From Classroom to Clinic: Reflections from My First Rotation - Grace Ferrell

    One of my favorite things about Pitt’s genetic counseling program is our confidence building model, where first year students are primarily immersed in the classroom before heading into clinical rotations during the summer months and for the remainder of our training. I personally appreciated the time I had to learn the majority of information needed prior to seeing patients. While this allowed me to really focus on content, the transition from classroom to clinic is one that took me time to adjust to. It’s for this reason that I want to share some pearls of wisdom that I’ve gleaned from my first eight weeks as a genetic counseling intern at the Children’s Hospital of Pittsburgh.

1) Your brain has got your back, and when in doubt, so do your supervisors! 

    One of the biggest obstacles for me when starting my pediatric rotation was the worry that I wouldn’t have all the answers and that by not having them, I would negatively impact a session. As I observed more sessions and witnessed genetic counselors handle tough questions, I learned a few things. I quickly learned that a challenging question is an opportunity to build rapport with patients. It can be beneficial to answer what you can of a patient's question, using the knowledge gained in the classroom, and then defer to the supervising genetic counselor. Alternatively, mention that you will look into it and get back to them as soon as possible. I think this can show patients that you are listening and care about their question, while also wanting to not speak out of turn. By recognizing my role as a learner, a lot of the pressure of having all the answers fell away, and I was reassured that there were ways to get the information needed.

2) A genetic counselor’s best friend isn’t their dog - it's OMIM, GeneReviews, ClinVar, and Google!

    Speaking of finding answers, this rotation showed me firsthand how genetic counselors utilize their resources to provide accurate information for their patients. Luckily for Pitt GC students, we have a whole bioinformatics course that helps us understand what platform and databases we can frequent to learn about a condition or variant of interest. Along with helpful bioinformatic tools, Google was an unexpected life saver as daily I would be learning about a new condition with associated clinical features that I had never heard of before. A sticky note with definitions of medical terminology was always nice to have in my back pocket. 

3)Feedback is your friend!

    Going into this first rotation, I knew I was going to be receiving feedback to a level to which I wasn’t accustomed. This can understandably bring about feelings of apprehension when you aren’t sure what to expect. However, any feelings of nervousness quickly dissolved when reflecting on a case and possible areas of improvement. Not only do genetic counselors already have an innate skill set for providing feedback in a respectful and comfortable manner, but what they shared often was so insightful and genuinely helped in aiding the development of my skills. If I received feedback I wasn’t expecting or didn’t understand, it was really helpful to walk through my thought process with the supervising GC to address how my thinking could be adjusted. Overall, I felt most proud when receiving feedback in one session and being able to immediately make the changes in the following one. Constructive criticism provides an opportunity to learn and grow.

Along with some of my favorite lessons listed above, these weeks have continuously reminded me of the importance of self-care and the utilization of one’s support systems. In order to show up for patients, it’s important to show up for oneself! Lastly, I’d like to thank all the genetic counselors out there who support GC students in developing our skills and confidence in the clinic.

A Counselor Prepares – Jerome Doerger

I was in elementary school when I saw the 8^th-grader’s-production of Annie. Between the classic red curly wig, shaved-bald-head of Daddy Warbucks, and the punchy rendition of ‘Hard Knock Life’ stomped out by angsty middle schoolers, I knew I wanted to be up there. I was able to achieve my goal by playing Tom Sawyer when I was in the 8^th grade. In high school I firmly cemented my identity as a theatre kid by being involved in every production possible while leaving other extracurriculars that used to fill my time behind. When I was 16, I knew I wanted to go to college to study Acting and specifically Musical Theatre.

This may be the point where you are asking yourself, “Jerome, what does this have to do with a Genetic Counseling?” And I totally understand this question. It is the question I have been asking myself since the moment I pictured myself even possibly switching careers and attempting to join the field of Genetic Counselling. However, over this last year of course-work and my first clinical rotation, the answer has been revealed to me.

One of the biggest lessons I learned in my acting training was that no matter what character you are portraying, the most interesting and compelling version is the one that you bring the most of yourself to. Think of your favorite actors and the roles that they inhabit so well. Many actors can be transformative, but the ones that often ring the truest are done by performers who always bring themselves to a character. This parallels with one of the biggest lessons I’ve learned over the last year and that is the value a counselor can bring to a session, especially one that has many psycho-social considerations. Sometimes the most important thing you can do is just be a human and stay present with the human sitting across from you.

Often as counselors we need to interpret complex topics involving genetics and testing methodologies. Combine this with a patient who may have recently received a shocking cancer diagnosis, or a parent who just wants to help their medically complex child. Sometimes reviewing the family history brings up complex emotions surrounding loved ones that have passed and relationships that have changed. It is crucial in these moments to inhabit this space of discomfort, allow the feelings and silence to happen, then offer the tissue and assure the patient everything they are feeling is okay. The best way I know how to be of service to patients in these moments is by bringing my whole self into the room and staying present.

In my undergraduate program we studied Stanislavski’s “An Actor Prepares”. Konstantin Stanislavski was a titan of the Moscow Art Theatre whose methodologies catalyzed theatre and the craft of acting in the 20^th century. He is best known for concepts about identifying a character’s Objective or what the character wants. Often the best scenes occur when two characters’ objectives are in conflict with one another.

