For the first episode of the Prenatal Genetics Miniseries, Dr. Tamar Goldwaser goes over the basics. She explains the difference between genetic counselors and medical geneticists and the ways they often work together, plus situations in which patients may seek genetic counseling or care from a medical geneticist.
In the first episode of the Prenatal Genetics miniseries, Dr. Fox introduces Dr. Tamar Goldwaser, who gives a basic introduction to the subject of genetics.
Dr. Goldwaser grew up in New Jersey, and discovered a love for biology starting in her high school years. She quickly found that she wanted to take care of women, and says she enjoyed her OB/GYN rotation in medical school and “loved the action and intensity” of Obstetrics and Gynecology in residency at Albert Einstein College of Medicine. That residency also gave her a unique opportunity to learn about medical genetics, which she went on to complete an additional residency in at Montefiore Medical Center. Dr. Goldwaser notes that during a class she took at Sarah Lawrence College, her professor commented that “every subspecialty needs genetics,” and she adds that there is “no conversation about disease or disease processes without a genetics component.”
Dr. Goldwaser explains the various training and careers in the field of genetics as well. Genetic counseling is a graduate degree field, and genetic counselors receive training in basic sciences, DNA, inheritance, and helping patients make decisions regarding results of genetic testing. Medical geneticists, on the other hand, are MDs with special training in genetics. Dr. Goldwaser explains that these two types of professionals commonly work hand-in-hand, as genetic counselors rely on medical geneticists to help prescribe treatments or provide care after they review genetic testing results for their patients.
Dr. Goldwaser explains that in terms of prenatal genetics, couples typically meet with a genetic counselor to test whether they are carriers when they are planning to have a baby. In a situation where they are both found to be carriers or an amniocentesis test yields an irregular result, they may then see a medical geneticist for their care options.
Often, genetic testing is handled by pediatrician geneticists, who are called when a baby has unexpected problems that could be caused by a genetic condition. However, Dr. Goldwaser explains that our ability to make diagnoses or find genetic conditions before a baby is born is much greater than in the past. Therefore, it is becoming more useful for OB/GYNs to do this work. Having a prenatal genetics specialist often makes the process easier for Maternal Fetal Medicine Associates’ patients.
Dr. Fox and Dr. Goldwaser explain that genetics are complicated and, in some cases, difficult to explain to patients or interpret by medical professionals without specialty training. Dr. Goldwaser says that her training and background give her the opportunity to take a “deeper dive” and give patients a more thorough explanation, as she understands more nuances in the exact mutations that can be detected. She explains that the line between a simple variation and a disease within DNA can be unclear, and since the field is very complex and research is ongoing in many cases, it can be difficult to determine what information is helpful to the patient, what tests are even necessary, and how to communicate unknowns.
