The Complete Guide To Becoming A Geneticist

Published on: 5 Oct 2021

Geneticist

 

The Role Of A Geneticist:

Clinical genetics is a specialty that focuses on investigation, diagnosis and management of rare disorders and assessing the risk of some diseases based on the patient’s genetic makeup.(1) 

A clinical geneticist’s job is to perform genetic testing, genetic counselling and advise patients on their reproductive options and recommend prenatal testing for specific disorders where indicated.(1) A clinical geneticist will work with a variety of conditions, such as chromosomal abnormalities, single gene disorders such as cystic fibrosis or sickle cell disease, some cancers which are often inherited in a family such as breast or colorectal cancer, birth defects or congenital learning disabilities.(1) Clinical geneticists do not commonly prescribe or undertake surgical interventions.(1)

There is plenty of research opportunities within the field of genetics as it is a rapidly advancing specialty, developing alongside the improvement in molecular diagnostic techniques and advancement in our knowledge of the human genome and genetic diseases.(1)

Academic geneticists may work in the NHS, academic institutions and universities, private institutions, national governing bodies or even the armed forces.(1)

In the 2018/2019 census of higher specialty trainees across all specialties within the UK, it was found that 84% of all higher specialty trainees in clinical genetics were women.(2)

There is no CCT subspecialties associated with clinical genetics, but some geneticists may choose to focus on the genetics of specific disorders such as cancer genetics or dysmorphology.(1)

 

A Typical Week:

Clinical geneticists see patients referred to them with a clinical concern or a condition. Most of the patients will be outpatients with a smaller proportion of ward referrals.(3) Clinical geneticists treat patients of all ages, and they often screen multiple family members who might be at risk of a familial genetic condition.(3)

Most of their work will usually be carried out in one of the 23 regional genetics centres within the UK.(3) A typical day includes a specialist clinic (e.g., cancer genetics clinic, prenatal genetic clinic,…), follow-up clinics, responding to requests from different wards and giving diagnostic opinions where needed, multidisciplinary team meetings with other specialists, and many geneticists also undertake teaching roles and participate research.(3) 

Clinical geneticists normally do not work out-of-hours or in shifts, and only just over 5% of consultants in clinical genetics say that they are routinely on-call at weekends.(3) An on-call rota is implemented only in some clinical genetics units, especially in those focused on diagnosing neonatal or prenatal abnormalities.(3)

Some 34% of higher specialty trainees work less than full time, and less than full time working hours are also common in consultancy.(2)

Clinical geneticists work in multidisciplinary teams alongside clinical counsellors, clinical laboratory scientists and technicians, medical secretaries and administrative staff, as well as GPs, psychologists, neurologists, paediatricians and a range of other specialists.(3)

 

The Path To Becoming A Geneticist:

The specialty training for clinical genetics usually takes 6 years (2 years of core training, 4 years in clinical genetics higher specialty training).(4)

Core training can be done either via a Core Medical Training (CMT) programme, Acute Care Common Stem- Acute Medicine (ACCS-AM), or Level 1 Paediatrics.(4) The successful completion of CMT or ACCS-AM includes passing the full Membership of the Royal College of Physicians UK (MRCP-UK) exam, and the completion of Level 1 Paediatrics can only be achieved by passing the Membership of the Royal College of Paediatrics and Child Health (MRCPCH) exam.(4)

Trainees will then be required to register with Joint Royal Colleges of Physicians Training Board (JRCPTB) to apply for higher specialty training in clinical genetics.(4) The competition ratio for entry into ST3 in clinical genetics was 1.93 applications per post in 2019.(5) 

To acquire a CCT, trainees will have to have passed the Certificate Examination in Medical Genetics, as well as the ongoing assessment throughout the training programme such as Workplace Based Assessments and multisource feedback.(4)

Academic training in genetics is also an option. Some doctors aiming to work in the academic sector decide to start their training in genetics with an Academic Foundation post to help them develop the specific skill set needed for research and teaching, however this is not a requirement.

Doctors with academic aspirations usually start with an Academic Clinical Fellowship (ACF), usually moving onto Clinical Lectureship (CL) later in their career, but some trainees choose to continue as ST trainees, entering the clinical programme post- ST4 after their ACF.(1)

Medical students interested in working in clinical genetics are encouraged to join their university society for genetics, get involved with the GMC, and become student members of the specialist societies, e.g., British Society for Genetic Medicine or the Clinical Genetics Society. It is also beneficial to choose a research project relevant to the specialty.(6)

Foundation trainees should be able to demonstrate skills acquired during training and are advised to apply for rotations not only in genetics but also associated or similar specialties in case the clinical genetics rotations are full.(6)

It is best to find out as much as possible about the specialty by asking experienced doctors or their supervisor, or via taster sessions in the specialty. It is recommended to try and gain teaching and management experience and enter essay prizes and competitions.(6)

Core and specialty trainees in clinical genetics should ensure good grounding in general medicine, join the specialty societies, join Journal clubs, and try to get published or present their work at conferences.(6) 

 

Earnings:

NHS consultant salaries are the same for all specialties but vary between Scotland (highest), England, Northern Ireland, and Wales (lowest) and increase with service (up to 19 years). In 2020 the salary bands range from £77,779 to £109,849.  Salaries can be further enhanced with NHS excellence awards. 

There are opportunities for salary enhancement via working in the private sector, or via undertaking additional responsibilities. Salary also depends on the institution and will be different for geneticists working in universities or government bodies.

According to a table published by the Journal of the Royal Society of medicine in 2008, the ratio to private income to NHS income within clinical genetics is 0.09.(7) 

For more information on salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.

 

Resources: 

There are plenty of resources available to potential genetics trainees to further explore the specialty. The websites of professional bodies are particularly useful, for example the British Society for Genetic Medicine website, or the Clinical Genetics Society website.

Other useful resources include the Journal of Medical Genetics, research papers in genetics published in other journals such as the BMJ or Clinical Medicine Journal, and the University of Oxford Genetics podcast.

 

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References

  1. Clinical genetics, NHS Health Careers, https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/clinical-genetics (accessed Nov 2020)

  2. Focus on physicians: 2018-19 census- 2018-2019 HST census data tool, Royal College of Physicians, excel document, published 3 Oct 2019, https://www.rcplondon.ac.uk/file/16796/download (accessed Nov 2020)

  3. Working life- clinical genetics, NHS Health Careers, https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/clinical-genetics/working-life (accessed Nov 2020) 

  4. Specialty training curriculum for clinical genetics, Joint Royal College of Physicians Training Board, pdf, published Augv2010, amended Sep 2016, https://www.gmc-uk.org/-/media/documents/2010-clinical-genetics-curriculum--amendments-2016--final_pdf-68150420.pdf (accessed Nov 2020)

  5. Specialty recruitment competition ratios 2019, Health Education England, https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf (accessed Nov 2020)

  6. Training and development- clinical genetics, NHS Health Careers, https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/clinical-genetics/training-and-development (accessed Nov 2020)

  7. Table- conditional mean income by specialty, sorted by ratio of private income to NHS income, Journal of the Royal Society of Medicine, published 1 Jul 2008, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442143/table/tbl3/ (accessed Nov 2020)