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Guest McMastergirl

Residency in Medical Genetics

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Guest McMastergirl

Since I just matched to medical genetics and have been asked a few questions about it, I will give some information on the specialty here. I have done lots of electives in different places so I have a pretty good idea what I'm getting into.

 

When you specialize in genetics, your residency is called medical genetics but what you end up being is a clinical geneticist... or at least that's what most call themselves.

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Guest McMastergirl

The common things clinical geneticists do are:

 

1. Diagnose genetic/chromosomal/hereditary disease.

2. Provide information to patients about their risk of genetic disease, or the risk to their offspring.

3. Provide information to primary care docs and specialists about rare diseases and how to treat or prevent complications.

4. Explain and order genetic tests (these are simultaneously becoming more available and more complex).

5. Clinical research.

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Guest McMastergirl

A clinical geneticists typical week may include:

 

- outpatient clinics

- inpatient consults (mostly neonate/children)

- lit searches to prepare for patients

- writing papers (eg case reports)

- supervising genetic counsellors/residents/students

 

Almost all clinical geneticists work in academic centres.

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Guest McMastergirl

The Royal College medical genetics residency program is 5 years. The first two years are pediatrics, internal medicine and high-risk obstetrics rotations. The final 3 years focus on clinical genetics (consults and clinics), research project and lab rotations.

 

Alternatively, you can do a 2 year CCMG fellowship following any Royal College residency (most often pediatrics).

 

In the clinical genetics portion of the training, you study dysmorphology, metabolic disease, DNA testing, chromosome analysis, teratology, embryology, and counselling.

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Guest McMastergirl

A genetic counsellor holds an MSc in Genetic Counselling, which is a 2 year program. They are very well trained in genetics and molecular biology, as well as counselling. They have slightly different roles in different centres. They see patients with or without the MD, depending on the complexity of the case. They do the majority of the routine counselling, such as that for advanced maternal age. They do not diagnose genetic disease or give medical advice. Generally they are supervised by the MD.

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Guest McMastergirl

The average starting salary for a new geneticist in Canada is approx. $150 000. Geneticists work on salary because they see relatively few patients per week and would not survive billing OHIP! More experienced geneticists make up to $250 000 per year. As one clinical geneticists once told me, "We don't drive mercedes, but we're generally a pretty happy bunch."

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Guest arar

Hi!

 

Thanks so much for this information, McMastergirl. Do you have any info regarding avg hours of work, or what the proportion of time is spent doing research vs. patient time? How much demand is there for specialists in this area?

 

Thanks,

 

arar

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Guest Ollie

Thanks for the info! I've been pondering a specialty in med gen (that is if I get into meds first!). I did an undergrad research project and worked as a tech in a med gen lab, and I loved it! It doesn't seem to be that popular right now judging by the unfilled spots in CaRMS, but maybe that will change as this area explodes in the next few years.

 

Following arar's questions, what is the call schedule like during residency? I would guess that one's schedule is fairly intense in the first 2 years, and then maybe less so in the next 3.

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Guest McMastergirl

Hi Arar, I'm glad you're interested! I don't have any published stats on average hours of work, but generally it is a 9 to 5 type of job. Of course that can vary as much as any medicial specialty can.

 

One of my elective supervisors estimated that she spends

"¼ time with patients, ½ time doing patient activity without a body in front of me (such as reading, dealing with counselor activities, letter writing, calls, etc.) and ¼ in the admin and direct teaching, with more in admin than teaching"

(this was from a geneticist who works in a community hospital rather than a tertiary care centre)

 

As far as demand goes, right now there is lots of work, according to another supervisor of mine. Pretty pick and choose at this point. At McMaster there is only one MD geneticist and she says she needs at least 3 more!

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Guest McMastergirl

Hi Ollie! Good luck with getting into meds.

 

The call schedule in residency varies depending on the rotation. While on peds and internal medicine rotations, it could be as much as 1 in 4, but if you are doing an outpatient rotation (for example, peds rheumatology), you might not be on call at all.

Having not started my residency yet, I can't say for sure. The last 3 years are much lighter for call. There aren't any "genetic emergencies" as such... so no night call. You are on call within the hospital during the day while on genetics rotations, but how often depends on how many other residents/interns are on the service with you. (you'll see how it works once you're in med school).

Good luck!

M.

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Guest Ian Wong

Heya,

 

I tried sending you a private message, but your inbox is disabled. Could you maybe send me an email instead? I've got a project that I'd like your help with. :)mdpremie@yahoo.com

 

Thanks!

 

Ian

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Guest Shahenshah

first of all congrads on getting in!

 

I had a few questions regarding the field:

 

 

1) when you quote the salary, are there any overheads involved or is everything set up for you and you just go ahead and work

 

2) clinical research - is it a mandatory component to do actual research as a practioner..case reports and surveying lit .to be up to date are definitely imp. but I am referring more towards being pressured to release a publication every few years..

 

3) In US, I have heard of pharmaceutical companies hiring a lot of physicians in this field..is there a similar trend in Canada..I have been trying to get a feel for what the job market is like but can't seem to locate any website that is hiring physicians in medical genetics..would you have any links by any chance?

 

4) In US there are two fields - molecular genetics pathology and medical genetics..do you have any information on the differences between the two?

 

any input would be greatly appreciated..this field is completely new to me and I don't want to rule out anything at this point..

 

Thank you so much for your input in this thread so far..Its really been extremely valuable

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Guest McMastergirl

You ask some great questions... unfortunately, I don't think I'll be able to be much help! I don't know for sure the answer to any of your questions, but maybe I can find out. I will forward your questions to some people I know in the field already.

 

You are at Ottawa... I would strongly recommend doing an elective in Clinical Genetics there (CHEO) if you are interested... they are very nice and very organized!

