Intended for healthcare professionals


Advanced diagnosis and personalised treatment: the clinical geneticist

BMJ 2022; 377 doi: (Published 24 May 2022) Cite this as: BMJ 2022;377:o1160
  1. Adrian O’Dowd
  1. London, UK

The medical director and consultant clinical geneticist tells Adrian O’Dowd why doctors should look outside the box to find the right specialty

Clinical genetics was not the obvious choice for Lynn Greenhalgh when she was deciding which specialty to focus on as a young doctor, but it has proved to be a great fit.

Greenhalgh, medical director and consultant clinical geneticist at Liverpool Women’s NHS Foundation Trust, qualified in 1991 and was doing a Membership of the Royal Colleges of Physicians in paediatrics when she got talking to a locum paediatric registrar who was transferring to clinical genetics.

“It’s such a small specialty and I never knew about it before,” she says. “Genetics wasn’t really a thing back then in the late 1990s.

“We had one of those two o’clock in the morning conversations about what we were doing and I remember thinking it sounded really interesting. When I moved to my next job, I got the opportunity to sit in on some clinical genetics clinics and thought, ‘this is where I want to be.’”

After core medical training, Greenhalgh completed a master’s degree in clinical genetics at the Institute of Child Health in London and then completed specialist training in Bristol. She was appointed as a consultant at Liverpool Women’s Hospital in 2002 where she took the lead for cancer genetics across Cheshire and Merseyside.

In 2012, Greenhalgh co-secured a successful bid for the North West Coast Genomic Medicine Centre to deliver the national 100 000 Genomes Project across the area. The project was the foundation for the NHS Genomic Medicine Service and brought advanced diagnosis and personalised treatments to people with cancer or rare diseases.

Subsequently, Greenhalgh became medical director of the North West Genomics Laboratory Hub—one of seven such hubs across England that form the NHS Genomic Medicine Service.

The specialty is clearly something Greenhalgh believes in deeply, as she says, “In genetics, I love the way that you can have people who have been searching for an answer for decades for what has been happening with their kids or to them, and then all of a sudden, science moves on, you find the answer, and everything fits into place. It’s starting to unlock a whole world of possibilities.”

In addition to winning five awards for education, Greenhalgh also managed to secure more than £250 000 from Health Education England to support genomics education within the region.

Greenhalgh’s advice to young doctors starting out is: “Enjoy your time at medical school; work hard, but enjoy it and make good friends.” And then think widely about which specialty to choose.

“There are all kinds of nooks and crannies in medicine, genetics being one,” she says. “It might take a little bit of time to find yours. Be patient and keep being inquisitive and there will be somewhere that suits you in the spectrum of specialties.”

Greenhalgh’s commitment to her colleagues was evident when the trust had to deal with a terrorist bomb that was detonated outside the main hospital in November last year. “That was a tough time, but what I saw was the resilience of staff and how everybody pulled together,” she says.

“There were a number of people who were understandably traumatised—staff and patients—but we did a good job of wrapping around them. Our local mental health trust was phenomenal and we offered on-site psychological support.”

Greenhalgh also urges doctors to consider playing a role in management. “I would thoroughly encourage medics to think about medical management because we need the clinical voice,” she says.

Nominated by Victoria McKay

“As a role model, this is a timely nomination in light of the bomb at Liverpool Women’s Hospital. Lynn has been an inspiration to many in the clinical genetics and genomics community for the past few years, leading large scale genomics projects, especially those for patients with cancer.

“More recently, Lynn took over as medical director at Liverpool Women’s, leading the staff through the ongoing challenge of covid-19 and in the wake of the terrorist bomb. Quite a first year in post.

“Lynn always makes time for people and cares for the staff with compassion and kindness, even more so after the events surrounding the bomb. She champions the next generation of clinical leaders and is extremely generous with her time. I am very proud that she has been my supervisor, mentor, big boss, and has become my friend.”

  • Victoria McKay is consultant clinical geneticist at Liverpool Heart and Chest Hospital NHS Foundation Trust

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