By Gregory Kellogg

“Non-Traditional Genetic Counselor” – A Thing Of The Past? Reflections on the 35th NSGC Annual Education Conference

The National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) is an opportunity for genetic counselors to learn about advancements and discoveries in the fields of genetic counseling and genetics, as well as an opportunity to look toward future developments. With talks that included “Preparing Primary Care Physicians for the Future of Genomic Medicine” and “Prenatal Diagnostic Exome Sequencing: Genomics for the Next Generation,” one of the major focuses of the 35th AEC was the impact genomics is having, and will have, on the profession of genetic counseling and medicine as a whole. Today, the applications of genomic medicine present entirely new patient populations that in the past would not have interacted with genetic counselors. Similarly, patients undergoing genetic testing may no longer be affected with a genetic disease, but rather undergo testing for disease susceptibility, drug response, or personalized treatment options.

As genomic testing broadens the segment of the population to whom genetic testing is relevant, the role of the genetic counselor is also broadening. Genetic counselors are becoming involved not just in new content areas, but new settings, like health plans, utilization management programs, and consulting. Therefore, one of the talks I was most anticipating at this year’s conference was a panel discussion entitled “Genetic Counselors in Emerging Roles,” led by four genetic counselors who have made careers in what, until recently, were called “nontraditional roles.”

One of the major messages of the talk, made by Steven Keiles, Director of the Genetic Counselor Organization at Quest Diagnostics, is that the idea of a dichotomy between “traditional” and “nontraditional” roles in genetic counseling is outdated and obsolete. This was echoed by the other members of the panel and is supported by the results of the recently published 2016 Professional Status Survey, an annual survey of genetic counselors. Of the survey’s >2000 respondents, 23% indicated that they do not counsel patients on a regular basis, and >50% of that number work in a commercial laboratory or other industry setting. Overall, genetic counselors indicated specializing in any of an incredible 33 different content areas.

The panel stressed to the crowd, including many students who have not yet entered the profession, that there was no correct path to a successful genetic counseling career and encouraged the audience to take risks and explore roles that may be slightly beyond their comfort zones. Mr. Keiles did stress, however, that he thought the foundation for a successful “nontraditional” career was experience in a clinical setting early in one’s career. Jeahinine Austin, NSGC president, took to the microphone during the question and answer portion of the panel to disagree with the assertion that clinical experience was a necessary prerequisite to a successful “nontraditional” career. Clearly, even some of the most respected and successful members of the genetic counseling community do not agree on a “correct” path for a successful career, which highlights the varied experiences and options for career advancement available to genetic counselors.

Genetic counseling is no longer limited to the basic content areas of prenatal, pediatrics, or cancer. It continues to expand into areas like pediatric oncology, neurogenetics, and cardiogenetics, and even goes beyond the clinic to specialties like variant curation, personal genomics, and laboratory quality control. With the age of genomic testing truly upon us, the importance of the genetic counselor in healthcare has never been more apparent, and the opportunities for genetic counselors have never been more numerous. To continue the unprecedented growth of the profession, genetic counselors should be prepared to take risks, embrace these new opportunities, and have the confidence that their skill set is not as narrowly applicable as they might have thought. Genetic counselors entering the profession should be encouraged that there is no “correct” path to make a living as a genetic counselor, and that the age of genomic testing will only expand the already diverse and varied opportunities available to genetic counselors today.

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