Abstract
The genetic counseling (GC) profession has seen exponential growth in recent years, although the core identity of practitioners, focusing on the interpersonal impact of genetics on their clients' lives, remains unchanged. This chapter familiarizes undergraduate career officers and high school guidance counselors with the field, including the professional role of GCs in the North American landscape, the differences between U.S. and Canadian training programs, various clinical and non-clinical practice areas, and existing types of service provision. Typical indications for patient referral and case vignettes are added for clarity. Practice standards and the process of certification and licensure are reviewed, as are the missions, visions, and functional purposes of various organizations with which GCs may be actively engaged. Finally, readers are walked through the admissions process and examples of impactful mentorship and advocacy experiences in which applicants can engage to enhance their chances of acceptance to GC training programs.
TopIntroduction
Genetic counselors are health care professionals/practitioners who combine their knowledge of basic science, medical genetics, epidemiological principles, and counseling theory with their skills in genetic risk assessment, education, interpersonal communication, and counseling to provide services to patients and their families regarding genetic conditions (Association of Genetic Counseling Program Directors, n.d.). The National Society of Genetic Counselors (NSGC; n.d.) describes genetic counselors as those who help people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. According to the NSGC Definition Task Force (2006), the process of genetic counseling generally involves:
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Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence;
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Education about inheritance, testing, management, prevention, resources and research; and
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Counseling to promote informed choices and adaptation to the risk or condition.
Genetic counselors must obtain a Master of Science degree in genetic counseling. Their prior education typically includes a Bachelor of Science degree in a course of study such as biochemistry, biology, biomedical sciences, microbiology, genetics, or other health-science related fields. However, students with degrees in arts, humanities or other non-science-related disciplines may also be eligible if they have taken the appropriate prerequisite courses. A master’s degree in genetic counseling generally takes two years to complete, and includes training in counseling, psychology, ethics, advanced human genetics, genetic epidemiology, and more. Aside from the academic courses, the bulk of training is completed in clinical rotations in medical settings.
Genetic counselors work in a variety of settings, such as medical centers or physicians’ offices, patient advocacy organizations, government agencies, public health departments, and biotechnology companies. Those in clinical settings provide education and counseling for a variety of specialty areas, such as reproductive genetics, pediatric genetics, newborn screening follow-up, cancer genetics, neurogenetics, cardiovascular genetics, and ocular genetics. Many genetic counselors are involved in teaching, research, or industry. The profession is growing rapidly, with the number of certified genetic counselors expected to double in the next decade (NSGC, 2021). US News & World Report ranked genetic counseling #11 in Best Health Care Support Jobs and #71 of the 100 Best Jobs in 2021 (U.S. News & World Report, 2022).
The genetic counseling profession has seen exponential growth in recent years, fueled by rapid advances in genetic and genomic technologies. Nevertheless, the core identity of practitioners, focusing on the human and interpersonal impact of genetics on their clients’ lives, has not changed. The field of genetic counseling continues to attract candidates who are just as passionate about caring for their clients in a meaningful way as they are excited by the possibilities that advances in genetics and health care can deliver, such as whole exome/genome sequencing, CRISPR technology, pre-implantation genetic testing, and other methods of detecting and even preventing genetic disease. This enthusiasm applies equally to genetic counselors who practice in nonclinical settings, where the goal is to liaise with medical professionals, researchers and patients, or engage in variant interpretation, health professional education, public policy, newborn screening, or any number of other vital genetics services. Good candidates for the genetic counseling profession know who they are; this chapter should help them succeed.
Key Terms in this Chapter
Accreditation Council for Genetic Counseling (ACGC): Advances quality in genetic counseling education by developing and maintaining standards for educational and clinical training of genetic counseling students and implementing a peer-review process to evaluate programs.
National Society of Genetic Counselors (NSGC): Promotes the professional interests of genetic counselors, provides a network for professional communications, and advances the various roles of genetic counselors in health care by fostering education, research, and public policy to ensure the availability of quality genetic services.
American Board of Genetic Counseling (ABGC): Organization that certifies and recertifies genetic counselors and accredits genetic counseling training programs.
Canadian Association of Genetic Counsellors (CAGC): Promotes high standards of practice, facilitates, and supports professional growth and increasing public awareness of the genetic counselling profession in Canada. The CAGC administers the Canadian certification examination for genetic counsellors and provides continuing education opportunities for its members.
Non-Directive Counseling: The process of offering counsel to patients without making judgements on the information presented by the patient or offering advice or direction.
Graduate Training Programs: Masters level education in genetic counseling, currently offered at over 50 institutions of higher learning within the U.S. and Canada, involving academic studies, clinical/non-clinical fieldwork, and research.
Advocacy: Action that speaks in favor of, recommends, argues for a cause, supports or defends, or pleads on behalf of others. In genetic counseling terms, it means working for people or causes to help them overcome barriers and achieve meaningful goals, such as equity, justice, and positive living experiences, without judgement or discrimination.
Clinical Supervision: The act of supervising or being supervised in a clinical or non-clinical setting, such that the supervisee is provided guidance, feedback, and direction to improve his/her/their skills along the way toward becoming an autonomous, qualified genetic counselor.
Medical Genetics: The branch of healthcare involving the diagnosis and management of hereditary disorders, incorporating areas such as gene therapy, personalized medicine, and predictive medicine.