Dear Sherpa, I am an avid reader of your blog and quite often marveled by your great writing style.
Today, however, I cannot resist to add another point to your list:
The sherpa says and might be right in saying so:
"7. The lack of medical training for genetic counselors
8. The lack of genetics training for medical professionals "
Dr. Look (me) would humbly like to add:
9. The (frequent) lack of medical clinical experience/training for human geneticists
Keep up the good work
Regs Dr. Markus P. Look,
Internist Bonn, GERMANY
Doctor Look,
Thank you so much for your comments. I would like to add that the street runs several ways. We have several shortcomings. In the United States in order for a geneticist to train in Medical Genetics (which is a 2 year program), you must first have 2 years of clinical experience in an ACGME accredited residency in just about any field. Most medical geneticists are pediatricians. This is a natural extension as the majority of classical genetic diseases start in childhood. However, there are a little under 100 geneticists trained in Internal Medicine. Approximately 1 in 10......
So I may agree that most medical geneticists are not Internists, but there are many who at least rotated through IM in medical school and elder statesmen who are internists who grandfathered into pediatrics. Much more clinical exposure than new graduates of genetic counseling programs....
But I do agree.....as genetics changes from a small sub specialty of pediatrics into pediatrics becoming a small sub specialty of genetics...we will most indubitably need more IM geneticists!
Linked together into a network preferably......
That's why I am up here at Yale.....
The Sherpa Says: If you don't know about the 24th specialty in medicine, how would you ever know how to refer to them? Looks like the ACMG needs to hire 23andMe's PR firm!
Monday, October 27, 2008
Reader's Points and Clarification.
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5 comments:
Why is this a bad thing: "We have several shortcomings. In the United States in order for a geneticist to train in Medical Genetics (which is a 2 year program), you must first have 2 years of clinical experience in an ACGME accredited residency in just about any field. Most medical geneticists are pediatricians."
It isn't a bad thing at all! In fact that's what I meant by the street runs several ways....I wanted to highlight something we do very well. I think that having truly clinical geneticists is a very important thing. These clinician are the very thing that enables us to translate genetic discovery into clinical care. The US is very lucky to have these doctors.
-Steve
Agreed. That is why I had to ask. Didn't know if I was missing something or not.
For the IM departments, why not train NP's to work in that area? That way the patients will have more time to talk about the family history, present problems or concerns,etc, etc.
.....in order to be more precisely:
I am of course not of the opinion, that human genticists generally lack clinical experience. What made me post the comment was, that Dr. Murphy's initial posting simply lacked to acknowledge the two-way street point, when it comes to polygenetic disorders or disease conditions (obesity +/- metabolic syndrome etc..). Contextualisation of "soft" genetic data (= many genes, low odds ratios, no prospective validation of genotype-directed intervention so far) with real-life, i. e., environment and life-style of the donors, needs clinicians who are interested in genetics but also vize versa the geneticists who overwiew the longterm courses of chronic diseases with all their subtlities.
"Linked together into a network preferably......" is best way to do it.
Markus Look
Dr. Look,
You stated the ultimate goal of personalized medicine elegantly.
-Dr. Murphy
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