Alumni highlight – Scott Topper: from poet to clinical geneticist

By Leo Barolo

When Scott Topper was an undergraduate studying literature, he had little idea of where his education would take him. With a keen wit and a flair for creative writing, Topper went on to acquire a Masters of Fine Arts in Poetry before entering the job market. But it wasn’t long before his love of biology pulled him back to academia. In 2005 he entered the UW-Madison Genetics PhD program where he joined the lab of Dr. Audrey Gasch to focus on stress-activated signaling in budding yeast. It was there, and later as a fellow in the Genomics Sciences Training Program, that Topper realized his passion for genomics. After graduation, he became a clinical molecular genetics fellow at the University of Chicago, completed his board certification, and rose through various leadership positions to his current position at Color, one of the largest clinical sequencing companies in the country. Through his position at Color, Topper is also co-PI of the ambitious NIH All of Us project to sequence 1 million citizens and provide genetic counseling to better people’s health.

We talked to Topper about his current position, career trajectory, and words of wisdom he has to offer.

Dr. Scott Topper

What is your current position and how is it connected to genomics? 

I am the Chief Clinical Operations Officer at Color Health, a company that delivers large-scale public health initiatives across a number of different clinical areas, including genomics. I oversee a team of about 200 people who provide clinical genomics professional services (genome interpretation and genetic counseling), clinical laboratory testing, and clinical test development across hereditary genetics, COVID, infectious disease and clinical chemistry. We aim to provide accurate, accessible data to support health programs that drive meaningful health outcomes.

One of the most important and rewarding projects I have the opportunity to work on is the National Institutes of Health’s All of Us Research Program, a federal program that aims to advance precision medicine in the US by creating a deep, longitudinal, and open access data set of genetic and phenotypic information from over 1 million diverse participants. I am the PI on two grants that aim to engage and involve the participants over time, by generating and returning health-related, genetic information from their personal research data.

What is your job like on a daily basis?    

On a daily basis my job is a fascinating challenge. My responsibility is largely to enable an incredible team to make fast progress on the most important work. I spend a lot of time on organizational projects to make sure that we are aligned and effective, a lot of time learning from the team about the critical details they are facing and solving in our projects, a lot of time trying to help articulate the value and nuance of our aims, and a lot of time working with the executive team and external partners to establish future direction.

What about your training at UW-Madison was the most impactful in preparing you for your career?  

The most impactful part of my training at UW-Madison was learning to be a productive part of a community of brilliant and creative scholars and inventors. I had the incredible opportunity to learn from and collaborate with faculty and students who demonstrated a kind of limitless, purposeful, scientific ambition. I learned the value of asking scaled questions, gained an appreciation for how transformative new technologies can be in enabling leaps in scale, and learned the critical value of effective collaboration in moving projects forward. I was deeply inspired by the Wisconsin Idea– that the work of science could and should have a positive impact on the world.

What do you see as the most exciting challenges and opportunities in your field/company?  

It is eminently possible to drive step changes in population health in our lifetimes by re-thinking how and where basic healthcare services are delivered. A combination of technological improvements in screening modalities, effective and well-tested clinical protocols, reliable logistical services, and an honest focus on equity and inclusion can increase access, reduce cost, and improve health outcomes for all of us. There are difficult and critical structural problems to solve with regard to how healthcare is funded, how data is used and secured, how individuals interact with and are served by the care systems. The silver lining of COVID is that it has made it possible to imagine truly ubiquitous scaled healthcare programs.

What is your advice to current grad students interested in pursuing a career in your industry/field?  

Do everything you can to drive your project and your collaborators’ projects to success, and don’t be afraid to jump into something new. Integrity, collaboration, expertise, and storytelling all matter. Ask a ton of questions, care about the details, focus on outcomes, and learn to talk effectively about your work.

What is the single person, event, or experience that most influenced your trajectory to where you are today?  

Impossible question. But here are 3:

  • Audrey Gasch, who took a bet on inviting me into her genomics lab when she was a relatively new faculty member. Audrey is a brilliant scientist and a truly generous teacher who tackles incredibly complex biological and computational problems with a hungry mind, a clarity of purpose, a ruthless focus on detail, and an infectious curiosity and enthusiasm.

  • David Schwartz, who invited me into the Genomic Sciences Training Program. Dave challenged us to ask big, impossible questions, to focus on how new technologies could enable new ways of seeing and thinking, and to recognize the critical nature of cross-functional collaboration in getting important work done.

  • Casey Reiser (retired from UW in 2022), who led the Genetic Counseling training program, and who allowed me to participate in and learn about clinical applications of genetics while I was focusing on basic science. Casey made it possible to think about the impact and real-world challenges of applying genetics to medicine, while placing compassion and respect at the heart of that work.