What Difference Does Difference Make? An ASHG/FASEB Event on Diversity in Science

Posted by: Nalini Padmanabhan, MPH, Communications & Marketing Director, ASHG

Shirley Malcom
Shirley M. Malcom, PhD

“Diversity is a scientific imperative,” said Vence Bonham, JD, in his introductory remarks to last week’s ASHG/Federation of American Societies for Experimental Biology (FASEB) event, titled “What Difference Does Difference Make?”. The event featured keynote speaker Shirley M. Malcom, PhD, Head of Education and Human Resource Programs at the American Association for the Advancement of Science (AAAS), who led an informative, interactive, and spirited discussion among nearly 70 staff at ASHG, FASEB, and several other FASEB member societies.

With strong board support, ASHG is already undertaking steps within our community to improve diversity and inclusion in science and exploring additional efforts. By sharing ideas and feedback with AAAS, FASEB, and other scientific societies, who face similar challenges and operate in similar environments, we are committed to building on successful strategies to raise our collective effectiveness.

Diversity in Genomics Research and Among Researchers

Dr. Bonham, Chief of the Health Disparities Unit at the National Human Genome Research Institute (NHGRI), set the stage by describing the importance of diversity in genomic research cohorts and in the genomics workforce. He cited several studies showing that the vast majority of genome-wide association studies (GWAS) and genetics-based disease studies in the public domain focused on populations of European ancestry. Though there has been some change in recent years, he noted, populations of African, Latin American, and Asian ancestry are still significantly underrepresented.

Diversity in the scientific workforce follows similar patterns, he explained: data show the relative representation of African American scientists declines at each step along the career path, from graduate school applicant all the way through department head.

Access to Scientific Opportunity, Power, and Science as a Human Right

“The challenge we have in this country is that we are both too polite and too impolite. There are things we don’t talk about because it makes us uncomfortable, and part of the challenge we have had is that we have not been honest in our discourse,” said Dr. Malcom, framing her discussion. “Inequalities related to sex, gender, race, and ethnicity are all part of the same issue, which is the distribution of power. We don’t talk about power much, but it drives much of what we see that we do not like,” she explained.

The 1948 Declaration of Human Rights, recognized explicitly by most countries, includes the right to the benefits of scientific progress. Furthermore, she said, scientific curiosity is part of being human, and unequal access to a scientific career reflects differences in power within the field and the educational system. For example, those who set the research agenda define which questions the field considers important, how findings are assessed, and how success is attained. These decisions tell an implicit story about what science is, who science belongs to, and who can do science.

Dr. Malcom & Dr. Bonham
Dr. Malcom & Dr. Bonham lead a Q&A

Diversity Discussions Have Improved but Challenges Remain

Taking a historical perspective, Dr. Malcom traced how discussions of diversity have evolved since the 1960s and 1970s. Originally considering it solely as a legal issue related to civil rights, many started to improve inclusivity out of need – demographic shifts and a growth in research required more talent in the workforce. More recently, there is growing appreciation of the educational value of diversity as well as the innovation driven by a variety of perspectives and experiences.

“Today, women are the majority of students in higher education but not of the faculty,” she said. “There’s a mismatch between who is there and who teaches them, which affects the climate of the classroom. We need to create a new normal.”

Structural barriers and biases impede progress toward that new normal. These include difficulty in finding community and cultivating a sense of belonging, systematic undervaluing from faculty and peers, and a false assumption that difference equals deficiency.

That starts from admissions, she explained. “We have to get to a point where our programs recognize potential, not previously demonstrated performance, because not everyone has had the opportunity to actually be able to be successful in tests that we use to measure.”

Strategies and Current Efforts to Improve Diversity

Given these challenges, what can scientific societies do to improve diversity? Dr. Malcom offered several practical strategies. These include several activities that are increasingly front and center for ASHG. This year, we are beginning to track and emphasize greater diverse representation in our Annual Meeting program, and are working actively to promote more nominations and inclusion of diverse candidates for roles in society leadership and awards.

ASHG also will be exploring ways we can leverage and share with the field the learning, resources, and strategies of other leading groups, including SEA Change, an AAAS effort to support diversity and inclusion in STEM, especially in colleges and universities. It focuses on science departments and programs, helping them to identify unhealthy factors and instill best practices that create healthy cultures and foster diversity.

