Molecular Genetics Pathology Fellowship

[harlesmd]

I am interested in applying to molecular genetics pathology fellowship. Any suggestion for programs with strong molecular oncology training (other than MSKCC and Brigham) ? Programs with strong emphasis on modern molecular pathology ie NGS based technology are preferred.

Also how competitive is this fellowship?

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[bauber]

Yale, UNC, Pitt, Emory, UMichigan, UW, OHSU, Stanford would have what you're looking for. It's definitely somewhat competitive at these places but apply early, join/go to AMP, get on an AMP working group or committee as a trainee member, do molecular rotation if your institution has it, try to get on a project and you'll be good.

 

[harlesmd]

Thanks! I heard good things about UPMC and UW, will look into the others. What do you think about Baylor and UPenn?

 

[gbwillner]

WashU needs to be on your list.

You should go to a program that runs its own NGS platform developed internally and has a bioinformatics team. They should have a sequencing core/facility. Any program that does not do this should be out of contention, if you want adequate training for the future.

Some good programs are strong in CP, and this may run molecular, and not be what you want. Some of the above programs would not be what I consider to be strong in molecular, even if strong in AP or CP.

 

[deleted314957]

Gbwillner knows this area well from his hx on the board. I would listen to him/her

 

[harlesmd]

WashU needs to be on your list.

You should go to a program that runs its own NGS platform developed internally and has a bioinformatics team. They should have a sequencing core/facility. Any program that does not do this should be out of contention, if you want adequate training for the future.

Some good programs are strong in CP, and this may run molecular, and not be what you want. Some of the above programs would not be what I consider to be strong in molecular, even if strong in AP or CP.

I think many programs now run its own NGS platforms. I agree having a strong bioinformatics team is crucial. Wash U definitely is one of those programs running NGS platform very early on so much more experience in it.

My challenge is I am not AP/CP trained. I was trained as clinical geneticist and American Board of Medical Genetics and Genomics (ABMGG) certified. I did additional fellowship in hematology/oncology with lots of exposure in NGS analysis. Sometime I feel like some programs prefer pathology trained applicants. Although the fellowship training itself is ACGME accredited and jointly hosted by American Board of Pathology and ABMGG, some programs clearly requires prior training in AP/CP. I wish they could be more open minded.....

 

[gbwillner]

I think many programs now run its own NGS platforms. I agree having a strong bioinformatics team is crucial. Wash U definitely is one of those programs running NGS platform very early on so much more experience in it.

My challenge is I am not AP/CP trained. I was trained as clinical geneticist and American Board of Medical Genetics and Genomics (ABMGG) certified. I did additional fellowship in hematology/oncology with lots of exposure in NGS analysis. Sometime I feel like some programs prefer pathology trained applicants. Although the fellowship training itself is ACGME accredited and jointly hosted by American Board of Pathology and ABMGG, some programs clearly requires prior training in AP/CP. I wish they could be more open minded.....

Fields like to protect themselves, and pathologists are already running laboratories. If you want to treat patients with genetic diseases, molecular pathology is not for you. If you want to run a molecular lab focusing on cancer, AP skills (IMO) should be required. If you are running a molecular lab for micro or antigen phenotyping, CP is helpful.

 

[harlesmd]

Fields like to protect themselves, and pathologists are already running laboratories. If you want to treat patients with genetic diseases, molecular pathology is not for you. If you want to run a molecular lab focusing on cancer, AP skills (IMO) should be required. If you are running a molecular lab for micro or antigen phenotyping, CP is helpful.

Not sure if I would agree with that. I've diagnosed and treated patients with cancers so I would like to think I have more than enough exposure to cancers to be at least as good as pathology residents who just finished their general AP/CP training. Also, molecular geneticists are expected to know more than cancers, I believe inherited diseases and infectious diseases are part of the curriculum and I don't think knowing AP/CP is essential. We all learned pathology in medical school to serve as foundation.

 

[SunBakedTrash]

I've diagnosed and treated patients with cancers so I would like to think I have more than enough exposure to cancers to be at least as good as pathology residents who just finished their general AP/CP training.

This is not possible. Showing up at random tumor boards and harassing the path resident to show you bone marrows does not replace years of training. Thinking like this makes you dangerous.

 

[harlesmd]

This is not possible. Showing up at random tumor boards and harassing the path resident to show you bone marrows does not replace years of training. Thinking like this makes you dangerous.

I didn't mean to say that I am proficient in reading slides to diagnose cancers but as oncologist I know how to work up my patients, stage them and choose appropriate treatments. The information from tumor profiling will tremendously help me stratifying and selecting treatments for my patients. Is that wrong for me to learn more about molecular oncology ? Also, the training is beyond somatic / tumor profiling. It includes germline analysis for various indications including many Mendelian disorders which I, as clinical geneticist, will order on daily basis.

