Genetic Counseling

Automated DNA sequencing output. Credit: The Sanger Institute. Wellcome Images.

Automated DNA sequencing output. Credit: The Sanger Institute. Wellcome Images.

Coming from a perspective of exploring the breadth of public health and healthcare jobs out there, I enjoy learning about less-than-standard jobs in these areas. Hello genetic counseling.

A friend of mine at the University of Washington connected me with a genetic counselor there so that I could go to the UW Medical Genetics journal club and the genetic counselor clinic conference. This is definitely more of a niche field, so I’m not sure it’s for me (given my broad public health interests). Still, I was so impressed that I decided to spread the word. I’ll continue to ponder what I learned, as I was surprised by how well some of my interests mapped onto this work.

Side note: I didn’t know about journal clubs (for discussing the latest literature in a field) – it is a great idea. If a grad school I go to doesn’t have one for students, I think I’ll make one.

Genetic counselors help individuals navigate whether to get genetic testing and how to do it. They can then interpret the results and help people manage their lives given the new information. They can be advocates, educators, referrers, researchers, and lab workers. Depending on who you talk to, they can also help inform policy and public health work (I would agree that it sounds like they can). They work in clinics, hospitals, and labs, working both individually and with physicians. They stay up to date on genetics, a constantly evolving field, and navigate challenging bioethics questions. It was great to see that, at the UW, they get together regularly to discuss patient treatment options (the clinic conference). It was clear today that they take the whole person into account, tailoring treatment to not only genetics and family history, but also individual emotions and life circumstances. Emphasizing patient choice was clearly very important. Apparently, clinic conferences are common across genetic counseling groups, though they don’t happen if there is only one genetic counselor in a facility, say in a rural hospital. The amount of days per week that genetic counselors see patients (vs. other responsibilities, say research and lab work) depends on were they work, ranging from every day to once per week (to I imagine never, depending on the job).

What I like about this career:

  • Working with patients directly and providing in-depth support with an emphasis on patient empowerment.
  • The technical side: I haven’t looked at genetics in awhile, but I have to admit it’s pretty fascinating.
  • The lifetime education: I like how genetic counselors have to stay up-to-date with their knowledge, requiring constant professional development.
  • The options for expansion: When I look at this field, I see it both as a niche area and one with room for expansion and collaboration with public health (especially environmental health and epidemiology), policymaking, and medical anthropology. This is also, I think, a career generally applied in high-resource settings. I would be interested to see how it might be useful globally.
  • The teamwork (working with other genetic counselors, physicians, researchers, and labs).
  • The bioethics component – fascinating and challenging.

To quote from the UW Genetic Medicine Clinic website:
“​The Genetic Medicine Clinic at UWMC offers a full range of evaluation, diagnosis, assessment, genetic testing and interpretation, counseling and management. The clinic also provides referrals to appropriate resources for individuals with genetic disorders in their families or with disorders thought to have a genetic component.
In addition to general assessment, the medical genetics clinic team members have expertise in:
Genetic counseling and testing
Familial cancer counseling, testing and risk assessment, including breast, ovarian, colon, gastric, melanoma, pancreatic, prostate, kidney, sarcoma, thyroid, kidney, pheochromocytoma, von Hippel Lindau syndrome, Li-Fraumeni syndrome, Cowden syndrome, Birt-Hogg-Dubé, Peutz-Jeghers syndrome, familial adenomatous polyposis (FAP/attenuated FAP), MYH (MAP) polyposis Lynch (HNPCC) syndrome, hereditary breast and ovarian cancer syndrome, hereditary paraganglioma syndromes and CDH1/e-cadherin
Neurogenetics, including the Huntington disease center of excellence; CADASIL, familial Alzheimer disease; Charcot-Marie-Tooth/hereditary motor sensory neuropathy; hereditary ataxia; movement disorders; and muscular dystrophies
Inherited connective tissue disorders, including Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome, familial aneurysms and osteogenesis imperfecta
Pediatric neurogenetics
Genetic evaluation premature-ovarian failure
Genetic evaluation of male infertility
Genetic evaluation of female infertility
Turner syndrome
Inherited skin disorders, including ichthyosis, incontinentia pigmenti, neurofibromatosis, tuberous sclerosis and epidermolysis bullosa
Cardiogenetics, including Long QT and other cardiac rhythm disturbances, and familial cardiomyopathy
General genetics (primarily adults)
Pre-pregnancy genetic counseling and testing
Autism genetics”

In addition, I have some ideas for genetic counseling, such as applying it to examining epigenetics and improving health for people depending on their environments (e.g. radiation incidents). Also, I think genetic counseling could interact very well with epidemiology or medical anthropology.

To become a genetic counselor, one gets a master’s degree in genetic counseling (2 years). From what I heard today, the degree is a combination of genetics and counseling training. You can also get a MS/MPH combo degree from the University of Michigan.

Once I told the lovely individual showing me around about my public health interests, she introduced me to a second year student in the UW’s Genetic Epidemiology M.S. program (not a genetic counseling program). She seemed pretty into my epigenetics and environment-gene interaction questions, as she was doing her thesis on drug-environment-gene interactions. Thus, this could also be a great program for people interested in those areas. In addition, she said the program can involve a lot of interaction with medical anthropology, if you are fascinated with that field like I am.

This was, of course, also a lesson in how easy it can be to connect with people to learn about various career paths, if you only take the time to ask and be interested. Don’t be afraid of networking! I got this meeting by telling my friend, a genetics lecturer at the UW, over a text that genetic counseling sounds like an awesome field. Go for it.

DNA artwork painting on canvas from DNA Art Paintings. Image from DNAartonline.com .

DNA artwork painting on canvas from DNA Art Paintings.

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