While the issue is complex, Dr. Malcom is confident the outlook is positive and sees more potential for progress in the scientific community. “We have evolved in the way we think about diversity in science. Now I think we are at a point where we can begin to talk about diversity, equity, and inclusion as central for excellence in research,” she said. “We all have our biases, but the question is: what do you do in spite of them and how do you overcome them?”

Genetic Counseling Researchers Shape the Future of Precision Medicine 

Guest Post By: Heather A. Zierhut, PhD, MS, CGC; and Adam H. Buchanan, MS, MPH, LGC 

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Genetic counselors’ advanced training in – you guessed it – genetics and counseling, plays a key role in healthcare. Genetic counselors can guide and support people seeking more information about how inherited diseases and conditions might affect them or their families, and help interpret test results. While many genetic counselors work directly with patients, others focus on research to help in the development of new or improved treatment or care for people with genetic conditions. In honor of Genetic Counselor Awareness Day on Nov. 8, National Society of Genetic Counselors (NSGC) members Heather A. Zierhut, PhD, MS, CGC, and Adam H. Buchanan, MS, MPH, LGC, share how their research is shaping the future of genetic counseling and precision medicine.

Heather Zierhut Headshot
Heather A. Zierhut, PhD, MS, CGC

NSGC: What inspired you to be a genetic counselor?  

Heather: I think there are two main categories of people who become genetic counselors: those who have a long exploration into the profession or those who have a light bulb moment. My entrance into genetic counseling was like a laser light show. My undergraduate genetics professor briefly mentioned the career. Like any good researcher, I went to my tiny matchbook size dorm room and looked up everything I could possibly find on the topic. Fireworks were going off in my mind. Genetic counseling was love at first literature search.

 

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Adam H. Buchanan, MS, MPH, LGC

Adam: I’m one of those long exploration types. In college I cycled through several possible career choices. My career research was a great source of stories about the (sometimes gross) lives of a veterinary technician or hospital employee who cleans up after surgeries. But, nothing grabbed me until I worked with a genetic counselor while doing my thesis in a master’s of public health program. I loved the way genetic counseling combined the communication skills I was learning as a public health educator with the connections you make while interacting with patients.

NSGC: How did you first get involved in genetic counseling research?  

Heather: Like many aspiring Principal Investigators, my gateway to research was undergraduate summer programs. I loved the idea of being able to set up experiments, ask questions, and get answers all in a three-month time span. But after experimenting in yeast and fruit fly labs, I found myself wanting to research something different. I switched gears to my ultimate organism of interest, humans. It all started with two genetics icons, Janet and Marc Williams, giving me a small research project looking at outcomes of early hearing screening tests. Even after making the decision to pursue genetic counseling, I never lost my desire for research. I searched for a training program where I could find mentors to support my interest in clinical care and research. The desire for research mentors was first and foremost in my decision to go to the University of Minnesota.

Adam: When my kids were little and their favorite question was “why?”, I knew they came by it honestly – it’s always been one of my favorite questions, too. As a genetic counselor I sought out ways to answer the whys that arose in my clinical work. Like Heather, I was fortunate to have colleagues willing to indulge those questions and a mentor who looked for opportunities to involve me in all phases of research during my research apprenticeship – including writing and reviewing manuscripts and learning the ins and outs of grant proposal preparation. So, when I was driving home from a rural cancer genetics clinic one day and had a light bulb moment about how to more efficiently improve access to care, I had the tools to turn that spark into a viable research project.

NSGC: What do you enjoy about genetic counseling research?  

Heather: You either love and appreciate the ups and downs of research or you gut out the experimentation period in hope and anticipation of the day you get those final results. As much as I wish I could say that I love to stop and smell the research roses, I do not. I am a destination data person. Getting results is my favorite part of research. It’s like the best holidays all wrapped into one called Data Day. Knowing this about myself, I chose to pursue a doctoral degree in genetics and epidemiology with research projects that give me data sooner rather than later.

Adam: I’m totally with Heather on her love of Data Day. I also love thinking about the research process as crafting a story. If everything falls into place, you develop this beautiful narrative that arcs from why your research topic is important to patients all the way to how the study you’ve proposed will generate data that will help those patients. It’s a challenging process that takes a lot of tinkering and being able to communicate the big picture while having your details in order. That’s why it’s such great fun when it works.

