Today is the day!

Today marks the start of the decision period for Genetic Counseling programs and GC applicants.  We all wish you the best of luck today and throughout the remainder of the week!

Hope things are going smoothly– or at the very least you are taking steps to stay sane through this process.  Here are three last words of wisdom for you all:

1. Do not give up on your dreams.

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2. Take time from your day to do something fun.  Take a break– go to dinner– get some ice cream– anything to take your mind off a crazy day ((or to CELEBRATE a crazy day)).

3. Make the best decision for YOU.  Only you know how you truly feel– follow your gut instincts.

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D-Day: Smooth Sailing vs. Turbulent Waters ((by Sarah)).

Like my fine fellow-bloggers… D-Day was such a pivotal time in my life.  It was the most important big decision I had to make for ME thus far.  Just keep in mind that:

1. No matter what program…. you get to the same final product, or degree.  You will be a trained genetic counselor, even if there are an array of methodologies to get you there.

2. You really could try just about anything//live just about anywhere for two years.  Do what is best for you.  What will make you the happiest?

For some… it is smooth sailing.

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For me, D-Day was VERY much on the turbulent side.  I was wait listed for 3…. yes 3… days at 4 programs awaiting my fate.  Lots of phone calls and WAITING. ((with little sleep)) Eventually, I was accepted to the number one program on my list.  But only after some tears and a LOT of pizza, cookies, and disney movies with my friends.  Regardless of the outcome, you will survive!

Do not give up on your dream.  Try not to stress– that does not get you anywhere but sick to your stomach– and I know the feeling.  Try to think which program would be lucky enough to have you in it.  Do not loose that confidence in yourself or that cool, processional vibe.  You got this.

Like my fellow bloggers — I agree that it is of utmost importance to have some sort of idea which programs you want and to have them ranked when the day rolls around.  Which program is the best fit for you personally? Follow you instincts–or when in doubt, a pros and cons list.

And remember– if you do not get in the first time interviewing– it does not mean you should not be a GC.  I know of a few amazing counselors who got into a program the second year they applied.   You would never know it now.  One of my own amazing classmates who was accepted the second time around– is now deciding between several different, excellent job offers.  Persistence pays off.  You gain experience and maturity with time.  One student I met even said she was told it was unusual to get in on the first round.  While I would not go so far as to say that it is completely unusual, this is a competitive field!  But most of all– Try to stay positive!    ,

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If things do not go ideally, set up a plan.

1. Talk with directors of the programs you applied to, in order to see what you can do better for the future/make yourself a better applicant

2. Gain experience is various GC specialty areas

3. Work with children who have special needs and their families, since these are ultimately the people you will serve as a genetic counselor.  Gain a better understanding of how you can help in the future.  (therapy, intervention centers, etc.)

4. Research, hopefully something related to development or genetics

5. Apply again as a strong candidate with fresh experiences and new skills > show GROWTH.

Best Wishes!

D-Day…Be Vain ((by Melissa))

Are you in your last semester of undergraduate classes? Working hard for the money? Doing whatever you can to pass the time until decision day? You are not alone. You are all waiting to hear back from your respective schools that you have interviewed at. Whether you interview at one or twenty-one programs, a tough decision still rests in your hands: which program will be so lucky as to have you for the next two years?

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The four of us have been in your position. We are here to shed some light on things that helped us find our perfect Genetic Counseling program match.

But let me emphasize this point…THIS IS ALL ABOUT YOU. While it is true that a program has to extend you an offer to join them, you also have a powerful choice to either accept or respectfully decline that offer. How are you going to make such a decision?!

As you will quickly learn in your future Genetic Counseling career, each individual is different. What you are looking for in a program can be completely different from what another interviewee is looking for. 

My advice would be to identify what is important to you, and evaluate the schools you interviewed with based on this “checklist”. Items on the checklist are like SNP variants (slight changes in the DNA between individuals), so what I’ve listed here may not be identical to what you’ve had in mind. Which is OK, because I’m not you, and you aren’t me!

