Biological Sciences, especially Genetics is fascinating because we have barely scraped the surface of the infinite possibilities in this field !

Gayatri Iyer, our next pathbreaker, Scientist at Tata Institute for Genetics and Society (Bangalore), uses DNA analyzing technologies like PCR/polymerase chain reaction, next generation sequencing to uncover newer approaches to patient management for better health outcomes.

Gayatri talks to Shyam Krishnamurthy from The Interview Portal about how her fascination with genetics led her to genetic counseling as a career as well as doing a PhD in Medical Genetics followed by a stint as Postdoctoral Fellow at IIT Bombay where she worked on proteomics (study of proteins) of specific diseases.

For students, be ready to wait a little longer for things you actually want in life, because when it arrives, it wouldn’t matter how long the wait was.

Gayatri, what were your growing up years like?

I am a tamilian born and brought up in a city called Kalyan near Mumbai. My parents (both now retired) were managers in the hospital and chemical industries. I have an elder brother who is into the creative field of filmmaking. From childhood to adolescence, my extra curricular activities transitioned from drawing, singing, mono acting and dancing, to karate and playing badminton. As I grew up to be an ambivert, I also developed a liking for biology and the idea of using computers to interpret biological data excited me during my junior college which made me realize that it would be interesting to build a career around it. 

What did you do for graduation/post graduation?

I did bachelors in biotechnology from Birla College, Kalyan and simultaneously  enrolled to add on diploma in bioinformatics, a two years program from Mumbai University. I did a Masters in Applied Genetics from The Oxford College of Science, Bangalore. 

I also have a PhD in Human/Medical Genetics from Kamineni Hospitals.

What were some of the key influences that led you to such an offbeat, unconventional and rare career in Genetics?

It is believed that a person is a mosaic of all experiences he/she has had up to that moment. It is absolutely true when it comes to describing my understanding of science.  I am indebted to all my teachers right from school till now to have piqued my interest in biology and helping me decode other eccentricities of life. My high school science teacher, Shraddha Nibre ma’am who believes every student can do his/her best in life if one realizes that hard work is not a constant but a variable from one person to another and you keep increasing it until your LHS matches RHS. My BSc and Bioinformatics diploma head Dr. Geetha Unnikrishnan, MSc faculties Raji Sukumaran ma’am, Pavana Kamath ma’am and Dr. Sam Balu gave a flavor of what a modern, contemporary researcher and scientist should be like. 

Sure, I was a hardworking student, but my higher education has been more rewarding as I enjoyed what I studied and performed in laboratories.  While studying biotech, we were exposed to several life science fields like cell biology, zoology, immunology, microbiology, environmental studies, of which genetics and molecular biology sections intrigued my interest. In my first year of college, I read the book “Genetics” by RP Meyyan. The concepts felt logical and highly interpretable, I felt I could go beyond the curriculum and read the entire book in a couple of days. By the end of third year,  I had resolved to pursue masters in genetics. Since Mumbai did not have a programme for Masters in genetics, I moved to Bangalore. My journey during post graduation has been exceptional. The time away from home, newfound responsibilities, navigating new friend circles and hostel life transformed my perception about the world. 

To explain why I am passionate about genetics, I would like to briefly introduce the subject. Every living thing has cells in their body, cells have different components based on what activity they have to perform, if it is bacteria, it should be able to feed, excrete, and protect all by itself, whereas in plants and animals, there are different designated organs to carry out the functions. Irrespective of what type of cell a being has, each one of them have something called DNA (deoxyribonucleic acid). This DNA is what you can call the director of a cell, organ and the organism. You inherit DNA from your parents and you shall pass it on to your kids. DNA has smaller segments called “genes” that decide what our height, weight, personality, eye color, hair texture and other characteristics are going to be. Now if something goes wrong with this DNA, you see problems and differences in the respective characteristics. From bacteria to humans, all of us have different sizes and volumes of DNA which makes us all unique as species. When you apply this knowledge to health and wellbeing, the options for you to explore are indefinite. You get to learn exciting combinations of DNA, decode complex diseases like diabetes, cancer or why a newborn is having heart problems. Unless you don’t figure out what is wrong, you might never be able to treat it. This exercise is fascinating for me and I decided to pursue this career. 

How did you plan the steps to get into the career you wanted? Tell us about your career path

I realized human genetics, the part where genetics and heredity could explain diseases was my true calling. During my Master’s, when everyone was preparing for PhD entrances, I decided I wanted to do a course in Genetic Counseling and join the healthcare industry.  I joined Kamineni Hospitals, Hyderabad to pursue a Post Graduate Certificate course in Medical & Genetic counseling. The dean of the course is Dr. Annie Hasan. The course shaped my personality, thoughts and my perception to practice genetic counseling in a diverse country like India. The course had three blocks of classroom and laboratory training, a block where we would intern in different departments of cardiology, pediatrics, gynecology, oncology as well as visit societies like thalassemia where you would find individuals affected by genetic conditions. Our job was to take their clinical, family, social history and explain the basics of genetics, draw their family trees and identify who else in their family can be at risk of developing the same condition as well as which specialist they need to consult and if there were others similarly affected, how to get them connected.

