The following is a guest post by Anna Essendrup, M.S., CGC and Thuy-mi (Mimi) Nguyen, M.S..
Our names are Anna and Mimi, both graduates of the same GC program in Colorado. We now work together as lab genetic counselors at Mayo Clinic. We are really excited about this blog and are enthusiastic about sharing our experiences with non-traditional roles of genetic counseling. We are here to bust a few common myths about non-traditional roles.
“Do not begin your genetic counseling career in a laboratory unless you want to stay in laboratory forever”/”Once you transition to lab, you cannot transition back to clinic”
One of the BIGGEST myths regarding laboratory genetic counseling is that it is a “dead-end” in the genetic counseling field. You might think that once you have left the patient care arena and stepped into a laboratory role, you will lose your patient care skills and wouldn’t be considered for a role in that area today. This could not be further from the truth. Both laboratory and clinical genetic counselors use the same skills and knowledge base to interpret results, communicate genetic information, and develop a professional relationship with the client/patient.
For example, laboratory counselors may call results out to an ordering physician while clinical counselors call out results to the patient. Both calls require establishing rapport between counselor and client. Once that rapport is established, results need to be communicated at a level that is appropriate for the individual at the other end of the call. Genetic counselors have a keen ability to monitor the level of understanding that the client/patient may have and adjust the level of detail/explanation accordingly to ensure that each person fully understands the results presented to him or her. Genetic counselors also have training in non-directive counseling, allowing the clients to make their own decisions based on what is right for them or their patient.
Genetic counselors use a variety of skills throughout their practice, regardless of the setting. All settings for genetic counseling are critical for the quality care of patients awaiting a potential genetic diagnosis. We are able to educate and empower all healthcare team members to ensure that their patients received the best quality of care possible.
“Genetic counseling is all about stem cell therapy and genetic manipulation”
Genetics is a quickly growing field with many new developments that are highlighted in the media. Some developments can be overstated and dramatized by news outlets or other sources to make them more attractive to the general population. Buzzwords like “stem cell therapy” and “genetic manipulation” can take a dramatic spotlight; however, the majority of stem cell therapy and genetic manipulation has not progressed past the research phase. In actuality, and unfortunately, there are only a handful of clinically-available treatments which may be indicated based on results of genetic testing. Fortunately, many genetic counselors may have the opportunity to work in research. Research involves many aspects of genetics and counseling and can includes areas of gene-specific activity and expression, database compilation and review, best practices in selecting genetic testing, communicating genetic information, and supporting patients with and without a diagnosis.
The genetic counseling skill set is highly applicable to research. It is now evident that informed patient consent is not only ideal but critical to the research process. Genetic counselors are trained to have a wide understanding of scientific methods and concepts and, most importantly, are highly trained in translating complicated medical information at a level which can be understood by a variety of audiences. Because of this training, genetic counselors become an important point person for communication between all involved research team members and research participants. Genetic counselors are also able to bridge the gap between research and bedside to inform patients of research study options and increase access to these opportunities.
“A Geneticist is the same as a Genetic Counselor”
While geneticists and genetic counselors have a similar knowledge base and often work very closely with each other, our disciplines are unique and require different skill sets to become a master in the field.
Both MD and PhD geneticists train through at least 4 years of medical school and at least 2 years of residency. This includes extensive training in overall medicine, including diagnostics, physical examination of patients, and dysmorphology (the study of different body structures/features/birth defects). Genetic counselors require a 2 year master’s degree. This includes some diagnostics as well as counseling and education skills. Both specialists must pass board exams put forth by their respective professional organizations: Genetic Counselors take the American Board of Genetic Counseling exam, while the Geneticists take the American College of Medical Genetics exam.
Within the clinic and laboratory, geneticists and genetic counselors often work as a team, but with specific roles assigned to each. These roles may vary greatly based on setting but generally, geneticists are the individuals who are responsible for the interpretation of genetic testing and assigning diagnostics based on physical exam, clinical history or laboratory results. Genetic counselors are typically in the role of providing education regarding genetic concepts, including test results, and counseling the patient through decision making and adapting to a diagnosis (or non-diagnosis).
“Genetic counselors sit in isolation and do Punnett squares all day”
We like to think of genetic counseling as more of a skill set that can be applied to many medical and scientific situations, as opposed to a specific activity or role. That being said, genetic counseling involves a wide variety of disciplines and interaction with individuals in many different fields. On a day to day basis, genetic counselors also work as part of a diagnostic team which may include physicians, nurse practitioners, nurses, medical assistants and administrative staff. Genetic counselors are involved in education, research, counseling and many other settings. In the lab specifically, genetic counselors are not only involved in education, but also in a wide variety of additional tasks, such as coordinating receipt/sending of specimens, troubleshooting issues with testing, ensuring the correct test is performed for the patient, helping develop new tests/technologies and many more. Punnett squares are used as an education tool or as a part of risk assessment. They are ONE among MANY tools that genetic counselors use to complete their daily tasks, but certainly not all that we do. Punnett squares are simply one way to teach genetic concepts.