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Are you looking to be in a specific geographic area? Some interviewees applied to a group of schools in a specific region, while others applied all across the country. Were you comfortable with the surrounding area, and could you see yourself living there for the next two years of your life?

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Is money/financial aid an issue for you? If not, teach me your ways. If so, you also have a few things to consider: tuition – are you in-state? Can you get in-state? Are there employment options for you? 

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What type of exposures will you get in your training? Where are the rotations? Do you have the opportunities to engage in outside activities that will strengthen this clinical experience?

You are currently the greatest decider of your future, and you were the only one who interviewed with the program directors and faculty. As Austin mentioned it before, listen to your gut instincts! If you had a great experience with a program, remember why that was! Again you want to be as happy as possible with your two year training experience. You will become a great Genetic Counselor no matter where you go!

To touch on a less optimistic subject…there are some individuals who do not get an offer anywhere.  I like to think of rejection of a Genetic Counseling program as temporary. If you did not get an offer and know that Genetic Counseling is what you want to do, DO NOT give up. Speak with the program directors and ask them for advice as to how you could strengthen your application to become a sure candidate for future admission cycles. As Anna and Austin have said, you have the ability to overcome rejection, and that ability is perseverance. Reapplying shows more of your character than I can express, so do not be ashamed and continue to work for what you want.

We hope you aren’t stressing out too much, and can’t wait for another group of passionate Genetic Counselors to come around!

Best of luck!

D-Day ((Anna))

With decision day around the corner, I hope these posts help your decision making a smoother process.

I agree with Austin’s points, as those were main considerations for me. I would add that before you hear back from programs, make sure to rank them in order of preference because you only have a few days (maybe a week? I can’t remember) to decide, so knowing ahead of time which school you prefer will make your decision easier.

In terms of my personal experience with the interview process, I interviewed at 2 schools in different states and really liked both of them. It was a tough decision to choose one over the other but my decision ultimately came down to this:

  • The number of clinical hours
  • The variation of clinic sites (and their reputation!!)
  • Since both schools were in proximity to major cities, I chose the city that would enable me to take better advantage of my surroundings and expose me to different patient populations
  • Class size
  • Fellowship opportunities
  • Neighborhood
  • The city! I chose a city I could live in that would encourage a work-life balance

A few things to remember as well if you don’t get an acceptance. As Austin mentioned, if you don’t get in this time around, try again! Perseverance shows that being a genetic counselor is what you want to be! Don’t get discouraged- the fact you got an interview is no small feat! You already beat out so many applicants. Try to shadow or volunteer with a genetic counselor so next time you interview you can give specific details about your experiences in the field.

Good luck!

D-Day (D for decision, not Normandy) ((by austin))

Most of those of you that are applying for admission into one of the genetic counseling programs for this fall are probably either in the throws of interview season, or are anxiously awaiting responses. 

Decision day can be a day for celebration, a day of disappointment, and for some it can be more stressful than the interview process. That is, if you are one of those lucky applicants that gets an offer from more than one program :-)

Speaking from my personal experience, I applied to several programs, and only interviewed at one, so I can’t speak on this from personal experience. I can share, looking back, on some things that I’ve found to be very important differences between programs that may help someone who is in limbo make a decision.

1) How is the academic/rotation schedule set up?

Some programs have you start your clinical rotations during the first week of class and you are regularly in the clinic throughout the program, while others start solely with coursework and then pepper in clinic experiences as you progress. Having talked to people from other programs, there doesn’t seem to be a significant difference, but that is something I would not have thought to ask about.

2) Is there appropriate support for students? 

Depending on the size of your program, this may be a legitimate concern. Most programs are small, so your faculty/administrator to student ratio falls closer to the 1:1. However, in programs with more students, this can be a challenge. This is an issue that can be menial for someone who is more self-directed and independent, but can wreak havoc on those who are expecting a more involved experience. 

