Medical school vs. Genetic Counseling? Also, family life of residents/physicians??

[laneypease]

Hi!

This will be tough since I'm not sure how many others know much about GC, but here goes!

I LOVE genetics, and I love cancer genetics in particular. I work as a cytogenetics heme oncology lab tech at Mayo Clinic after graduating this year (2019). I started out in school as pre-med, then switched to pre-genetic counseling.

I crave lifelong learning, being an expert in my field, and truly serving and helping people. I also want a lifestyle that allows me to have a family and enjoy my life, and lets me travel.\
Basically..... I want babies and dogs and a nice home and adventure. But... I also want a fulfilling career in healthcare. Ahhhhhhh!

What I like about GC:
I help people process difficult information, I teach genetics all day, I get to learn new things for the rest of my life, Also, significantly less time dedicated to the program; 2 year Masters program and straight to the workforce. Lots more time for family and having kids and being a great mom (which is VERY important to me) I know lots of GCs with families, the majority of GCs are female so the environment is mother-friendly. Pay is decent, but not amazing; $80k a year according to the program I'm looking at. (Also, I have everything I need for a complete competitive application for school. No extra legwork needed)
What I don't like about GC:
I don't actually get to FIX the patient's problem. I help them understand, help them get answers, help them cope, but I don't treat anything. Generally only see patients once or twice, don't develop long-term relationships.

What I like about MD/DO:
I treat problems AND help people learn and understand more of their diseases. I am an expert, and I also get to learn new things for the rest of my life. I get to help patients actually FIX problems, and I get to make the diagnosis. Oh, and pay is nice of course.
What I don't like about MD/DO:
LONG SCHOOLING AND RESIDENCY. NO TIME FOR FAMILY. AHHHH. Most likely have to move for school. Also: I still need to take MCAT and get shadowing hours.

Additional info:
3.62c
3.5s
350 hours clinical advocacy volunteering (working with ER sexual assault victims)
60 hours international clinical volunteering
50 hours nonclinical advocacy (sexual assault hotline)
30 hours community outreach type volunteering (nonclinical)
2 years as president of a club
6 years customer service, including 2 years management
1-2 years clinical genetics laboratory experience, working with pathologists, including a certification in cytogenetics
4 months of research lab work, just grunt work
No MD shadowing
16 hrs GC shadowing, plus phone calls/seminars
GRE: 165V,160Q,5.0W
TBD MCAT score

Thoughts?

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[laneypease]

Also~ is it really that difficult to put family first as a med student, resident, physician? I see so many mixed opinions on this. (I'm a woman who wants a family)

 

[Trollest]

@Goro @gonnif @LizzyM

 

[Goro]

You can have a family and be a medical student/residents/attending.

But you will have to make sacrifices.

If you can see yourself doing something else other than medicine, don't do medicine.

If you cannot see yourself doing anything but medicine, do medicine

 

[LizzyM]

You seem to have identified the pros and cons of the two options quite well.

You need some physician shadowing to really get a better idea of what physicians can fix and what they can only diagnosis and manage (and not always manage very successfully). Do that and then see where you end up in making a decision.

 

[Corali]

I know several doctors who work part-time, so I feel like depending on your specialty, you can have whatever work-life balance you want after residency. It just depends on what you want out of your career. Med school and residency are going to be long commitments regardless of specialty, though.

 

[laneypease]

You can have a family and be a medical student/residents/attending.

But you will have to make sacrifices.

If you can see yourself doing something else other than medicine, don't do medicine.

If you cannot see yourself doing anything but medicine, do medicine

Some days I can't imagine myself doing anything else. I've wanted it since I was 5. Other days I'm scared as heck that I'm going to hate the process, have no time, and miss out on too much else in life. OR, that I'll waste time and resources to get in and not even get into a program. I see other pre-meds that only study and prepare for school, but I've never been that student. I've been a working, involved student that didn't focus the majority of my time on my studies like them, and now my GPA represents that. My lack of confidence in my decision to pursue med school worries me.

 

[Goro]

Some days I can't imagine myself doing anything else. I've wanted it since I was 5. Other days I'm scared as heck that I'm going to hate the process, have no time, and miss out on too much else in life. OR, that I'll waste time and resources to get in and not even get into a program. I see other pre-meds that only study and prepare for school, but I've never been that student. I've been a working, involved student that didn't focus the majority of my time on my studies like them, and now my GPA represents that. My lack of confidence in my decision to pursue med school worries me.

You're going to have to figure this one out on your own.

