Career as a NP, GC, or PA?

[because]

I'm trying to decide between PA, genetic counseling, and NP. I would love to have your input. I listed below what the pros and cons are for each field (for what I feel important for myself).

GC Pros:

1: I get to be considered an expert in genetics

2: I get to deal with the whole family for longer than just a few minutes at an office visit

3: Get the chance to deal with some very complicated cases and emotional cases

4: I get to teach others the subject I love.

5: I want to help university athletes test for sudden cardiac death (studies show that most athletes that die from sudden cardiac death results from familial inheritance)

6: I want to develop an international training program.....a lot of countries don't have any genetic counselors. So I want to bring in people from countries that don't have any genetic counselors and train them here and send them back home so there home countries can have genetic counselors.

7: I get to "help" with a physical exam.....

8: There seems to be plenty of jobs

GC Cons:

1: Lack of respect from MDs/DOs/PhDs/PAs (its not that I couldn't know stuff from learning on my own, but my thoughts and opinions would most likely not be respected)

2: It is a female dominated field (96% females) (I'm a male)

3: The National Society of Genetic Counselors refuses to expand their training to add pharmacology, physical exams, and pathology training.

4: Low salaries (average is only around $50k starting)....I want to help support my lady the best I can. I'm doing all of this work for myself and her.

5: Most GCs lack the guts to speak out.

6: Not able to diagnose a patient......lack of training in the sciences behind conditions (no pharmacology, no pathology, no anatomy, no management training for conditions).......I really dislike the lack of the training in the sciences.

PA Pros:

1: Decent salary....decent job secruity....flexibility in work location (pediatrics, OB/GYN, internal medicine, etc)

2: Get to help diagnose patients with genetic conditions (I will do a certificate in clinical genetics from Simmons College)

3: Deeper training in the sciences...pharmacology, pathology, histology, EKG interpretation, etc

4: Can have a private practice...just have to have a physician oversight.....so maybe I could develop the countries first medical genetics company run be a PA (with a MD as the boss of me) and hire a GC to work with me

5: I have the work experience already done (direct patient contact experience.....this is why you should do the CNA so you get some experience and you can do the PA thing if you don't get into a MD or DO school)

6: Having a person looking over my shoulder...reviewing the medical charts...good way to have a second eye and second view point about the patient

7: I can improve my GPA enough to get into some school some place.

8: There are more PA schools than GC schools (GC schools = 25 and PA schools = around 135). So I have a better chance at a PA admissions

PA Cons:

1: Have to take time being trained in emergency medicine, surgery, and some other areas that I basically don't have any interest in.

2: Tuition is a lot....at least not even close to as much as MD or DO school is.

3: Risk the chance of not being able to participate in the subject I love (I'm sure I would come across patients with metabolic disorders, genetic syndromes, etc in a pediatrics department....but most children are healthy and most pediatric patients you see is the same routine stuff

4: Longer work hours (I would prefer to have weekends off to watch football during the fall/winter)....so I run the risk of having to work on the weekends

NP pros and cons are very similar to the PA pros and cons. If I go the GC route, I will still be missing:

1. A license

2. In-depth clinical science training

3. Pharmacology education (including the lack of pathophysiology and anatomy)

4. Clinical exam ability

5: Diagnosing abilities

I enjoy learning about the field of medical genetics and teaching others about the subject of human genetics.

If I were to become a genetic counselor (if I were to get admitted to a program), I would like to work in a clinic doing what a GC normally does working with genetic conditions working in a pediatric, cardiology, or internal medicine department (maybe also working with a research lab on a part-time basis). I would also like to work with local university athletic teams testing for sudden cardiac death (studies show that most athletes that die from sudden cardiac arrest are familial inherited conditions).

I would love to develop an international genetic counseling training program where I can bring in people from other countries. Most countries in this world do not have genetic counseling services. So I would love to be the person that gets things started in those other countries.

There are only a couple of things about being a GC that I don't like:

1: the inability to perform a physical exam (I would love to do this for patients suspected of having a genetic disorder) and the lack of training in physiology and pharmacology (I'm looking to do an online Master's degree from the University of South Florida in Medical Sciences as a result of this so I can be well learned---to go along with reading the medical /science literature on my own).

2: having a say in the diagnosis of the condition if not working alongside a doctor.

I'm considering a career as a physician assistant or NP, but I know I would miss not working in a clinical genetics department. If I were to become a physician assistant or NP, I would also do a certificate from Simmons College in clinical genetics (I know this does not qualify me as a GC).

Because of the limitations as a GC, I'm having a tough time deciding if I want to become a GC, a PA, or NP since my love is for human genetics. If I were to become a PA or NP, I would do everything in my power to try and help advance genetics in the clinical setting to my best ability.

As far as becoming a M.D. goes, I'm not competitive for medical school and I don't want to go through the long training process and accumulation of educational debt.....I will be 28 this summer (I want to work and not be in school for years on end) and I'm already loaded with educational debt from undergraduate school. So I'm not looking to be an M.D.

Please leave me know what your thoughts are.

I know this may not be the best place to post this. I'm just looking for view points and what other people think.

[subee, MSN, CRNA]

Read your post and pretend someone else wrote it. I think you've answered your own question. Good luck.

[daisydoll]

Can you be a NP and specialize in genetics??

[core0]

Can you be a NP and specialize in genetics??

You can, but you run into issues of scope. Many genetics problems cross age boundaries. Most of the NPs that I know in genetics are PNPs doing pediatric genetics. This becomes a problem when adults are referred to the clinic. Realistically genetics are integrated into modern medicine within the specialties. In GI I did genetic counselling and consent. Ordered genetic testing and explained the results. The same happens in any number of medical specialties.

To the OP genetic counselling is interesting and for the right person its rewarding. However, it can be very frustrating not being able to treat any of the conditions uncovered. Also most of the positions tend to be within academic medical centers which can be a difficult environment to work in. There are PAs that work in medical genetics but largely they either have previous experience in medical genetics or PhDs in associated subjects. You could consider doing medical genetics first then PA school. However, if you are competitive for PA school you should be competitive for medical school or osteopathy. Clinical genetics failed to fill all their residency slots the last few years indicating that it is a relatively non-competitive residency/fellowship. It can be accessed from either medicine or peds. There are also some four year programs that are straight through. Considering that the time for PA+genetics is the same as medical school this may be a better way to go. Of course this increases cost (especially DO programs) and clinical genetics is not the best paying specialty.

Finally as a comment on PA school. You will be exposed to parts of medicine during PA school that you never knew existed. I was absolutely sure that I was going into neurosurgery after PA school. Eight years later I find myself in transplant medicine after practicing in pediatric and adult GI. You never know where the journey will take you or what you will find on the way.

David Carpenter, PA-C