind of impact/applicability do you want it to have?

I will look more into it, and ask around. I may end up deciding against it as well, there is still time for me to decide, thankfully.

No prob.
I think it is a good field if you want limited patient contact and lots of research opportunities, and truly love the subject matter. For me, the real problem was that I didn't want to work on rare disease and was more interested in cancer genetics and diagnostic test development for more broadly-useful diseases.
 

med_heidelberg

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No prob.
I think it is a good field if you want limited patient contact and lots of research opportunities, and truly love the subject matter. For me, the real problem was that I didn't want to work on rare disease and was more interested in cancer genetics and diagnostic test development for more broadly-useful diseases.


Forgive my ignorance .. but why can't one work in cancer genetics as a medical geneticist? Do you have to stick with rare disease? Seems like with medical genetics you would have leeway to pursue the research programme you wish. Which speciality would be more suited to cancer genetics research?

I'm looking for something intellectually stimulating but at the same time, not insanely time intensive. I also wouldn't mind teaching .. I was a TA in grad school and enjoyed it. I'd rather get paid less than work insane hours and be on call frequently. (I'm female and hope to have a family later on).
 
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gbwillner

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Forgive my ignorance .. but why can't one work in cancer genetics as a medical geneticist? Do you have to stick with rare disease? Seems like with medical genetics you would have leeway to pursue the research programme you wish. Which speciality would be more suited to cancer genetics research?

I'm looking for something intellectually stimulating but at the same time, not insanely time intensive. I also wouldn't mind teaching .. I was a TA in grad school and enjoyed it. I'd rather get paid less than work insane hours and be on call frequently. (I'm female and hope to have a family later on).

You can work on whatever you want. It is EASIER though to work on a subject that has some clinical relevace to what you do for a living. That's probably what 99% of people do.
 

homeobox_genes

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No prob.
I think it is a good field if you want limited patient contact and lots of research opportunities, and truly love the subject matter. For me, the real problem was that I didn't want to work on rare disease and was more interested in cancer genetics and diagnostic test development for more broadly-useful diseases.

I'm sorry, but your responses are full of schoolboy misconceptions about clinical genetics. It's clear that you don't have training in the field (your PhD in genetics doesn't count)--you sound like someone speaking about it from the outside, who doesn't have an accurate view (or who has a cliched view) of what the specialty is about, the caseload, the disease burden seen, the case diversity, or the clinical opportunities.

Med_heidelberg, PM me if you want. And do some more research on your own.
 
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