 

[TelemarketingEnigma]

Honestly, speaking as someone possibly interested in medical genetics, GC may be a really good option for you. It probably depends heavily on the setting in which you end up working (GCs have a number of options beyond the clinic too), but at least in the genetics clinic at my school the GCs play a huge role, and work very collaboratively with the MDs. You may also find that for many patients with genetic conditions, there is no "fixing" them anyway - despite many big advancements on the horizon, for most patients with genetic conditions it's unlikely that we'll be fixing their DNA anytime soon. Much of the "fixing" may be done by other types of physicians (cardiologists, neurologists, etc) that manage the actual presentation of the patient's genetic condition. For what its worth, all of the GCs I've known have really loved their career choice.

The couple things I would consider doing medical school for instead: If you want to be an "expert" with a terminal degree, and if you want to have a deeper knowledge base for aspects of medicine beyond genetics. That said, with the growing nature of the GC field there is still lots of room to become an respected leader in genetic counseling (lots of genetic counselors are involved in research, policy, etc) but it can definitely impede you if you decided you wanted to be, say, a PI on a research grant (those usually require a terminal degree such as a phd/md).

 

[gyngyn]

Residency is only an 80 hour work week now.

 

[Osminog]

Here’s a rule of thumb: If you’re debating between a career in medicine and a career in something else, always go with the career in something else.

Only choose medicine if you truly can’t see yourself doing anything else. Pursuing a career in medicine comes with enormous sacrifices that aren’t worth it unless you really have the passion and dedication. I’m a current medical student, and I’m pretty sure that the people who clean the bathrooms at my institution are substantially more happy, free, and financially stable than I am right now. This endeavor honestly wouldn’t be worth it if I thought that there was a, say, 40% chance that I’d feel deeply fulfilled doing something else.

Good luck.

 

[Naruhodo]

I agree with a lot of what @TelemarketingEnigma had to say, but I'll also throw in a few other thoughts. For context, I used to teach for a well-respected genetic counseling program (feel free to PM me if you'd like to discuss specifics, I realize the whole "match" process that programs are now doing can be stressful) and am currently a medical student. I share your love of genetics, and also contemplated different career paths. I recently ran into a former GC student of mine, who was telling me how accomplished she feels having already worked at 3 world-renowned cancer centers and being only 26yrs old (a bit of a tone-deaf comment given my age/years of training still to go, but I take her point). There is also no doubt that your experience as a genetic counselor will be shaped by the medical doctors/NPs that you work with. Different jobs have hugely differing levels of autonomy - in some jobs you will be the "genetics expert" that patients see, whereas in other settings you may feel treated more like a scribe/pedigree drawer. I have had the pleasure to know some absolutely incredible genetic counselors, and sometimes with seniority they were able to pick and chose the doctors they wanted to work with. I've also heard more than one young GC talk about wanting to quit a job because an attending was being awful to them and making life miserable. Most of the genetic counselors I know have felt underappreciated at least at some point (perhaps the double-edged sword of a female-predominant specialty?).

There is high demand for genetic counselors and numerous jobs, including many that are part-time/ family friendly. Also, salaries continue to rise (especially with industry competition from commercial labs that hire GCs). Many lab GCs and in some specialized settings (think VA) are earning well-above the 80k mark. Anecdotally, someone I know was offered a $125k salary when she was less than 2 years out of training to help start up a new prenatal genetics program. The upper end of what GCs are earning overlaps with the average pediatric geneticist salaries, which is on the lower earning end for physicians (this is true of many pediatric sub-specialties that don't perform many procedures and yet can't see the same volume of patients as a general pediatrician). Adult geneticists and prenatal geneticists do earn more though.

As for the timing, there's been rumors for years that programs are going to start offering genetic counseling doctorates. If they do, obviously that training will take longer than the current 18mo-3yr master programs. The pros are that you'd have more time to develop your research interests, and perhaps a better shot at more clinical autonomy and leadership positions. Downsides would be more time in training, and some GCs I know worry that this will eventually raise the bar for entry-level positions and advancement.

Adult medical geneticists are rare and sorely needed, especially in the area of cancer genetics which is booming. After medical school, regardless of whether you go the MD or DO route, as even an average student you will basically have your pick of phenomenal genetics training programs. There's some combined IM-genetics programs at places like Hopkins that sometimes don't fill because they don't have enough applicants. Alternatively 2 PDs have told me that you can do 1yr of basically any US residency and be considered for genetics fellowships (you do not have to be board-eligible in another specialty). Still, even with this accelerated route you'd be looking at 7yrs of training between med school and residencies. But again, the job market is likely to be favorable when you get out.

I agree with others that your work/life balance will depend on what you make it. This route is not an easy one by any means, and it's a deeply personal choice about your long-term vision for your life. Don't let fear of rejection guide the decision. OK, that's probably enough from me. Good luck and feel free to let me know if you have questions.