Author Archives: Brynna

Life as a GCA: Part 2 – Clinical Genetic Counseling

After leaving all of our beloved M&G readers on the biggest cliffhanger with our “Life as a Genetic Counseling Assistant (GCA)” segment, I’m happy to announce that Part 2 is here! Below, Lauren describes her experiences working as a GCA and how she assists genetic counselors in a clinical setting.

If you missed Part 1 featuring Lab Genetic Counseling, scroll down to Moriah’s previous post!

As always, join the discussion by leaving a comment below or joining us on Twitter at @mapsandgenes!


Hello everyone, my name is Lauren Boucher and I am currently a genetic counseling student at Virginia Commonwealth University. I worked as a GCA for Southern Illinois University School of Medicine (SIU) from June 2018-August 2019, and I will be sharing what it was like to work in a clinical setting. To reiterate our goal for these posts, it is our desire to provide a resource for potential applicants and prospective students by discussing what it’s like to hold a GCA position and how it has/will help us as we look forward to joining the Genetic Counseling (GC) community!

Main Duties

When I initially signed my contract with SIU, the only thing my supervisors and I knew about my position was that they had no idea what I would be doing – only that my purpose was to reduce the insane workload of the existing genetics team! It was truly a loosely defined and ever evolving position that resulted in me becoming a jack of all trades. I would divide my job responsibilities as patient communication/education, billing/test coordination, and primary contact for genetic testing laboratories.

Patient communication was, without a doubt, the most important part of my position as a GCA. I am so lucky to have had the opportunity to participate in clinic by shadowing our medical geneticist and genetic counselors. Collecting family histories, interacting with patients during the appointments, collecting medical records, coordinating genetic testing, answering questions, and even being an outlet for anxious parents/patients was the most enjoyable part of my job. This meant that I spent an absurd amount of time on the phone, but hey, that is why Bluetooth headsets exist right?

Next, billing coordination was by far the most surprising responsibility I had as a GCA, mostly due to the sparsely defined position description. Looking back on this now, I would not be surprised at all to be handling billing matters since it is considered within the field to be a task that GCAs commonly perform.  After a few weeks of working, my supervisors asked how I would feel about getting more involved with billing and I was absolutely terrified. To preface, I entered this position knowing that insurance pays for some of a person’s medical bills and that was about it! My providers would first tell me what they wanted to test for (i.e. panel of certain genes, chromosomal microarray, whole exome sequencing, etc.). It was my job to select the appropriate laboratory/genetic test while considering the patient’s insurance to ensure the best financial option for the patient without compromising test quality. This involved being extremely familiar with, not only insurance companies and types, but also with many of the testing labs themselves. In addition, I often assisted in petitioning insurance companies to cover certain genetic tests by writing letters of medical necessity and calling companies to get more information on a denial to strengthen our appeal efforts. This was the largest learning curve I have ever experienced and is actually a part of my position that I value a lot since I developed applicable skills for my future career.

Lastly, collaboration with genetic testing laboratories was a pivotal part of everything I did as a GCA. This is in fact, how I met the lovely Moriah who is a lab GCA at GeneDx! When lab GCAs, billing departments, or even GCs have questions and/or are requesting information, I’m the first point of contact for all of the labs our facility utilizes.  In addition, I would call in whenever I’m checking into lab billing policies, test limitations/coverage, or routine monitoring of our patient’s testing as it moves through the lab. This responsibility resulted in most of my 100-plus e-mails per day, but working with so many amazing people within the genetics field who care so much about our patients made me even more excited to be a part of this amazing community!


As I have only worked as a GCA for SIU, I can only speak to my experiences here. I could probably go on for two pages about all the benefits of being a clinical GCA, but I am going to focus primarily on the opportunity to interact with a large variety of people that are involved in the genetic testing process. Due to working in a large hospital system, I have become familiar with the hospital’s protocols and feel comfortable collaborating with other sub-specialty providers. It is amazing how much variation there is between each provider, insurance company, and laboratory; everyone operates differently, and the value of being exposed to so many different types of providers and organizations cannot be understated.