In the third block of the course, we had to do a project and I chose to work on a rare genetic disorder called Prader Willi Syndrome (PWS). In PWS, children find it difficult to gain weight in the first year of life, later start overeating and become obese. They can be intellectually slow and have mood swings. It used to be difficult to diagnose (identify the condition) back in 2014 and many doctors were unaware how and where to send the genetic test. I used to coordinate with an Italian group for the free test during my project and developed a caregiver guide for the parents. Even though my course ended, I still had not received the reports from Italy. They came a couple of months after my  completing the course. 

I got selected for the post of genetic counselor at Datar Genetics and was stationed at Apollo Hospitals, Chennai. I also cleared the genetic counseling certification exam from the Board of Genetic counseling.  I was part of a preventive healthcare team where we would explain to people who came for a master health check up about their lifetime risk of developing conditions like diabetes, Alzheimers, cancer, cholesterol, hypertension etc using a genetic test. Datar genetics would do the test and send back the reports and I would counsel patients on lifestyle management. Because of the training I received at Kamineni Hospital and my formal certification, I was the most sought after counselor and was also incharge of training the staff about the test and teaching them the basics of genetics.  I worked for four months before a new chapter of my life began. 

Why did you decide to do a PhD in Human/Medical Genetics?

While pursuing the genetic counseling course, results of my post graduation were out and I had secured first rank and gold medal in Bangalore University. I was delighted for two reasons, one was because I came first in the entire university and second was that I was eligible to apply for the INSPIRE fellowship to apply for a PhD programme. Though I did not actively think of pursuing research,  my mentor at Kamineni, Dr Annie Hasan made me realize I could be in research and still be a good counselor. There are not many people who get to make a difference in the lives of people with genetic conditions by applying research to accelerate the diagnosis, management or treatment through therapeutic processes. Thus we wrote a proposal to work on disorders like PWS to develop an affordable test in India so that patients do not have to wait for such a long time to know whether they have the genetic condition or not. I was selected for the programme and had to resign from my job at Datar genetics. 

During my PhD at Kamineni, I was also permitted to practice genetic counseling. I would see patients from different departments with concerns of infertility, skeletal abnormalities, heart problems, kidney concerns among others. I also served as a teacher of the very course I took in Genetic counseling. In 2017, I wrote and cleared the Level II of the Board of genetic counseling India. I became the coordinator of the GC course and would also conduct workshops, teach MBBS students about genetics, visit special schools, and different patient societies. I published scientific papers both from my research and from my genetic counseling practice. 

I submitted my PhD thesis in January 2021 and moved to my hometown Kalyan as I wanted to be closer to home in my next career stint. I joined Lifecell International as a genetic counselor and worked remotely due to the pandemic. At Lifecell, I spent more time discussing cases with clinicians than patients. I was incharge of sharing reports with clinicians, counsel patients, interpret genetic findings, discuss with the laboratory team and release genetic reports to doctors and patients. At times I wound visit clinics to conduct genetic counseling sessions. Since it was all remote, it would get hectic several times. Also I was missing doing active research. I applied to IIT Bombay for a postdoctoral researcher role and was selected for the role. I resigned from Lifecell and joined IIT in June 2022. At IIT, I worked on something altogether different than my previous experiences. I worked on proteomics (study of proteins) and digital health. I would plan and perform novel experiments to understand the protein biology of multiple myeloma, a type of blood cancer, and a few types of brain tumors. On the digital health front, I learnt how to use large health datasets, analyze them and make sense of what goes wrong when the body develops disorders like diabetes and different types of brain tumors. I also used to work as a guest lecturer at the Oxford college of science, my MSc college, to teach genetic counseling. Life at IIT prepared me for my future position as an independent scientist. The different phases of trying varied roles helped me reach a step closer to my next role. I learnt of the Tata Institute for Genetics and Society, Bangalore, a place where all projects use the latest science and technology for the betterment of the society. I applied for the role and was selected. Here I got to apply both my genetic counseling and research skills to improve the lives of people affected by genetic conditions.

How did you get your first break? 

I was selected as a genetic counselor from the campus placement at Kamineni Hospitals. There were a few rounds of interviews where they gave us scenarios of how we could counsel patients with certain health conditions and what types of test one would recommend in cases of different medical histories. Having a grasp of several languages is a desirable and needed trait for genetic counselors. I can converse in English, Hindi, Marathi, Tamil, Telugu and can follow Bengali, Malayalam and Kannada which worked out in my favor to be selected for the role of counselor of Datar genetics to be stationed at Apollo Hospitals in Chennai 

What were some of the challenges you faced? How did you address them?

Like any career and profession, I also had several challenges in my journey. After every few years, I had to move to a different city, adjust in and figure out logistics. Bangalore, Hyderabad and Chennai though are all south Indian cities and I am myself a south Indian, it was not a cakewalk. There are several personal and professional adjustments one would have to make in order to have a meaningful career. This teaches the significance of time, money and resources management to have a cordial day to day life. It is essential for everyone to be transparent with their own conscience otherwise they can get mentally disturbed. I engaged in my hobbies of painting and cooking as stress busters.