3) Where is it?

For some people, location is just as important as anything else. Thinking about not only the geographical environment that you’ll be tied to for the next two years, but also the rotation experience that the area has to offer. If you’re looking for a wide variety of experiences from your clinical rotations, you’re probably going to be more satisfied going to a program near New York City where there is a diverse population, rather than South Dakota where the population is fairly homogenous (I can say that because a) they don’t have a program and b) I’m from there :-)

4) Trust your gut!

You interviewed there. You met the people. You got to check out the campus. Generally in the time that is required to conduct the admission interviews, you can get a pretty good idea for whether a place is a good fit or not. Granted, they’ll all be on their best behavior (as you should be), but in the end, you’ll be spending a lot of time in this place with these people. This is especially helpful if you are making a decision between two programs (not an issue I had to worry too much about).

And remember – you worked hard to get here. If you got into one program, celebrate! If you didn’t get into any programs, take some time to be upset/disappointed/angry, and then make sure to contact the schools you interviewed at and let them know what a pleasure it was to meet with them. I would also strongly recommend that if there was a primary person that you interviewed with, touch base with them to thank them for their time and ask what you can do to make your application stronger for the next year. They will remember that you took rejection (which is something we all get but not everybody can handle) well, and that you’re still very interested in their program. Plus they’re basically telling you what you need to do, so lap it up.

And if you got into more than one program, you got some decisions to make.

Good luck to everyone out there!

3 things professional 20 somethings should be doing ((by Sarah)).

For all you new or prospective GCs out there… Here are a few tidbits I am ((slowly)) learning about professional life…

My Must Haves:

1. A well-curated LinkedIn.

From professional networking to finding future jobs– you should get a LinkedIn stat if you do not currently have one.  And– keep it up to date! You never know who may see it! ((I have had several companies email me about potential jobs via LinkedIn too!))

2. A proper email AND twitter.

A proper email may seem obvious– but is important to note.  By proper email– think a professional email account free of any hobbies/interests/etc ((ie. “cheer_girl_fo_life@” or “girl_crazy_soccer_stud@” require an upgrad)).  Likely stick with some form of your name.

Now a professional twitter is something I have been thoroughly enjoying//had not thought about much before.  I now have GC friends who I primarily if not exclusively know via twitter.  It is an amazing way to keep up with new occurrences in your field as well.  ((Always be thinking about networking!))

3. Keep that CV updated. ((And references list!))

Whenever you do something new– update that CV right away so you are never caught unprepared.  This also goes for those young professionals who are already employed– you never know when someone may ask for a copy!  ((Thanks to my NSGC mentor for this tip!))

When thinking professional references– build a diverse list of 3-5 complete with emails, phone numbers, and work addresses.

Best of luck!

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Best Resources For Your Best Practice ((Anna))

TEXTBOOKS

A Guide to Genetic Counseling (Wendy Uhlmann, Jane Schuette, Beverly Yashar)

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Chromosome Abnormalities and Genetic Counseling (R.J.M. Gardner, Grant Sutherland, Lisa Shaffer)

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Counseling About Cancer: Strategies for Genetic Counseling (Katherine Schneider)

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Genetics in Medicine (Thompson, Thompson)

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The Practical Guide to the Genetic Family History (Robin L. Bennett)

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The Developing Human: Clinically Oriented Embryology (Keith Moore, T.V.N. Persaud, Mark Torchia)

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Oxford Desk Reference Clinical Genetics (Jane Hurst, Helen Firth, Judith Hall)

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Smith’s Recognizable Patterns of Human Malformation (Kenneth Jones, Marilyn Jones, Miguel del Campo)

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How to Talk with Families about Genetics and Psychiatric Illness (Holly Peay, Jehannine Austin)

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Practical Genetic Counseling (Peter Harper)