 

[bauber]

I've diagnosed and treated patients with cancers so I would like to think I have more than enough exposure to cancers to be at least as good as pathology residents who just finished their general AP/CP training.

You may like to think that, but you are quite wrong.

You can learn plenty about molecular oncology without doing an MGP fellowship. Honestly, an MGP fellowship really isn't about learning molecular oncology nor do you need one to read about and understand the implications of XYZ EGFR variant in your patient. There are endless resources out there.

 

[harlesmd]

Sure you can learn all of those yourself but there are more to it, I need to learn about regulatory aspect of running a molecular genetics lab, how to develop an assay and validate them, and finally I won't be able to sign out a molecular pathology report without the formal training.

 

[SunBakedTrash]

Sure you can learn all of those yourself but there are more to it, I need to learn about regulatory aspect of running a molecular genetics lab, how to develop an assay and validate them, and finally I won't be able to sign out a molecular pathology report without the formal training.

You could try looking into “laboratory genetics and genomics” fellowships, which looks like mostly cytogenetics and constitutional genetics with some cancer stuff mixed in. It’s primed for PhD geneticist candidates so they aren’t going to expect you to interpret cancer morphology at the level they would expect a pathologist to be able to for an MGP fellowship. This would probably provide what you are looking for.

 

[harlesmd]

LGG is 2 years while MGP is one year, unless they have strong somatic training, I won't be doing that. If dermatologist can do dermatopathology fellowship, a geneticist with additional 3 years of oncology training can do molecular pathology training. There is reason why the boards think that ABMGG certified physician (not PhD) is eligible to apply for the fellowship and sit for the board at the end of their training. This is my personal opinion and I might be totally wrong if I end up not getting any interviews.

 

[caffeinegirl]

I would be weary about downplaying your pathology colleagues on a pathology forum, and also downplaying pathology candidates during your application process. They will be your peers and colleagues after training.
As for your comparison of a dermatologist and dermatopathology - a dermatologist actually receives more training in dermatopathology than an AP pathology resident, and many programs prefer dermatologists to pathologists for fellowship.

From the ABMGG website (Training Options | ABMGG)

Molecular Genetic Pathology focuses on diagnosing and confirming diagnoses of Mendelian genetic disorders, diseases of human development, infectious diseases, and malignancies, as well as assessing the natural history of those disorders. Molecular Genetic Pathology is recognized as a subspecialty by the American Board of Medical Specialties (ABMS) [www.abms.org]. Residency training programs in this subspecialty are accredited by the Accreditation Council of Graduate Medical Education (ACGME) [www.acgme.org], are one year in duration, and available only to licensed clinical geneticists who are board certified by ABMGG or diplomates of the American Board of Pathology. These training programs instruct molecular genetic pathologists in the principles, theory, and technologies of molecular biology and molecular genetics. Upon graduation, molecular genetic pathologists can provide information about gene structure, function, and alteration, as well as apply laboratory techniques for diagnosis, treatment, and prognosis for individuals with related disorders.

Stanford for example states "Eligible candidates for the Molecular Genetic Pathology fellowship must be board certified or board-eligible by the American Board of Pathology or the American Board of Medical Genetics."

Good luck with your application process.

 

[harlesmd]

Thank you for your reply. That was not my intention to downplay the pathology colleagues here. I felt the other way around actually. My initial intention of this posting was to ask for advise for good molecular pathology fellowship programs I need to look into. I provided my training background because I have noticed some MGP fellowship programs (eg. MSKCC, University of Utah) will not consider ABMGG diplomates to apply for a position despite the statement you quoted above. As someone without formal pathology training, I am open to learn whatever it takes to be a successful fellow.

 

[LADoc00]

Im going to post another thread: but I need to eat crow when I am wrong. Mol. Path is 100% by far the best current fellowship in Pathology.

I would advise everyone especially those with graduate school genetics, virology or immunology experience.

 

[gbwillner]

You are correct, sir.

This is the future of our specialty.

 

[confused_doc]

Thank you for your reply. That was not my intention to downplay the pathology colleagues here. I felt the other way around actually. My initial intention of this posting was to ask for advise for good molecular pathology fellowship programs I need to look into. I provided my training background because I have noticed some MGP fellowship programs (eg. MSKCC, University of Utah) will not consider ABMGG diplomates to apply for a position despite the statement you quoted above. As someone without formal pathology training, I am open to learn whatever it takes to be a successful fellow.

Did you do an IM residency before you did clinical genetics?