NSGC: What advice do you have for aspiring genetic counseling researchers? 

Heather: I shifted research directions completely after completing my PhD. The shift was the right direction for my newly developed skill set, but I needed help getting started. I reached out to people with expertise and asked them to assist me. I applied for numerous early investigator grants and was told repeatedly that I needed more experience in the field. Not letting it slow me down too much, I started collecting pilot data to build my case. Others in the field started to take notice and I was asked to be on several national committees. These combined efforts led to funding through the Jane Engelberg Memorial Fellowship, a grant intended to promote the professional development of individual counselors and to improve the practice of genetic counseling. This took persistence and a following a slightly different path than I had envisioned. My advice is don’t be afraid to take risks and get out of your comfort zone.

Adam: All research starts with a good idea. And our clinical experience can provide a wealth of research ideas. Pay attention to the whys that linger in your mind after seeing patients. Also, researchers fail. Sometimes spectacularly – unfunded grant proposals, rejected manuscripts, and studies that go off the rails. This is a particular challenge for the over-achievers who make up the ranks of genetics professionals. But, it’s an inevitable part of doing research that moves the field forward. Keep your head up, rely on the mentors Heather mentioned – they’re out there and they really do want to help – and learn from everything. Finally, find a research focus that gets you jazzed. It’s a lot easier to be persistent when you’re excited about your work.

NSGC: What genetic counseling research are you working on now?

Heather: My current research is on the vast under-diagnosis of familial hypercholesterolemia (FH) and issues that arise in communication of genetic information in FH families. There are 1 in 250 people out there with a treatable genetic cause of high cholesterol. It’s my research and my job to make sure that people with FH know the risks and have opportunities to prevent heart disease in their families. But as with anything having to do with families and communication, it’s complex. Our research team chips away at finding ways to screen families and help them become aware of their heart disease risks. We hope to give an opportunity to end the cycle of heart disease in their family.

Adam: I’m leading a group that was just funded by the NIH to study how children and their parents react to receiving genomic results for conditions that do not occur until adulthood (such as hereditary breast and ovarian cancer syndrome). There are lots of intriguing questions we’re hoping to answer in this study, particularly about the psychosocial impact of this information and how family members use it to guide their healthcare. It’s a topic that has been written about a bunch, but there’s barely any empirical data to guide whether and how to provide this information to families in practice. We’re looking forward to adding our story to the mix and helping families in the process.

Heather Zierhut is the associate director of the University of Minnesota Graduate Program of Study in Genetic Counseling and assistant professor in Genetics, Cell Biology, and Development. Current areas of research include the psychosocial and public implications involved with the provision of genetic counseling services, implementations of whole genome sequencing, and outcomes of genetic counseling. 

Adam Buchanan is an assistant professor in the Genomic Medicine Institute at Geisinger, Co-Director of the MyCode Genomic Screening and Counseling program, and a member of the American Board of Genetic Counseling. His research focuses on access to genetic counseling and assessing behavioral and psychosocial outcomes of genetic counseling. 

Starting Your Postdoc Hunt: When and How to Prepare

Posted By: Rohit Thakur, Marie Sklodowska-Curie research fellow, University of Leeds, United Kingdom

“What are your plans after PhD”? – one of the most daunting and stressful questions often asked to graduate students. For many pursuing a career in academia, the obvious next step is a postdoctoral position.

The ideal time to start applying for postdocs is one year away from your graduation. At the beginning of the final year of my PhD, I made a list of institutes to explore. Based on this list, I directly contacted the principal investigators (PIs) whose work I found really exciting. After hearing back from them, I arranged a meeting with them to learn about their research. This provided a wonderful opportunity to network and establish professional relationships with them.

I also found the Conference to Career chat sessions with field experts extremely useful. At one of the sessions, Prof. Fred Winston shared very useful tips on setting criteria for choosing a postdoc lab, such as quality of mentorship, success rate of previous postdocs in academia, and publication rate of the lab. If you start early you are more likely to end up with multiple offers by the time you finish your PhD.

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Mr. Thakur discusses his poster presentation with Martin Lauss, PhD, Lund University, at the 2017 Joint GenoMEL/BioGenoMEL/MELGEN Scientific Meeting (courtesy Mr. Thakur)

Don’t Underestimate Geography

Starting a postdoc hunt can be overwhelming, given the numerous places a graduate student can potentially apply to. It can become easier if you can think about where (geographically) you would like to do a postdoc. After identifying a region, you just have to locate the productive labs that do the science that you find exciting.