However, the main benefit of being a clinical GCA is the opportunity for genetic provider and patient interaction. From an educational standpoint, working as a clinical GCA gave me the opportunity to shadow our amazing GCs and medical geneticist who have taught me so much. Not only do I get to see and learn about these genetic conditions first-hand, they also allow me to develop skills that will be useful when I become a GC, such as guiding the questions pertaining to family history, drawing pedigrees, and participating in patient education. Because we are a very small team, the providers here would always take the time to mentor me however they could. Whether it was breaking down complex genetic concepts for the tenth time to help me understand, providing constructive criticism, or even just saying a kind word when I did something well, their endless support is the reason I’m going into graduate school confident in my ability to succeed.

I think the best way to explain my role in patient care is by providing an example of a deconstructed patient case and my involvement throughout the genetic testing process.

Clinical GCA Workflow

  1. Assist in collecting records prior to patient appointment.
  2. Under the supervision of a GC, direct questions pertaining to family history and draw a pedigree during the appointment.
  3. Perform a benefit investigation/ initiate a prior authorization to retrieve a cost estimate for the patient.
  4. Call the patient to coordinate testing. Fill out Test Requisition Form accordingly for the laboratory. Mail out all paperwork and a kit with blood draw instructions.
  5. Make sure patient’s sample arrives at the laboratory, is accessioned accordingly, and the test starts running.
  6. Served as primary contact for the patient and laboratory if there were questions/concerns.
  7. I occasionally delivered negative results to patients after discussing recommendations with the provider. Sent results containing pathogenic or variants of uncertain significance to my providers.

While the providers had a huge role in my development, I have also met some incredible patients that have made lasting impacts on me. Every patient has something new to teach you, so they are a crucial part in developing a GC’s counseling skills/style and are a huge part of what makes every GC unique!

Furthermore, I also valued the opportunity to work with laboratories and insurance companies. While billing was the most difficult part of my job responsibility, I consider this to be one of the most valuable skill sets I developed during my time at SIU. Not all clinical GCs have to navigate these billing areas; however, I have spoken to some GCs who wish their training had included exposure to billing and insurance before entering the workforce. As I enter my graduate training, my experiences with billing as a GCA make me more confident about being accountable for these processes in the future as a genetic counselor.

Furthermore, this was my opportunity to be a fierce patient advocate and help to overcome one of the largest barriers to care that exist which is affordability. This exposure also makes you realize that with the rate genetic technology has improved and evolved, the same cannot be said for insurance and legislature progression. For example, whole exome sequencing is an amazing diagnostic tool that has been available since 2012, but there are some insurance companies who still refuse to cover the cost of this test because they consider it to be “experimental.” These discoveries put into perspective the many obstacles that GCs and the entire genetics community have yet to overcome and provided me with the determination to want to get involved to make a difference. Side note: This was also a fantastic topic of discussion for interviews. 😉

Valuable Skills for a Clinical GCA

Below are a few of the skills that my providers specifically mentioned that they would want to see in a clinical GCA. Keep in mind that you don’t have to possess all of these skills right now, and many of them can be developed over time.

  • Proactive – Communication Skills
  • Patient Advocate – Attention to Detail
  • Tenacity – Problem Solving
  • Organized – Microsoft Office
  • Compassion – Genetics Background

A common question is how much of a genetics background do I need to have to become a GCA? All clinical sites are probably different, but SIU required a bachelors degree as well as genetics courses. During my interview for the position, I was asked to describe an autosomal dominant mode of inheritance to a patient who had no genetics background. I personally took several genetics courses during my undergraduate career, but as a reference, I suggest looking into certified genetic counseling programs and their education prerequisites to give you an idea of what exposure you may be expected to have when applying for a GCA position.

