Clinical work with patients almost always requires an MD (or equivalent) degree awarded by a four-year medical school. Usually, this is preceded by a four year bachelor's degree at an undergraduate college. After completing the four-year medical program, an internship and residency program is frequently done with emphasis in the field of specialization (in this case, genetic medicine). Fellowships can also be pursued in the respective fields after achieving consultant status. However, genetic counseling and areas of research can be done by those with an MSc or PhD in the subject matter.