Network, Network, Network!

If you are going to a conference, write to PIs beforehand whose work you find interesting. Network with them by inviting them to your poster and follow up with them afterward.

Start Your Application Early

Visit lab websites of PIs who you are interested in working with and pay close attention to the lab’s current interests required skills for postdocs. Use this time to develop a skill that will increase your visibility as a potential candidate. Write PIs an informal query about potential postdoc positions to PIs, including your CV and cover letter, and get your material proofread by your mentor and colleagues.

Get Your PhD Research Paper Ready to Submit

Showcasing your PhD research is a great way to convince future PIs about your skills and your ability to lead a project independently. If you have a paper ready to be submitted to a journal, get its preprint out on bioRxiv and mention it on your CV.

Seek Advice and Feedback

If you are contacting a field expert, openly ask for feedback and advice about your current research project. This is a great way to interact and establish professional relationships with PIs.

Finally, get out of your comfort zone. Aim higher but be realistic. Keep applying until you land an offer from your dream lab. I would also recommend attending the ASHG/JAX Conference to Career Program for honing your networking skills.

Acknowledgments: I am highly thankful to my supervisors Jenny Barrett, PhD; Julia Newton-Bishop, MD, MBChB, FMedSci; Jeremie Nsengimana, PhD; and Göran Jönsson, PhD, for their exceptional mentorship; and European Commission Horizon 2020 program for funding my PhD.

Rohit Thakur, B. Tech, is a PhD Candidate at the University of Leeds. He has been an ASHG member since 2017.

 

Welcome HHMI-ASHG Fellow, Sarah Abdallah

Posted By: Ann Klinck, ASHG Communications and Marketing Assistant

ASHG is excited to be partnering with the Howard Hughes Medical Institute (HHMI) for the HHMI-ASHG Medical Research Fellowship. We’re happy to welcome third-year Yale medical student, Sarah Abdallah, to the position.

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Sarah Abdallah, HHMI-ASHG Medical Research Fellow (Courtesy Ms. Abdallah)

This program allows medical, dental, and veterinary students to take a year off from training and perform mentored laboratory research with support of a grant. “Our hope is that the experience will ignite students’ passion for research and encourage them to pursue careers as physician-scientists,” says David Asai, HHMI’s senior director for science education in a press release.

Sarah was interested in the fellowship because “it seemed to provide access to a community of scientists and to enriching experiences on top of my research, like attending conferences and meetings.”

Sarah’s research is focused around obsessive compulsive disorder (OCD). Specifically, it involves looking for post-zygotic variants in whole-exome sequencing data from individuals with OCD and their parents. These variants arise spontaneously and are not inherited from parents. By identifying the post-zygotic variants, it may be possible to understand the contribution of such variation to OCD development, identify risk genes, and eventually find new treatments.

“I am hoping this project will contribute to the collective understanding of the genetic basis of OCD. Many people with OCD do well, but I have seen firsthand how it can present as a very disabling, persistent disorder, and current pharmacologic treatments are not completely effective for all patients,” Sarah said.

ASHG member and Sarah’s primary mentor, Thomas Fernandez, MD, is an assistant professor in the Child Study Center and of Psychiatry at Yale. Another ASHG member and her co-mentor, James Noonan, PhD, is an associate professor of genetics at Yale.

During her fellowship, Sarah is hoping to gain more experience in computational genomics and is seeking guidance on how to combine her clinical and research interests into a career. She trusts that people like Dr. Fernandez will be able help her find the right path. She is considering a career in child psychiatry and pediatrics, but “either way, I hope to keep contributing to research on the genomics of neurodevelopmental disorders along with my clinical practice,” she said.

Launched 29 years ago, the HHMI Medical Research Fellows Program supports each Fellow through a year-long research project with a mentor of the Fellow’s choosing, and facilitates peer networking among Fellows and alumni as well as seminars with senior investigators. For more information, see the Program website.

 

Networking Session was Great! What’s Next?