Final Thoughts

Being a GCA for SIU School of Medicine has been my most valuable experience and was the best decision I have ever made in preparing for a career in genetic counseling. After not receiving any interviews for the Fall of 2018 application cycle, I was told to get more exposure to the field and direct GC experience. Generally, an interview with a GC is the minimum requirement, but many programs recommend shadowing or other types of exposure to the field as well. Some of you may be aware of the fact that genetic counseling programs are extremely competitive, so becoming a GCA can give you the experience and skills you need to be a competitive applicant! Last year I tried again and was fortunate enough to be matched to Virginia Commonwealth University’s M.S. Genetic Counseling program for Fall of 2019! During my interviews I could emphasize was my thorough clinical skill set, a clear understanding of the field, ambitious career objectives, and an absolute certainty that I want to belong to the GC community due to my experiences as GCA. I have no doubt that without this position, I would not be where I am today.  I hope this series will be a useful tool for everyone who is interested in being a GCA and want to be a part of this amazing field as well.


The Inside Scoop: A Prospective GC at NSGC

It’s finally December! With the Fall 2020 application cycle in full swing and semesters are coming to an end, we are wrapping up the year strong here at M&G. It’s been a big year for genetic counseling – from reaching >5,000 Genetic Counselors in the U.S. to celebrating NSGC’s 40 years  – our profession is only getting better with age! As we reminisce on the old year and look forward to the new, grab a cup of cocoa and curl up with this new post from Rushna, where she shares the lessons she learned from NSGC. Here’s to 2020 and our profession continually elevating!

Hello, fellow GC-to-be’s! My name is Rushna Raza, and I am a prospective genetic counseling student applying this cycle for Fall 2020 admissions (ask me how that’s going). This past November, the National Society of Genetic Counselors hosted their 38th Annual Education Conference in Salt Lake City, Utah- celebrating 40 years of NSGC!

I had the amazing opportunity to attend the Prospective Students Outreach Event hosted by the Student/New Member Special Interest Group on the last day of the conference. The event featured insights from current genetic counseling (GC) students, case studies from practicing GCs, and a Q&A panel of Program Directors from across the country, all there to inform and inspire the next generation of GCs. Here are some key takeaways from my one-day immersion in all things GC!

Know Your Narrative

To open up the conversation around applications, a representative from the Association of GC Program Directors spoke a bit about what makes a strong applicant. The “classic profile”, loving to help others and learn about genetics, is a given. What makes you a great fit for genetic counseling? A well-rounded applicant is one who not only checks the boxes of pre-requisites, but one who shares their experiences in a meaningful and relevant way. You can think of the roles you’ve had in your family, school, or community. You can describe that “aha!” moment when you first discovered genetic counseling, or share the conversation with a patient that put it all in perspective. And when it comes to selecting programs, the panelists suggested reading each school’s mission statement- what is their vision for graduates? From here, you can feel out which curricula align with your personal values and professional goals, whether it be community service or industry research. For personal statements and interviews, I found the most helpful nugget of advice was to make a list of specific anecdotes highlighting moments of strength and insight: a client you helped in a tough situation or an interaction with a mentor, for example. Current students shared that, surprisingly, their interviewers asked thoroughly about their time as a barista or babysitter- think of the transferable skills! A big theme at NSGC this year was diversity and inclusion in the field. Your experiences navigating life as a first-generation student, living with an invisible disability, or being a single parent counts. Knowing yourself and your motivations well can help you in all aspects of the application process!

Network Authentically

The Prospective Students event concluded with a rotating networking session, giving us the chance to speak with GCs and students from all kinds of specialties and settings, revealing the diverse settings GCs can practice in. The activity was a great example of how valuable initiating and maintaining relationships in a relatively small field can be; you can learn something from every GC or student you encounter. One thing that initially drew me to the profession is the spirit of mentorship and generosity in GCs open to connecting with prospective students. Throughout the conference day, I even ran into GCs and prospectives I follow on Twitter (definitely fangirling). Jotting down names and notes from captivating presenters and students you chat with, then following up with them online or during breaks is one way to build your early career network. Striking up conversation with other GC hopefuls was also fun- it was a special feeling to be in a room full of future colleagues! Pro-tip: If you don’t already have an elevator pitch about why you’re interested in genetic counseling, make one up now!