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Facilitating the Genetic Counselling Process (Patricia McCarthy Veach, Bonnie LeRoy, Dianne Bartels)

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FOR YOUR INTEREST

The $1000 Genome: The Revolution in DNA Sequencing and the New Era of Personalized Medicine (Kevin Davies)

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Far From the Tree: Parents, Children and the Search for Identity (Andrew Solomon)

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Genetic Rounds: A Doctor’s Encounters in the Field that Revolutionized  Medicine (Robert Marion)

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The Emperor of All Maladies: A Biography of Cancer (Siddhartha Mukherjee)

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The Spirit That Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures (Anne Fadiman)

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The Immortal Life of Henrietta Lacks (Rebecca Skloot)

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The Curious Incident of the Dog in the Night Time (Mark Haddon)

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Handle with Care: A Novel (Jodi Picoult)

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Carrier: Untangling the Danger in My DNA (Bonnie Rough)

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Must Read Interview: Psychiatric Genetic Counseling. ((Anna & Sarah))

Interview with Anna: Psychiatric Genetic Counseling 

Sarah: How did you become interested in psychiatric genetic counseling?

Anna: I have a BA and an MA in psychology, and was always fascinated by psychopathology. After I completed my MA in Vancouver, British Columbia and started looking into genetic counseling, I came across Dr. Jehannine Austin’s research group. In her research, she uses a clinical genetics approach to understanding mental illness. I found that her research allowed me to incorporate my interest in psychology with my interest in genetics.

S: How were you able to obtain a psychiatric genetics rotation last summer?

A: Dr. Austin had launched the psychiatric genetic counseling clinic a few months before I moved to New York to complete my genetic counseling degree, so unfortunately I didn’t get the chance to observe any sessions. They had taken 2 summer students just as I was leaving, and I was told to keep my eyes open for the following summer. When I found out about the position, I jumped at the chance to work with the team again and to learn more about the clinic.

S: What was one of the biggest differences you noticed when counseling in a psychiatric genetics clinic?

A: For one, they don’t offer genetic testing. Second, the session is extremely psychosocial driven, which makes it longer. I also saw the amount of guilt and shame people experienced when discussing their mental illness, or the mental illness of a loved one. There is so much stigma people face so it’s not something many people talk about. Maybe some think that if no genetic test is offered than what point is having a clinic like this? But I got to see some dramatic changes in peoples’ beliefs about what causes mental illness and how they can protect themselves. I also got to witness a ton of weight lifted off people’s shoulders as they came to terms with the fact that they did not cause their child’s mental illness. That is huge!

S: What are some the mostly “highly genetic” psychiatric conditions?

A: That’s a difficult question to answer. I think with mental illness in particular it’s very multifactorial. However, I don’t think people realize that we all have the capacity to develop a mental illness. This is because we all have some genetic predisposition that we are born with- some more than others- and it’s the different experiences we go through that can determine whether one person goes on to develop a mental illness or not. Someone with a strong family history of mental illness may have a greater vulnerability than someone with less of a family history. But genetics is not destiny and there are things we can do to protect ourselves from getting sick. We do have control and I think that’s an important message for people.

If we see someone with developmental delay and psychosis genetic testing is offered for 22q11 deletion syndrome (DiGeorge), because 22q11 is the greatest risk factor for developing schizophrenia.

S: What other types of health care providers are vital for a Psychiatric Genetics Clinic?

A: Many of the patients we saw were referred by their psychiatrist or psychologist. But the nature of the clinic accepts self-referrals as well, so any health care provider could refer their patients. But it’s really important to have other medical professionals on board because there is a genetics component to mental illness and this clinic really helps people understand that involvement.

S: What did you enjoy most about a multidisciplinary clinic environment?

A: I think working in a multidisciplinary environment is great because you can learn so much from your colleagues. It also allows me to appreciate what patients go through when they see all these specialists; I can be more compassionate because it can be frustrating having to coordinate and attend a bunch of appointments.