Posted By: Rohit Thakur, Marie Sklodowska-Curie research fellow, University of Leeds, United Kingdom

During ASHG 2017, I participated in the Conference to Career program, organized by ASHG in collaboration with The Jackson Laboratory. The program taught various skills such as networking, elevator pitches, informational interviewing, and how to follow up effectively, some of which I highlighted on the MELGEN blog last month. Today, I wanted to focus on the aftermath of networking: The art of following up! Before I start recommending strategies, I wanted to share my experience of how effective follow-up can lead to wonderful opportunities.

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Rohit Thakur (left) and colleague Joey Mark Diaz (right), participants in the ASHG/JAX Conference to Career Program (courtesy Mr. Thakur)

During the ASHG meeting, I was intrigued by a talk by Manolis Kellis, PhD, after which I prepared my elevator speech and talked to him about his group’s ongoing research. I was very interested in their machine learning approaches. Dr. Kellis was very kind and put me in touch with his graduate student. After returning from the conference, I followed up with Dr. Kellis, and that led to potential talks of collaboration between our groups. Dr. Kellis also offered to host me for a month-long internship in his group at MIT, which I accepted.

From my limited experience, I can say that effective follow-up is a necessary step towards building a strong network. Here are some recommended strategies.

Write an Email – 24 Hours’ Countdown

Follow up with people after networking by sending a personalized email within the next 24 hours, while the meeting is fresh in their minds. This email should include a thank you note and all the relevant information – articles, programming scripts, and anything else you had agreed to share after the networking session – and express interest in scheduling another meeting.

Connect with Them on Social Media

Social media has made it easy to connect with people from around the world, through platforms like Twitter, LinkedIn, and ResearchGate. You can keep in touch by congratulating them for their recent achievements and recognitions, and wish them on other occasions such as birthdays, and the New Year.

Invite Them to Give a Seminar

If you are fascinated by someone’s work, you can always invite them for a department seminar. As a trainee, you can recommend speaker names to the head of your department suggesting why they should be invited and how it will benefit your department’s research. Not only will this strengthen your relationship with the speaker, but will also help in fostering collaborations between other trainees/researchers and the speaker.

Always Give First and Expect Nothing in Return

Networking is a team sport. You can follow up with people by offering them your help and suggestions in a constructive manner. If following up leads to a successful collaboration, then you should always give equal opportunity in decision making, leadership, responsibilities, and benefits.

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L-R: Manolis Kellis, PhD; Mr. Thakur; and Alvin Shi, PhD Candidate at MIT (courtesy Mr. Thakur)

Acknowledgements: My project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 641458. I am highly thankful to my supervisors Jenny Barrett, PhD, Julia Newton-Bishop, MD, MBChB, FMedSci, Jeremie Nsengimana, PhD, and Göran Jönsson, PhD, for their exceptional mentorship and encouragement to expand my horizons. I am thankful to the organizers of the Conference to Career Program for developing networking skills of ASHG trainees and to Dr. Kellis for providing me with a wonderful learning opportunity in his group at MIT.

Rohit Thakur, B. Tech, is a PhD Candidate at the University of Leeds. He has been an ASHG member since 2017.

Expanding Role for Genetic Counselors: Good for Our Profession, Great for Our Patients

Guest Post By: Erica Ramos, MS, CGC, President-Elect, National Society of Genetic Counselors

As we observe the first annual Genetic Counselor Awareness Day on Nov. 9, I can’t help but be astonished by the changes in our profession and how they are shaping, and being shaped by, the exciting advances in how we diagnose and treat genetically-influenced conditions. As President-Elect of the National Society of Genetic Counselors (NSGC), I have never been more proud or excited to declare “I am a genetic counselor!” and share how we bring the voice of patients and clinicians to all areas and applications of genomics.

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Erica Ramos, MS, CGC (courtesy NSGC)

When I completed my genetic counseling training in 2001, I couldn’t have predicted that I would find myself working on the leading edge of clinical genomics. When I began working at a genomics biotechnology company in 2012, I was only the second genetic counselor on staff. According to the 2012 NSGC Professional Status Survey (PSS), a mere 0.5% of our profession was employed by R&D or biotechnology companies.

Four years later, the 2016 PSS showed this had doubled. Today, there are 17 genetic counselors at my company, working collaboratively with scientists, bioinformaticians, developers and executives, contributing our skills and expertise to areas such as medical affairs, market development, product marketing and strategic planning, and sharing the real-world impact that their work ultimately has on patients and their families.