Stay In the Loop

After the Outreach event, prospective students were invited to attend any afternoon Platform Presentation, educational sessions that feature a series of quick presentations in a particular area of genetic counseling. I attended the Innovations in Somatic Tumor Testing with a genetic counselor from my workplace, and it was fascinating to hear about research efforts in cancer genetics by other medical centers. Other Platform Presentations happening at the same time discussed ethics and psychosocial research, patient use of tests results, and neuromuscular/psychiatric genetics. Clearly, there is a lot going on in the field, which is great news for prospective students because the opportunities truly are endless. One way to find your own niche in the profession is by regularly sampling genetics news sources like blogs, articles, and podcasts that can both help your professional literacy and keep you acquainted with hot topics. I’ve also found following researchers, genetics companies, and patient advocates on Twitter to be helpful in getting the lay of the land. However you keep up, staying informed about current research and issues can initiate great conversations and inspire future goals!

These are just a few themes that really resonated with me during the event. I hope they inspire you to believe in yourself, get involved, and keep at it!

Have a happy holiday season!



Learn more about the NSGC 2019 Annual Education Conference:

NSGC Website


DNA Today NSGC 2019 Reflection



Life as a GCA: Part 1 – Lab Genetic Counseling

Hello readers! It’s been awhile since we’ve posted, but thank you for being patient. With the 38th National Society of Genetic Counselors (NSGC) Annual Conference wrapping up last week in Salt Lake City, attendees celebrated the 40th anniversary of NSGC – a proud accomplishment in our young profession! There were inspiring speakers, panelists, and GCs galore! Among the various engaging talks, there was discussion on how to best provide support to genetic counselors, especially in the role of support staff. With that being said, we have Moriah and Lauren, who are/were genetic counseling assistants (GCAs) that wrote a two-part guest post on their experiences and how they support genetic counselors and other staff in both the lab and clinic.

Do you have experience as a GCA or are interested in learning more about how to become one? Please let us know your questions/thoughts in the comments below. You can also join us on Twitter with our handle, @mapsandgenes!


Hey all, this is the first in a two-part series about what it’s like to work as a genetic counseling assistant, also known as GCA. My name is Moriah, and I have worked as a laboratory GCA at GeneDx in Maryland since August of 2018. My lovely counterpart, Lauren, will also be sharing her experience as a clinical genetic counseling assistant in the next installment! While we have very different duties, we each play an important role in patient care.

Our goals are to communicate to you—potential applicants and prospective students—what it’s like to hold this position as we ready ourselves for a genetic counseling program. We will both address the main duties of our positions and the benefits that our roles have imparted to us. Both of us are reapplicants—Lauren is a matriculating student for the class of 2021, and I am a prospective student for the Class of 2022. Each of our positions has given us a unique experience which will not only strengthen our applications, but also provide us with a foundation of skills that we will utilize throughout our careers, including effective communication with patients, providers, insurance companies, and labs; patient advocacy; and patient and professional education. We hope that this will be an informative series for you and that it opens up possibilities as you embark on the journey to a genetic counseling program with us.

Main Duties

My job revolves around test utilization management with the primary responsibility of approving test orders before testing is started. The GCAs at GeneDx spend a good part of their day reviewing every single test order, to verify we have sufficient information to complete testing and that the order is clinically appropriate (we get hundreds of orders every day!). There are about 30 GCAs who are all split into different programs based on medical specialties or test methodologies— including cardiology, neurology, rare diseases, microarray tests, and exome sequencing—who screen and monitor the tests of each particular program. A typical day might look like this:

  • Review list of orders that arrived
  • Approve orders that can be started, or hold orders that are problematic
  • Communicate with providers about orders that were held, and resolve issues
  • Attend various meetings, trainings, and/or presentations
  • Work on individual rotating duties and projects

