News at Medicine - May 2020 - A new way to practise: Integrating genetics and family medicine

A new way to practise: Integrating genetics and family medicine
May 21, 2020
Daniel Evans is one of only three people to complete the MD-PhD program in the Faculty of Medicine. For Evans, this means he can be a physician and a scientist, something he always knew would be his path.
“I knew I wanted to help people early on. My grandmother, Mary Evans, was perhaps one of the biggest influences on my life and my decision to pursue medicine. She had Parkinson's disease and watching her grow old, she taught me a lot about having grace in the face of adversity. I think she would have been proud of me this year,” notes Evans, who comes from a family of six.
Evans completed a bachelor of science (hons) at Memorial in 2012 before starting in the Faculty of Medicine’s graduate program in human genetics. The same year he wrote his PhD comprehensive exam, Evans was accepted into Doctor of Medicine (MD) program and later, the joint MD-PhD program. He completed both simultaneously, winning several awards in both and publishing some very impactful research during medical school.
Evans describes the MD program as an opportunity to learn about a vast array of medical topics and that the same applies to graduate studies, but with more emphasis on knowing everything about a focused set of topics and on a much deeper level.
“I compare it to the difference between trying to sail the world's oceans, or having a broad knowledge base, versus trying to scuba dive to the bottom of Marianas Trench, or diving deep on one subject.”  

Passion for genetics

“Genetics is a great field because the technology is always advancing, and integrating new discoveries with patient care is something I find rewarding,” said Evans.
When he started his graduate work, geneticists were just gaining access to a new technology called next-generation DNA sequencing. Evans’ PhD research focused on working with families from Newfoundland who have rare disorders with mutations that could not be discovered with conventional DNA sequencing, but they could by using this new method of whole exome sequencing.
His research led to the successful discovery of two new mutations, one in a disease called retinitis pigmentosa and the other in Weill-Marchesani syndrome. Evans also worked with his supervisor Dr. Michael Woods on the genetics of hereditary colorectal cancer in Newfoundland. 

Listening to stories

The St. John’s native says he’s most proud of the positive impact he’s had on the families he’s worked with, having completed clerkship rotations in rural Newfoundland, including family medicine in Twillingate, internal medicine in Gander and general surgery in St. Anthony. 

“There are many beautiful places to visit and it was nice to see the bigger picture of life on the island,” Evans said. “There are also some really great mentors who teach in these communities and I think training in smaller, more close-knit health care teams has taught me the value of collaboration and professionalism. I think it influences you to think more holistically about health care, be broader in your learning and it encourages you to go the extra mile for your patients.”  

It was some of those families he met who participated in Evans’ genetics research, for which he’s very grateful. 
“I think on a very fundamental level, genetics explains a lot about life and a lot about people. For me, it's about listening to people's stories, their family histories and their personal struggles,” he said. “The story of genetics is something that impacts everyone, from our eye colour, our medical history, even the way our bodies metabolize certain medications. It explains evolution and our ancestral heritage and is something that links us all together.” 

Double celebration

During his academic career, Evans’ awards included two Human Genetics Research Forum awards for best presentation, two Memorial Volunteer Incentive Program awards (one silver and one bronze), a Medical Graduate Student Society Scholar and Community Involvement Award, the Dr. Angus J. Neary Scholarship in Human Genetics, Beatrice Hunter Cancer Research Institute: Cancer Research Training Program Award, the Dr. Roger C. Green Scholarship in Human Genetics, the Dr. Ralph John Day Award, among others. In 2019 he became a Fellow of the School of Graduate Studies.

Evans defended his PhD thesis during his clinical rotation in internal medicine and passed with distinction. On the medical school side, he’ll be starting as a family medicine resident in Victoria, B.C. in July.
He wants to use his research experience to help bring new discoveries into a medicine practice. “I like the idea of being a family doctor with genetics training specifically because I think it's an important skill set for any physician to have. I'm hoping to join a small group of family doctors who are working to bring modern genetics into routine clinical practise.”