 

By the way, do you have a website or forum where I can post a message to Ottawa med students, regarding housing? I'm looking for a one bedroom apartment near CHEO for June!

Thanks :)

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Guest Shahenshah

I can definitely see if anyone is renting out a place for one month..Unfortunately, I have given my consent to someone to rent my place from june to august but he has not got back to me yet...I can email you the details, if u can just send me an email to shahenshah007@hotmail.com..I'll also see if I can find a forum that can give you more housing options..renting for just 1 month might be tough but I'll find out..

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Guest McMastergirl

Hi,

As promised, I forwarded your questions to my friend who is a practicing geneticist, and here are her answers:

 

1) when you quote the salary, are there any overheads involved or is everything set up for you and you just go ahead and work YES EVERYTHING FROM OFFICE TO SECRETARY TO COUNSELLOR TO PAPER AND COMPUTER AND EXAM SPACE AND EQUIPMENT ETC. IS TAKEN CARE OF

 

2) clinical research - is it a mandatory component to do actual research as a practioner..case reports and surveying lit .to be up to date are definitely imp. but I am referring more towards being pressured to release a publication every few years..DEPENDS ON DEPARTMENT YOU WANT AND THE CONTRACT YOU CHOOSE. IF YOU HAVE A % OF YOUR SALARY NEGOTIATED TO COVER ACHADEMIC ACTIVITIES, THEN PUBLICATIONS MIGHT BE AN EXPECTATION

 

3) In US, I have heard of pharmaceutical companies hiring a lot of physicians in this field..is there a similar trend in Canada..I have been trying to get a feel for what the job market is like but can't seem to locate any website that is hiring physicians in medical genetics..would you have any links by any chance? HAVEN'T REALLY OBSERVED THAT HERE. IN MY EXPERIENCE THEY OFTEN ARE MORE INTERESTED IN THE PhD TYPES FOR THE BASIC RESEARCH AND NURSES FOR CLINICAL TRIALS. THEY DEFINITELY COLLABORATE WITH MD GENETICISTS FOR SPECIFIC TRIALS (EX. GENZYME AND THE METABOLIC GENETICISTS)

 

4) In US there are two fields - molecular genetics pathology and medical genetics..do you have any information on the differences between the two? I'M NOT CERTAIN. iT MAY BE THAT THE FIRST IS THE TRAINING SOMEONE WHO WANTS TO RUN A LAB TAKES. i'M GUESSING THE FIRST MIGHT INCLUDE THINGS LIKE USING GENETIC TECHNOLOGIES IN DIAGNOSING INFECTIONS, OR FORENSICS WHICH ISN'T REALLY INCLUDED IN THE FOCUS OF THE MEDICAL GENETICIST. THE LATER WOULD HAVE MORE OF A CLINICAL FOCUS ON DIAGNOSING SYNDROMES, MANAGING RISKS ETC., BUT USE LOTS OF MOLECULAR TESTING TOO.

 

Hope this helps (it helped me!)

McMaster girl

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Guest Shahenshah

hi McMaster girl,

 

thanks a lot for going through the trouble to get all this GREAT information!!

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Guest 4EverRose

Hi there,

 

I have an interest in molecular genetic pathology so I know a little bit about it. In US, molecular genetic pathology is a 1-year fellowship program - it is a joint function by the American Board of Medical Genetics and American Board of Pathology. My understanding is both medical genetics and pathology residents can get into this fellowship after being board certified. A description of this fellowship can be found at the ABP website:

 

www.abpath.org/ReqForCert.htm#MGP

 

Also some statistics are available for this fellowship from the FREIDA database:

 

www.ama-assn.org/vapp/freida/spcstsc/0,1238,190,00.html

 

In Canada, we have a molecular pathology fellowship program that ranges from 6 months to 2 years. However, it seems like this program is offered to pathologists, not medical geneticists. Also it is aimed at oncology work. The following is the link to this program:

 

www.molecularpathology.ca/index.html

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Guest McMastergirl

So I am almost a month into my Medical Genetics residency. My first year will consist of internal medicine rotations. This block I have been on CTU - general internal medicine. The hours are long and call is very busy. The nice thing about being a genetics resident is that I can avoid doing procedures and looking after the complex medical patients if I want, because there are internal medicine residents around who are very keen to do these things!

 

My next rotation is Endocrinology. The other rotations I have scheduled for this year are GI, Pathology, Oncology, Rheumatology, Neurology, Ophthalmology, Respirology, Nephrology and Derm. I think four of those blocks are electives, so you can do anything during these (ER, surgery, whatever). I tried to stick to outpatient rotations when possible. This year, you only have to do call if your rotation requires it. Endocrinology is home call. Next year however, I will be doing pediatrics, and you are on call for general peds no matter what rotation you are in (at least this is how it works at CHEO).

 

An interesting thing I am finding out here is that most of the residents and staff MDs are not even aware there is a genetics residency here. I enjoy enlightening them! I'm sure I won't run into this when I am doing my peds year, but the internists don't tend to refer to genetics at all.

 

The medical genetics program at CHEO just got re-accredited with no appreciable deficiencies! The program director is excellent and a genuinely nice person. If you are a med student interested in genetics, come do an elective at CHEO!

 

Melissa

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Guest Kirsteen

Hi there,

 

I've seen the acronym in a few other places and was wodnering what it is--CTU? :rolleyes

 

Cheers,

Kirsteen

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Guest Ian Wong

Clinical Teaching Unit. This name is used in a few medical schools to designate time spent rotating through Internal Medicine. Therefore, "I'm doing CTU this month" = "I'm doing general Internal Medicine this month."

 

Ian

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