Mine is just one example of genetic counselors’ expanding roles. We are leading patient-centered original research and are integral to Geisinger’s MyCode study, The Ohio State University’s Statewide Colon Cancer Initiative and All of Us, to name just a few. We are driving growth and change in clinic by branching into specialty areas including neurogenetics and psychiatric genetics. NSGC surveys tell the story: In the 10 years leading up to 2016, the number of specialty areas where genetic counselors work went from 14 to 33, a 135% increase.

Vast and exciting career opportunities are fantastic for the genetic counseling profession and ensure a bright future for those entering our field. But as good as this trend is for our profession and the 4,000 certified genetic counselors in the U.S., the benefits are even greater for other genomics professionals and, critically, to patients.

Genetic counselors have deep scientific and medical knowledge. Paired with our communications and counseling skills, we are a valuable resource in translating research advances in genetics and genomics to healthcare providers and patients. As media coverage of these advances expands, providers and patients often have questions about how these new discoveries impact their care. We unravel the complexities of research so that clinicians and patients receive clear, accurate and digestible information, regardless of their culture or background.

So, here’s to Genetic Counselor Awareness Day! Working together to improve appreciation and understanding of how we and our partners in genomics empower patients and their healthcare team and provide them with ever improving personalized attention and care.

Erica Ramos, MS, CGC, is President-Elect of the National Society of Genetic Counselors (NSGC). She has been a member of ASHG since 2014. 

How I Work: Brian Shirts

Posted By: Elisabeth Rosenthal, PhD, Member of the ASHG Communications Committee

We sat down with ASHG member Brian Shirts, MD, PhD, to learn more about his work at the cutting edge of clinical genetic diagnostics, including how his work intersects with his faith.

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Brian Shirts, MD, PhD. (courtesy Dr. Shirts)

ASHG: Tell us about your position and how it fits into your institution and its goals.

Brian: I am Assistant Professor of Laboratory Medicine at the University of Washington. Being in a clinical department means part of my job is doing clinical genetic testing in patients. Since I am at a university, the other part of my job is teaching and doing research. In order to have this position, I did medical school and doctoral training in human genetics. Then I did specialty training to be board certified in Clinical Pathology and Molecular Genetic Pathology. When I started graduate training, I did not know that the position I currently have existed. When I first met a physician who specialized in genetic diagnosis, I quickly realized, “That is what I wanted to do all along!”

Working at a university, I need to be on the cutting edge of clinical genetic diagnostics. I specialize in hereditary cancer testing and understanding the health effects of extremely rare genetic variants. When I say “extremely rare”, I mean genetic variants that I may see for the first time when I look at the results of a patient receiving clinical genetic testing, or a variant that may have only been seen in one or two other people in the world. In cancer risk genes, these variants are usually inherited and clustered in families, so I like to call them family-specific variants.

I am lucky because my research interests and my clinical work go well together. I spend over half of my time doing research and developing translational applications that will allow myself and others to apply my research discoveries to clinical diagnostics.

ASHG: How do you keep up with the latest in genetics science and use this in your work?

Brian: I try to attend the ASHG Annual Meeting and the Association for Molecular Pathology meeting as often as I can, as I think these are the best forums for the latest in genetics science and genetic diagnostics, respectively. I also read several journals and go to journal club presentations as often as I can.

ASHG: What are your favorite genetics websites?

Brian: I have to give a plug for my website on family studies for rare variant classification: findmyvariant.org. Some of my other favorite genetics websites for non-geneticists are: Genetics Home ReferenceLearn.Geneticsmy46, and Genetic Alliance.

ASHG: What are you currently reading/thinking about?

Brian: I am always thinking about how to apply population genetics principles to clinical diagnostics. For something completely different, I like to read the best books that my kids are reading. I am currently reading “Mr. and Mrs. Bunny–Detectives Extraordinaire!” by Polly Horvath.

ASHG: What everyday thing are you better at than everyone else? What’s your superpower?

Brian: When I go to church, others tell me that I have an extraordinary talent for asking appropriate yet thought provoking questions during Sunday School. Being an outspoken scientist in a faith community can be difficult to navigate, but communicating with people from different backgrounds is a really important skill to develop.

Brian Shirts, MD, PhD, is Assistant Professor of Laboratory Medicine at the University of Washington. He has been a member of ASHG since 2004.