When there are errors in the way testing was ordered, we are responsible for communicating with the clinicians about the issue and working with them to resolve any problem so that appropriate testing can be started. For example: A provider who has rarely or never ordered genetic testing may order multiple tests to be run concurrently, but some of the tests are overlapping panels that evaluate the same genes and therefore are redundant.  As GCAs, we call the provider to explain the issue, ask some basic questions about conditions that they’re most suspicious for, and with the help of our lab GCs, we work to help the provider choose the most clinically relevant testing. We also may discuss with the provider the order in which testing is run. For example, we may suggest that tests be run one at a time—reflexively—rather than all at once, especially if there are existing clinical guidelines recommending this approach. If one of the early panels provides a molecular diagnosis, then later tests can be cancelled and excess testing is avoided. This is a win for the patient, because the overall cost of testing is reduced. And when the patient wins, we all win! Scenarios like this show that labs have valuable partnerships with providers—they give us their expertise on their patients, and we give them our expertise in how to best utilize our testing for the patient’s benefit.

Through my experience as a GCA I have learned that ordering testing can be very complex! Some providers may not be as familiar with varying testing methodologies or what information a particular test can or cannot provide. Even experts in the field may need guidance; every lab structures their testing options differently, and it can be challenging to figure out which tests will give them the information they need. Add in layers of complexity for appropriate familial testing, billing concerns, and lab logistics, and you can see how there are so many pieces of the puzzle when trying to achieve the right test and an accurate result for each patient. Between the lab GCs and the GCAs, we bear a large responsibility for client education in this regard, and we help them navigate the ins and outs of how to effectively use our tests so that the patient gets the absolute best care.

I have found there are a few important qualities which make someone a successful laboratory GCA at GeneDx. Firstly, having basic genetics knowledge is a huge benefit. Different GCAs have different educational/professional backgrounds and varying levels of interest in becoming GCs, but already having a foundational knowledge of genetics certainly makes learning our testing system much easier. Detection of different conditions is often test-dependent; for example, Duchenne Muscular Dystrophy  is unlike other disorders in that most pathogenic variants arise from large deletions or duplications in the DMD gene. Therefore, we initially recommend DMD deletion and duplication analysis first, with a reflex to DMD sequencing. For many other disorders, we would typically recommend starting with sequencing and then proceeding to del/dup testing. Therefore, a background in molecular genetics helps us understand the technology available in our lab and the “why” behind testing recommendations.

Secondly, attention to detail is crucial. We consider each sample that comes to us to be our own patient, so being able to gather all the details to ensure proper testing is being completed is very important to us. We don’t like having to hold up tests because of a small mistake, but fixing those issues can be vital for patient care! Can you imagine if we completed targeted carrier testing for the wrong genetic variant? A typo could lead in an incorrect result for the patient and an inappropriate follow-up.  Many of our calls to providers are to ensure that we have the all the right info before proceeding to testing as we try to minimize this risk.

Thirdly, having a communicative and team-oriented attitude will help you thrive in this position. Although each GCA has their own workload, they also have a team of other GCAs and GCs willing to support them. We are able to refer to our team when we have a problematic case, an unclear policy, or general genetics questions that relate to our tests. We all know that good coworkers can make or break a job experience, and I love my team because they are hardworking and dependable. Additionally, we can give and take constructive feedback on the quality of our work. For example, it’s important that we let each other know if we’ve made errors, because we want to avoid anything that may impact test turnaround time or patient care in the long run.


As a reapplicant, the sheer number of things that I’ve learned while working in a diagnostic genetic testing lab in the past year makes me feel much more prepared for the next application cycle. Firstly, I’ve developed critical skills in science communication. To be an effective GCA, it is necessary to be competent in succinctly explaining test methodology, panel options, and lab logistics. As we all know, providers’ time is valuable, and they need concise and quality information from us to make decisions about how to care for their patients. This skill is valuable between teams, too. For example, GCAs from different educational backgrounds and with expertise in different departments exchange knowledge all the time about how different tests are run, what clinical information is needed about patients, and why. This skill will be helpful when communicating and educating patients, families, and other professionals in clinic, and is something to highlight when applying to genetic counseling programs.