Moving back to Mumbai in 2021 when I had spent 6 years at Hyderabad was challenging as I had brighter prospects at Hyderabad, and moving to Mumbai meant I had to start afresh. But since my family was in Mumbai and I had been away for 8 years, I took the leap of faith and shifted gears. I had applied to innumerable institutes for both genetic counseling and research positions.  During the two years in Mumbai, I did a remote job as a genetic counselor which was corporate and hierarchical in approach which did not suit my liking. I applied to IIT and secured the position of postdoctoral fellow. I shifted gears again and learnt newer things in life and science. Each level of my career demanded a different me and a different approach to learn the tricks of trade. It can get tough while trying to learn different things but when you are able to master things, there is nothing more rewarding.  I saw an opportunity at Tata Institute and moved to Bangalore because I had the belief that I would get to apply all my skills, have society centered work and start a new chapter. Persistence is what kept me going and the willingness to learn, unlearn and relearn helps me navigate complex situations in both professional and personal life. 

Where do you work now? What problems do you solve?

I work as Scientist at Tata Institute for Genetics and Society, Bengaluru

I work on developing tests that could identify why some children have abnormal growth, behavior and are intellectually slower than other children of their age. I use DNA analyzing technologies like PCR/polymerase chain reaction, next generation sequencing to learn what the DNA has to say and if a newer approach to patient management can be adopted for a better health. I am also working on understanding why different people respond differently to medicine and how genetic tests can help doctors in safer medicines. As a genetic counselor, I also educate patients, families and the general public about the genetics of medical conditions and how to use this knowledge to make crucial decisions of their lives like family planning. 

Major part of my work revolves around DNA analysis and developing pipelines. I design the experiments and include the essential analysis steps and review the process. I have able bioinformaticians who do the coding, but we validate the final output with thorough review from molecular biology, genetic counseling, bioinformatics teams and after correlation with patient data. 

What skills are required for your role? How did you acquire the skills?

Information about what are the genetic conditions reported in India? Is there an already available test to identify it, what would be the cost and time that a family spends on it, can we reduce the time or cost using novel technologies or develop a simpler solution? How to identify family members who are at risk of having the same disorder, communicating the genetic findings to patients, families and their doctors? Helping doctors to make use of the genetic report. Knowledge of international practices, networking with experts in the field and willingness to learn new things and make use of them to enhance your work are desirable traits to have in my profession.

What’s a typical day like?

I start my day around 9:30 AM. I check for new experiments to design, DNA data to analyze, or read scientific publications to understand the concepts better and also know about newer findings in the field. Around 11:30, I sit with queries or discussions around research or patient query emails that I have to address, check over progress of my team members, supervise their tasks/reports, discuss with my peers and have meetings. Post lunch, we start our wet lab activities, set different experiments, we have presentations and discussions around troubleshooting, review patient data, talk to partnering clinicians, plan and execute lab activities. Towards the end of the day, we either have talks/seminars scheduled or I finish my admin related work and plan for the next day. 

What is it you love about this job? 

It gives me an extreme sense of job satisfaction, everything that I learnt right from my graduation till my post doc has relevance in what I do. Sure, the field is evolving and sometimes what you know can be challenged and proven otherwise, but there is thrill in unmasking complexities of genetic inheritance. What I do has direct relevance to society, I get to meet and work with researchers, patients and healthcare workers and develop projects. I get to meet parents who are motivated to not only make a difference in the healthcare of their child but also others who are similarly affected. They form a major driving force of inspiration to several people like me in the field. 

How does your work benefit society? 

As you can read from above, everything that I do has a direct relevance to society. My work revolves around making diagnostic journeys shorter and more accurate for the patients affected with genetic disorders so that their management/treatment can start at the earliest. 

Tell us an example of a specific memorable work you did that is very close to you!

There are several such milestones, like being a phone call away for patients who need advice on genetic testing and family counseling. Another is to be able to develop genetic tests and generate awareness among clinicians about rare genetic disorders. In two incidents, I  was able to identify a new gene associated with a genetic condition because of which a family could plan their next child which was healthy. I also published the findings. 

Your advice to students based on your experience?

Do not be very rigid about your goals, as you learn and discover new things in life, there are endless concepts that can excite you and you can pursue them. Keep asking yourself what kind of career would bring out joy and satisfaction and chase it with all your heart. Be ready to wait a little longer for things you actually want in life, because when it arrives, it wouldn’t matter how long the wait was. I had applied to both IIT and Tata Institute more than a year ago before the actual interview calls happened. But when it happened, I was grateful for the opportunity and was ready to grab it. 

Future Plans?

Promote the field of research genetic counseling. 

Develop smart tools for DNA analysis and interpretation that can be portable or app based so that all clinicians and individuals have a real time understanding of genetic information to improve healthcare. 

Improve the genetic literacy of our country.