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Medical Genetics after Internal Medicine?

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I learned that it's possible to become a medical geneticist by doing a 3-year Canadian College of Medical Geneticists (CCMG) fellowship after 3 years of internal medicine training. Other than the additional year of training, this path seems to provide more flexibility than the 5-year medical genetics program (you can still choose other internal med subspecialties) and someone who follows this path ends up having more qualifications.

I was wondering if there are significant barriers to entry to the 3-year fellowship, and whether there are additional pros/cons of each route. 

Thank you!

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You can do the same thing with Pediatrics too IIRC. I don't think there are really any negatives to it other than the extra year as you said, but that most people who want to do medical genetics probably do not want to do IM as they are very different (medical genetics and peds on the other hand have much more overlap as you would do lots of peds rotations on the 5 year direct MG program so that's a more favourable alternative).

And conversely, most people who like IM (NO peds cases) would probably not like medical genetics enough to essentially do 3 additional years of fellowship for a pay cut.

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Would anyone have an insight into the future of the role of medical geneticists? Would it be reasonable to expect them to be needed outside of large, urban centers? Will they be more in demand, or less because each specialty will become well-versed in the genetics within their area (ex: as more discoveries are made through research, cardiologists will be experts congenital heart disorders, so the MG may not be needed as much, and similarly with neurologists and neurological disorders, and so on...)?

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