Careers in Genetic Counseling Katie Farmer, MS, CGC Certified Genetic Counselor Tallahassee Memorial Hospital katie.farmer@tmh.org

Definition of Genetic Counseling Genetic counseling is the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. This process integrates: Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence. Education about inheritance, testing, management, prevention, resources and research. Counseling to promote informed choices and adaptation to the risk or condition. National Society of Genetic Counselors

Activities in which Genetic Counselors Engage Provide information and support to families who have members with birth defects or genetic disorders and to families who may be at risk for a variety of inherited conditions. Identify families at risk, investigate the problem present, interpret information about the disorder, analyze inheritance patterns and risks of recurrence and review available options with the family.

Activities in which Genetic Counselors Engage Genetic counselors practice in the following areas of specialty: Prenatal Pediatric Cancer Genetics Adult Laboratory

Activities in which Genetic Counselors Engage Prenatal Example: Ms. Roberts is a 28 year old woman. She is 17 weeks pregnant and this is her first pregnancy. She has a routine blood test at her OB’s office. She is told that it screens for Down syndrome and some other conditions. A week after the test ,she receives a call from the nurse saying she came back “screen positive” for trisomy 18. The nurse tells her the chance her baby has trisomy 18 is 1 in 100. She is referred to a genetic counselor.

Activities in which Genetic Counselors Engage Role of a Prenatal GC Review results of screening test Obtain pregnancy and family history Explain the cause and features of trisomy 18 Discuss further testing options Facilitate decision making Follow-up with further testing results Use counseling skills to help patient cope with test results Locate support resources for patient

Activities in which Genetic Counselors Engage Pediatric GC Example: Emily is a 2 year old girl who was born with profound hearing loss. She is the only individual in her family with hearing loss. She was recently evaluated by an ENT to consider cochlear implants. The ENT recommended that she have a Genetics evaluation to understand the cause of her hearing loss.

Activities in which Genetic Counselors Engage Role of a Pediatric GC Work closely with a medical geneticist Review medical records Obtain pregnancy, medical and family history Discuss known causes of hearing loss Discuss testing options Coordinate testing Counsel regarding test results and recurrence risk Provide written information Identify appropriate community resources

Activities in which Genetic Counselors Engage Cancer GC Example: Mary is a 48 year old woman who is referred to a genetic counselor because her sister was recently diagnosed with ovarian cancer at age 52. Her father and paternal grandmother were also diagnosed with breast cancer at ages 58 and 45 respectively. Mary tells you her sister has a mutation in the BRCA2 gene.

Activities in which Genetic Counselors Engage Role of a Cancer GC Obtain medical records and relative’s test results as appropriate Obtain family and medical history Pedigree analysis Discuss features and genetics of hereditary breast and ovarian cancer syndrome (BRCA) Discuss risks and benefits of genetic testing Review cancer risks and options for risk reduction Arrange for testing if desired and follow-up counseling

Organizations or Businesses that Employ Genetic Counselors Majority of genetic counselors work at: University medical centers Private or public hospitals Some genetic counselors: Work in laboratories Coordinate research studies Are employed by the state Work in private industry

Graduate Training Needed to become a Genetic Counselor Master’s degree in Genetic Counseling 2 year degree programs Graduate coursework Clinical Rotations Thesis/Capstone Project

Graduate Training Needed to become a Genetic Counselor www.abgc.net

Certifications or Additional Training Needed to become a Genetic Counselor Certification from the American Board of Genetic Counseling Sit for board exam usually within a year of graduation Must maintain appropriate amount of continuing education units (CEUs) every 5 years to keep certification (otherwise you take the exam again)

Employment Opportunities for Genetic Counselors NSGC 2012 Professional Status Survey

Salaries Genetic Counselors Earn NSGC 2012 Professional Status Survey

Flexibility in Working Conditions for Genetic Counselors Most jobs are full time, but part time positions are available Many industry jobs (working with laboratories) allow for working remotely Some level of travel is required with many of these positions Professional attire is required

Skills & Experiences Undergrads Should Acquire if Interested in Genetic Counseling Each program has its own requirements Check multiple program web sites for more information (www.abgc.net) Prerequisite coursework typically includes: One year of general biology One year of general chemistry One semester of biochemistry One semester of genetics One semester of statistics In general, successful applicants have a minimum GPA of 3.0

Skills & Experiences Undergrads Should Acquire if Interested in Genetic Counseling - Volunteer experience Crisis counseling hotlines and Planned Parenthood Experience working with individuals with special needs - Shadow a genetic counselor NSGC – Find a counselor (www.nsgc.org) - GRE GRE scores at and above 70th percentile range are considered competitive Some programs require GRE specialty exams as well - Three letters of recommendation - Personal statement

Most Rewarding Aspect of being a Genetic Counselor Opportunity to work with patients/families Provide information and support to help individuals adapt to what can be difficult situations Exciting field that is always progressing/evolving

Biggest Drawback of being a Genetic Counselor Must be mindful of burnout Navigating health insurance system for patients is not always easy

Website Recommendations for students interested in Genetic Counseling American Board of Genetic Counseling www.abgc.net Accredits genetic counseling training programs and administers certification for genetic counselors Has links to all training program websites National Society of Genetic Counselors (NSGC) www.nsgc.org Professional Society Has information on how to find a GC near you Has information about genetic counseling as a career