S: What is it like to counsel someone with a psychiatric condition? Are there some unique strategies you use/saw utilized in clinic?

A: Honestly, it didn’t feel any different than counseling someone without one. The biggest thing for me though was trying to break down their misconceptions about mental illness and all the internalized guilt and shame. I also very much appreciated that people were willing to discuss their mental health with me- a complete stranger. It’s such a sensitive topic but when you give someone a safe atmosphere to open up, it’s amazing how liberating it is for him or her, and for yourself.

I found it really beneficial for patients when we used diagrams. The flipbook we used illustrates “mental illness jars,” which help explain everyone’s genetic predisposition.  ((S: This “mental illness jar” illustration can be found in Dr. Austin’s book, which is noted below… at the top of page 91!))  It helped people visualize what having a genetic vulnerability means and how environment contributes to one’s risk. Also, we allowed the patients to explain their story to us. Why did they think they got sick? What do they think caused their mental illness? And what are some things they do to protect themselves from having a relapse or getting sick in the first place? The sessions were very patient driven, which was nice.

S: What are some “take away points” people should keep in mind if they want to go into counseling patients who have a personal or family history of a psychiatric condition. Or some pros and cons regarding the field, in your opinion?

A: I think it’s really important for counselors to know that it isn’t difficult to counsel people with mental illness. And it is very important not to brush over or skip the psychological assessment on patient intakes. We can’t be afraid to go there with our patients. Our brain is an organ like any other organ in our body. And when our brain doesn’t work as it should, we take medication or go for therapy. That shouldn’t be any different than taking insulin for diabetes or heart medication etc.

I think a big pro of discussing mental health with patients is creating that dialogue about mental illness and creating a greater awareness. Hopefully that will reduce the stigma, shame and guilt people experience. Unfortunately, I think that it has been somewhat of an uphill battle because the genetics of mental illness is so complex. There is no quick fix, easy answer or blood test we can offer, and that can be hard for some people.

I think that it is important for health care professionals to understand that we all have our patients’ best interests in mind and that takes a multidisciplinary approach. And sometimes it’s not about what test we can administer or what drug we can prescribe. Sometimes all it takes is just someone to listen, and as genetic counselors, I think that’s one of the things we do best.

Those who are interested in learning more about counseling people with mental illness can read Dr. Austin’s book: How To Talk With Families About Genetics And Psychiatric Illness.

((Huge thanks to Anna for the interview, very enlightening!  Hope you all enjoyed this post and her answers as much as I did! –Sarah))

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Reader Question: Advocacy Work! ((by Sarah))

A delightful reader wrote to us, asking about advocacy work.  What it is, how to find it, and what types to do.  Thanks for the great question!

What it is.  According to NSGC, “Advocacy experiences are an important aspect of the application. Advocacy experiences usually allow the applicant to obtain training in interpersonal and communication skills as well as providing an opportunity to work with the public and people in a one-to-one setting.”
Examples would be volunteering at a rape crisis center or phone crisis line, at planned parenthood or a pregnancy center, at a free medical clinic (like a volunteers in medicine program), at a women’s shelter, or at a shelter or program developed to help people who are in poverty, disabled, or who have chronic disease, etc.  Places are always in need of volunteers and community support.
Experiences teach you many life lessons about how to work well with others while fostering communication skills.  Any experience volunteering in a health care setting would likely help in the application process.  Even jobs helping file medical records or volunteering as a patient scheduler would be beneficial.  ((granted I am not involved with who is accepted…. these are just things I or my classmates have done along the way!))
Where to find it. Try organizations in your local community, look to the yellow pages, local hospitals, and university voluntary service organizations.  The psychology department at my college had a outreach program and course for students interested in the medical field.
Do I need it? I believe programs require or strongly recommend some sort of advocacy.  This is because, as a GC, you need to know how to relate and advocate for the health and well being of the patients you see. Plus- it is always good to give back to the community where you live!
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