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Fetal genomics with Dr Jessica Woods

Blog 23 June 2021

Dr Jessica Woods talks about her work as a fetal genomics fellow – and how you could follow in her footsteps

I was appointed as a Fetal Genomics Fellow in early 2020, becoming one of the first UK Obstetrics & Gynaecology (O&G) trainees to take advantage of the national focus on genomic transformation. The development of the post reflected the realisation that the genomic era had arrived, and we needed to catch up fast.

Prior to starting this role, like many trainees and consultants, I had a rather abstract understanding of genomics in healthcare. I quickly recognised that genomic medicine isn't abstract, it isn’t just research or for those working within subspecialities – it's already part of the work we do every single day.

Genomics underpins discussions about pre-implantation genetic diagnosis and non-invasive screening tests in the private sector. It is key when counselling women concerned about a family history of cystic fibrosis or other genetic disorders, and for families with fetal abnormality or suffering pregnancy loss. It is central to discussing familial inherited cancer syndromes in gynaecology.

Genomics has an integral role within our practice and is relevant to us all. 

Why is genomics important in O&G?

Genomics is the term used when we examine the whole genome of a parent or fetus, as opposed to genetics, which is looking for single gene changes.

It is involved in all aspects of preconceptual, preimplantation, prenatal and postnatal genetic disorders, whilst genomic testing of cancers, and pharmacogenomics are revolutionising our management of gynaecological malignancy.

Genomics is influencing practice right across our speciality and we need to ensure our patients benefit as research is translated into real-life testing.

Transgenerational genomics is a hugely exciting field specific to O&G. We are in a unique position as providers of women’s healthcare throughout the life course and across generations.

There are great benefits to a molecular diagnosis: access to specialist care, predicting outcomes, supporting reproductive options, and planning the perinatal management of affected fetuses. 

Gene editing and gene therapy makes headlines and isn't far away in terms of practical applications. Diseases such as severe combined immunodeficiency disease are now highly treatable due to genomics, and it is vital that O&G professionals are genomics literate, so we can counsel and signpost to the most appropriate tests and deliver the best possible information to our patients.

Genomic education: what’s in it for me?

To ensure that genomics is embedded in all we do, the RCOG is collaborating with the Royal College of Midwives and Health Education England (HEE) to invest in educational resources for midwives, trainees and members of the college.

From self-guided learning plans, to a genomic medicine masters funded by HEE, there are range of learning opportunities to support your practice and develop your skills.

Another exciting development is GeNotes – genomics notes for clinicians – an educational project coming soon. This online platform will provide instantly accessible factsheets for an array of clinical scenarios to help clinicians in real-life consultations.

By autumn 2021, a stream of material dedicated to fetal and women’s health pathways will be available, and will link with a cross-speciality medical genomics encyclopaedia; consider it like Wikipedia for clinical genomics, written by experts.

For updates on GeNotes, follow the Genomics Education Programme on Twitter @genomicsedu or Facebook, or sign up to its newsletter.

A day in the life

Employed full time by Leeds Teaching Hospitals NHS Trust as a fetal genomics fellow, my working week is split between providing routine obstetric care to our patients, focussed sessions within fetal medicine and clinical genetics whilst studying part-time to complete the Genomic Medicine MSc at the University of Manchester.    

Following the introduction of fetal exome sequencing, I have helped develop service pathways, worked to strengthen relationships with hospitals within our referral network and the teams within our North East and Yorkshire Genomic Laboratory Hub. I have collaborated in regional and national working groups involved in improving awareness of genomics and genomic literacy and I am currently developing education programmes across the country. 

Fellowship posts in genomic medicine are being developed nationwide as we continue to appreciate that genomic medicine is core to much of the work we do. Whilst balancing the varied workload can be challenging, these posts allow development of invaluable clinical, research and management skills.

Genomics training opportunities

Genomics training infographic: Image shows a doctor starting on a journey, including: "University qualifications, university modules, GeNotes Genomics encyclopedia (coming soon), Massive open online courses, RCOG online learning plan"
Genomics education infographic "Where do I start?" (full size image): Image shows a doctor starting on a journey, including: University qualifications, university modules, GeNotes Genomics encyclopedia (coming soon), Massive open online courses, and RCOG online learning plan.

Fellowship posts in genomic medicine are being developed nationwide as we continue to appreciate that genomic medicine is core to much of the work we do. Whilst balancing the varied workload can be challenging, these posts allow development of invaluable clinical, research and management skills.

Health Education England is providing funding for the Genomic Medicine MSc for courses commencing September 2021.

See the RCOG Genomics Hub with resources and learning plan and further training opportunities