Secondly, I work closely with our lab genetic counselors, and as a result, I am now familiar with the role of lab GCs, their scope of practice, and have gotten exposure to their genetics knowledge. We have some genetic counselors who primarily write our reports, and some who work specifically to provide customer service to providers. Many genetic counselors and others also act as experts on particular genes and conditions, and GCAs are afforded opportunities to attend various presentations and get a taste of report writing and variant classification. Needless to say, the educational value in this position is amazing. Everyone here has so much to contribute, and I am always so impressed at the scope of the knowledge that is contained in this one building—GCs are just a few of the many hands that it takes to keep this place running. To name a few, we have accessioners who process our incoming samples, review analysts who identify genetic variants from the sample data, lab directors who keep our lab operations running, and clinical directors who provide molecular and clinical expertise. Working closely with this staff provides a lot of opportunities to forge professional relationships and the possibility for mentorship. As a secondary benefit, many of my current fellow GCAs will someday be genetic counselors with their own special knowledge. Fostering good relationships now will allow us to continue to learn from and draw on each other in the future.

Lastly, I have developed a lot of “soft skills” that will be important in my future career. Besides the pure genetics-related knowledge that I have banked, having this work experience has helped me develop good leadership, multitasking, and problem-solving skills. I’ve taken initiative on various duties and projects that involve monitoring and coordinating multiple cases at once and providing proper case management. These skills are used beyond special projects, though; we all practice them as a team, whether it’s reminding each other to cover time-sensitive duties or pursuing testing solutions for cases with complex inheritance or complex family dynamics. These experiences have improved the quality of my communication skills—in science communication, yes, but also in the way that I communicate with my various co-workers. Since each employee has his or her own priorities and expertise, I need tailored communication for each person. I don’t use the same language for a lab director or an analyst who may be an expert in a particular gene or test when I’m talking to a sales representative who may not be as familiar with it. I also use different language to provide information to a patient compared to when I speak with a provider who is more familiar with genetics. Personally, this increased self-awareness of and improvement in how I communicate has showed growth; some of the feedback I’ve received from programs and other job interviews in the past has been about being able to more confidently and clearly tell them why I belong there. Where I lacked experience and examples in a prior application cycle, I now have enough experience under my belt to showcase that I have a strong knowledge base and concrete examples, that I’ve begun to learn the language of the field, and that I can be flexible and versatile.

Final Thoughts

Although I didn’t know what to initially expect from a genetic counseling assistant position, it has become much more valuable to me than I could have anticipated. As a prospective student, having exposure to different aspects of genetic counseling is highly sought after. Through GeneDx, I have gained experience in a lab, obtained knowledge and developed skill sets that are important for effective genetic counseling, and have found multiple valuable opportunities like volunteering and telegenetic shadowing. As genetic counseling programs become more competitive and as genetic counselors are voicing their need for administrative help, the number of GCA positions are continuing to increase. If you want or need to take time between college and grad school, this is an excellent position to consider.


As we say goodbye to summer days spent at the beach, fall is right around the corner. Meaning, the next round of applications for the 2019 genetic counseling cycle!

To help prospective genetic students prepare, I recorded an episode with my good friend, Kira Dineen, on her genetics podcast, DNA Today. Along with two other amazing GC applicants, Brianna and Katie, we discussed our own experiences with the application process along with the brand new Match system. (A post on the Match system is in the works!)

Kira and I were also able to compile advice from over 50 accepted genetic counseling students! The results from the survey can be found on My Gene Counsel and on DNA Today.

GC App (Part 1) T (2)

Episode and survey data can be found here. Also, be sure to check out the follow up episode coming out in early 2019!

In other news, we have some updates! We currently rebooted our Twitter so please join in the #gcchat with us and others in the genetics community at @mapsandgenes. Also, stay tuned for updates in the Opportunities and Experiences tab!

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