Hello blogosphere! As Jade alerted you in her last post, our summer clinical fun has ended and the reality of the semester ahead is rushing towards us like a mack truck. I touched down a few days ago and am finally starting to get back in synch with the time zone thanks to lots of sunshine and Vitamin B12/C.
I spent my 24 hours of travel time (8 of which were in LAX…I hate layovers!!) pondering my summer experience and trying to figure out a plan of attack for this year. I am in disbelief that I am a second year student already! As a first year, I felt that the second years were demi-gods of genetics counseling. I certainly don’t feel like I have divine powers now that I’ve completed my summer placement but what I do have is confidence. I can really see myself doing genetic counseling, sitting down and discussing a wide range of conditions to patients from a spectrum of situations, because I’ve had practice doing it all summer. You hear it all the time but it’s really true- practice, practice, practice! It was difficult to keep pushing and challenging myself throughout the course of my rotation but I am happy that I did- it helped me get so much more out of the experience and I even surprised myself.
The NZ genetics service gave me many opportunities to practice genetic counseling but also to expand my understanding about how a genetics clinic works in another country. It was challenging at first to understand the healthcare system and where the genetics service fits in, but once I got the hang of it, I thought it there was some really great aspects to it. For example, all genetic testing is covered by the national healthcare system, so it’s free of cost to patients. Another cool thing about the service is that it’s national, making it easier for the counselors and geneticists who work at the three regional offices to collaborate on cases and share information, especially when families are scattered throughout the country. This made confirmations of diseases/diagnoses in family members a little bit easier, although detective work and hunting for medical information is still a large part of the counselor’s job in NZ.
The country has a population of 4 million people, so there aren’t as many GCs as there are in the USA…by a long shot, but they are able to cover the needs of the population well, in my opinion. The regional services hold outreach clinics in various areas within their area to ensure that no citizen has to travel more than 2 hours to reach a genetics clinic. Overall, the cases that the GCs see are predominantly cancer-related, followed by preconceptual cases, and then everything in between. I found that pediatric cases were almost exclusively seen my geneticists and that prenatal cases (ie abnormal serum screen, increased risk for Down Syndrome) were seen by perinatal specialists, usually with no genetic counselor involvement.
One of the most important things I learned is that some things are universal. For the GCs in NZ, there was always more work that needed to be done outside of clinic (story of GCs life!), they were passionate about the field and about the care of their patients, and they were wonderful supervisors to their American student!