Some Ins and Outs of Genetic Counseling

Today, as promised, is my discussion of genetic counseling. I hope you enjoy it.

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As I mentioned in my first post, I am a future genetic counselor. I realize that not everyone knows a whole lot about the field so I decided to answer some questions about it. Please realize that I am not a genetic counselor yet, just an aspiring student, so if you are in need of more information please visit the National Society of Genetic Counselors website.

What is a genetic counselor?

A genetic counselor is an educator. With their background in medical genetics and counseling techniques, they serve as a guide to help you make the most informed decisions possible. They realize that not everyone understands all of the complex information that comes along with a diagnosis of a genetic disease or disorder and they are there to break it down into manageable “bite-sized” pieces.

What sort of genetic counselors are there?

Genetic counselors come in three main “flavors”: prenatal, cancer, and pediatrics. Prenatal counselors work with couples who are, or are looking to become, pregnant. They discuss risks to the fetus, possible screening procedures available, and any family history concerns brought to the table by the couple. Cancer counselors work with individuals who have been diagnosed with cancer or those with sufficient family history to warrant concern. They assess the risks to the person as dictated by their family history and possibly their test results should they already have been diagnosed. They also provide information about various genetic testing options (think along the lines of the well publicized BRAC testing). Pediatric counselors work with children and mostly focus on disease and disorder categorization and management. Frequently they work with medical geneticists or pediatric doctors during the initial assessment of the child.

It should be noted that not all genetic counselors work in a clinical setting, like in a hospital. Many work in industry now with the advent of direct-to-consumer (DTC) genetic testing. Companies that do DTC marketing often employ genetic counselors to field questions from customers and to call out results when necessary. The range of places where genetic counselors are being hired is constantly evolving and by the time I get into the field in two years, there will probably be more positions in the non-clinical realm than are currently available.

What level of education is required to become a genetic counselor?

Genetic counseling students first obtain bachelor degrees in any range of subjects from biology to psychology. They then apply to any one of the 30 accredited programs in the United States, or the three in Canada, and once accepted spend two years doing didactic work and clinical training. They graduate with a Masters of Science in Genetic Counseling and take the American Board of Genetic Counseling Certification Examination. Once the individual has passed the exam, they are awarded the title of Certified Genetic Counselor. Some states have recently passed licensure law for genetic counselors and in that case, an application may be required to become licensed in order to practice.

Why do you want to become a genetic counselor?

I have wanted to be in the field of genetics since I was six years old. I was constantly fascinated by the differences I observed in the people around me. The science of genetics is the best explanation for those variations and because of that I wanted to learn as much about it as possible. I attended multiple camps throughout high school that introduced me to lab techniques used to separate DNA and such and gave me more experience with the complex subjects of genetics not necessarily covered in my regular classes. Heading into college I thought I wanted to work in a genetics lab as a technologist but it fast became clear that I really didn’t love the wet bench work and solitary nature associated with a lab.  In light of this, I went on a search for another route to take my love of genetics. I found the perfect marriage of human connection and science in genetic counseling. Not only would I get to stay on top of the new science and breakthroughs in the field but I would constantly be interacting with patients. This, to me, was the best thing in the world.

What has your journey been like?

When I figured out that genetic counseling was what I really wanted to do, I sought out genetic counselors to shadow. I got in touch with several cancer counselors back in the metropolis where my parents lived and spent my sophomore Christmas break experiencing my first taste of the genetic counseling field. I couldn’t get enough. I found a genetic counselor located much closer to my undergraduate institution and plead my case for an “internship”. Though she couldn’t pay me, she did offer me a weekly place in her office and I jumped at the chance. Not many long term shadowing or intern positions exist in this field so to get the opportunity to be with a practice once a week was incredible.

Every Monday, I arrived at the maternal fetal medicine office where the prenatal genetic counselor worked. I got to sit in on all of her sessions and she was kind enough to discuss each one with me and let me examine the records for myself (don’t worry, I had signed several confidentiality agreements with the hospital before I was allowed around medical records and patient information). She was interactive and helpful and even included me in the stillbirth assessment program she was involved with. I have no doubt this continuing intern position helped me in the Masters program application process.

In addition to making connections with practicing genetic counselors, I worked with a program called Special People United in Riding (SPUR). It is a form of equine therapy directed at mentally and physically disabled individuals, young and old.

I also was a rape survivor advocate for a crisis hotline. They had a call forwarding system that allowed me to work from school despite the call center being located where my parents lived, a state away. This volunteering allowed me to gain experience with counseling individuals in crisis, a very real possibility in the field of genetic counseling.

Lastly, I made sure to branch out from my biology/genetics undergraduate course load and take some psychology classes as well. I focused on the counseling side of things given my future ambitions.

All of these things made me a strong candidate when applying to Masters programs in the fall of 2009 but I was not accepted into a program that year so when I graduated with my Bachelor’s degree in 2010 I accepted a graduate position at the same institution. Not satisfied with any of the majors offered, I created my own major, bioethics, with the help of my long-time undergraduate mentor. I felt this subject served as a nice corollary to my upcoming genetic counseling studies. Instead of spending the normal two years it takes to achieve a Masters degree, I decided to do it in one year. During the fall of 2010, I reapplied to genetic counseling Masters programs and this time I was accepted. I graduated with my Masters in July of 2011 and am currently ready to enter my second Masters program in just a few short weeks! I will graduate again in May 2013 and will take the boards to become certified.

What do you think your career will look like in ten years?

If all went as planned, I see myself as a prenatal genetic counselor who also works in an infertility clinic once a week and is deeply involved with a stillbirth assessment program. I developed an interest in fertility and sterility during my Masters creative project which I just finished a month ago. The prevalence of the issue is incredible and there is so much we don’t know, there is so much yet to be explored. My desire to be an integral part of a stillbirth assessment program comes from my interning experience, hands down. The situations encountered by a program of this nature are certainly not pleasant but the chance to provide a family with closure is one that I am not willing to pass up.

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Thank you for reading and I hope you feel a little more educated about genetic counseling. If you have any questions, please ask!  I am so passionate about this field and I am more than bubbling with excitement to get started. Plus, as classes and clinicals take off you can bet there will be more discussion about my academic journey on this blog so I want everyone to feel in the loop.

On a separate note, later today I’ll be posting for What I Ate Wednesday! Yum!