The Field of Genetic Counseling
The PhD/Postdoc blog series features scientists at different stages of career development as they explore and plan for their next steps. Over the course of six months, Zakiya Qualls, Annina DeLeo, Rwik Sen, and Erica Akhter will give monthly updates on their progress. Check back every Wednesday for new blog posts!
One of the fields I’ve considered moving into is Genetic Counseling. Genetic Counselors (GCs) have a combined Master’s degree in genetics and counseling in order to effectively work with physicians, technicians, and patients in getting patients needed information about the genetics of a given condition, what tests are appropriate and what information they will reveal, how a condition may affect other family members, and assisting in making informed choices about healthcare conditions.
There are currently about 4,000 genetic counselors, a position that has grown by 85% since 20061, and is still growing as more patients become more aware of and interested in genetic testing. While some states license their genetic counselors, almost all positions require graduates from accredited programs to pass the examination offered by the American Board of Genetic Counseling2.
Unlike being a principal investigator, the day-to-day life of a GC has much more of a team atmosphere, and like an MD, you get to meet with patients and make a more direct impact in their lives. Typically, GCs work in a hospital and will be enmeshed in a network of doctors, technicians, patients, other GCs, and sometimes researchers. A day of counseling might include four 1-hour sessions with time to review patient charts beforehand. A counseling session is usually followed by a referral for the patient to see a doctor or take a test. The GC will often follow up the meeting with a summarizing letter to make sure the patient has all the information they need about next steps and to make sure they have all the facts from the counseling session. Often, one day of the week will be spent on administrative tasks, such as catching up on paperwork. One of the big challenges in the field is combatting the cost of tests, some of which will be new enough that they are not covered by insurance. Therefore, part of the administrative day may be spent working as a patient advocate with insurance companies.
As more and more genetic tests and therapies become available, GCs have become specialized into one or more fields1:
- Prenatal and Preconception – for women and their partners who are pregnant or thinking about becoming pregnant
- Pediatric – for children and their family members
- Cancer – for patients with cancer and their family members
- Cardiovascular – for patients with diseases of the heart and/or circulatory system and their family members
- Neurology – for patients with diseases of the brain and/or nervous system and their family members.
As I mentioned earlier, genetic counselors must have a Master’s degree from an accredited program, of which there are currently 37 in the United States, 4 in Canada3. Some might wonder, why would anyone who has already completed or is about to complete their Ph.D. want to go back for more school? While not the most common path to genetic counseling, I know of at least 3 Ph.D.s in the Boston area who have are enrolled in GC Master’s programs. According to one program administrator, having your Ph.D. can be an advantage on the genetics side of the degree and can often help in obtaining financial assistance in the form of teaching fellowships. Furthermore, having a Ph.D. means you are already familiar with grant writing and research, which are useful skills for those GCs who decide to perform research either as part of a hospital or in industry developing new tests and or therapies.
To be admitted into an accredited Master’s program you will need to have completed some prerequisite courses4. A typical program might ask for:
- A semester of genetics
- A semester of psychology
- A semester of biochemistry
- A semester of statistics
- A year of biology
- A year of chemistry
These must be completed at the undergraduate level at least, and you must be at least enrolled in any missing courses at the time of program interviews. Another advantage of being at an academic institution already when you consider becoming a GC is that you can often take any missing prerequisite courses for a reduced fee. Most programs require you to submit GRE scores from the past 5 years, but this requirement will often be waived if you are pursuing or have completed your Ph.D.
If becoming a GC sounds interesting to you, I highly recommend going on informational interviews with GCs in your area. If possible, shadow one to get an idea of what the work is like. One of the best activities to prepare for this job, and one that will give your application a boost, is volunteering with support hotlines and groups, as this work is somewhat similar to being a GC. There are also many resources on the web, including videos of GC sessions, to give you a better idea of what this job is like.
Although going back to school may seem daunting for some, being a GC allows you to have direct contact with patients and make a more immediate impact on patient health than you might through research alone. For those Ph.D.s with a more social side, the ability to interact with others as part of a team may be a big incentive. Overall, the GCs I’ve talked to, and especially those with Ph.D.s, are finding the experience of interacting with patients to be a very fulfilling one.