In our second semester Genetic Counseling course we learned about the Reciprocal-Engagement Model (REM) as a foundational practice theory. I quickly started to see the parallels between Stanislavski’s Objectives and the REM’s Process Goals, or the desired genetic counseling outcomes. Continuing to fall into place, the REM’s Strategies and Behaviors aligned with acting’s ideas of Tactics or the approaches an actor uses to achieve their objective. The obstacles that characters face in excellent dramas often present can be seen in the uniqueness each patient brings to a session and how a counselor navigates each individual session supporting patient autonomy while ensuring they are making an informed decision.

This is all to say that wherever you find yourself in your Genetic Counseling journey, be sure to bring your whole self. It is easy to compare yourself to others and the traditional paths folks have taken to arrive in Genetic Counseling, often with a pre-med background and a fresh bachelor's degree in science. Take it from a proud recipient of a BFA (Bachelors of Fine Arts) that the niche passions you pursue can still inform and assist in your journey into new dreams and goals.

There’s Never a Dull Moment in a Pittsburgh Summer - Alex Schleicher

One of the most important lessons we learn in the Pitt genetic counseling program is how to balance professional success with self-care. Having previously lived in cities with millions of residents, I was worried Pittsburgh wasn’t going to offer the same level of events and excitement I find vital to my self-care routine. To my delight, I was very mistaken.

 

Consider this post a travel-guide to help incoming students fall in love with the city and current students in the throes of clinical rotations find some reprieve after a long day or week. Here I have summarized some city highlights as well as key resources that can be used as you find your own niche in this city we are lucky to call home.

               

Pittsburgh is a city that is small but mighty, offering endless activities, festivals, and patios to enjoy over the summer. My search began like most do these days, looking for local influencer accounts sharing happenings and must-visit spots throughout the city. Accounts such as:

          @visitpittsburgh
          @stufftodoinpittsburgh
          @ana.eats.pgh
          And my personal favorites; @pghcoffeegal and @foodismysavior_pgh

These creators skillfully share fun and exciting activities and local eateries that are bound to put a smile on your face while also providing an opportunity to socialize with your cohort family. 

There is one annual event in Pittsburgh whose reputation is so widespread, it is synonymous with the city itself:

Picklesburgh: July 18-21

For any newcomers, it is important to recognize that Yinzers (Pittsburgh locals) love pickles, a lot. So much so we have a free, weekend-long festival dedicated to all-things-pickled. Voted the #1 Specialty Food Festival in the US three times, you are sure to find a new tasty treat. Beyond just the briny cucumbers, they offer pickle pizza, pierogies, ice cream, cotton candy, beer, spirits, and more.

 

These remaining highlights are by no means exhaustive, but they are a great jumping off point to enjoy summer in our little corner of Western Pennsylvania.

 

Music and Art Festivals

It feels like almost every weekend there is an amazing art or music festival to visit in various neighborhoods around Pittsburgh where you can mingle and discover local culture.

 

-          Millvale Music Festival: Every May, 300+ music acts are showcased at this free community-organized event. This festival will take over the main strip of Millvale, where you can venture through the many participating establishments to hear music from reggae, jazz, country, rock, and beyond.

 

-          Pittsburgh Pride: The first weekend in June, Pittsburgh kicks of Pride month with countless activities and events throughout various neighborhoods. Along with the community parade, you can find free concerts and local vendors to support our inclusive community.

 

-          Northside Music Festival: June 14-16^th the historic Deutschtown transforms into a free indoor and outdoor festival where you can enjoy music from local bands while sampling tasty food from an array of food trucks and vendors.

Let’s Go Bucs!

Another thing newcomers quickly learn about Yinzers, is that they LOVE sports. We are lucky enough to have an NFL, NHL, and MLB sports teams for year-round entertainment. PNC Park, home of the Pittsburgh Pirates, has been repeatedly voted The Best Ballpark in America. Overlooking the Allegheny River and downtown Pittsburgh, there are few better ways to enjoy the beautiful summer weather with friends and family.  One added bonus is Pitt students can purchase select tickets at a 50% discount, making this an affordable group outing to cheer on our local baseball team!

 

I’ve been caught on many occasions calling Pittsburgh “pleasantly surprising”, since after two years as a graduate student at Pitt, I am still finding new and exciting things to help unwind throughout the year. I hope that these recommendations help new and current students feel the magnetic effect that Pittsburgh has on everyone who has the pleasure of living here.

Celiac in the City: A Student's Guide to Gluten-Free Pittsburgh - Megan Piechowicz

Over the past twenty-three years of my life, an abundance of experiences has shaped me into the person I am today. At six years old, I was diagnosed with Celiac Disease. A year of my family’s life was spent visiting at least a dozen pediatric gastroenterologists and other specialists. At a surface level, the solution seemed simple. However, seventeen years ago, eating gluten free (especially in first grade) was not as easy as it is today. Now, discovering new foods, and finding new restaurants to eat at, is one of my favorite parts of life. When I found out I would be leaving my small hometown to pursue my education almost 500 miles away, one of my first tasks became finding places to eat. Below is an abbreviated list, with photos, of some of my favorites that I have discovered in Pittsburgh within the last eight months!

 

Strip Steak, asparagus, and potatoes at Urban Tap in Shadyside

   

Pasta and salad at Girasole in Shadyside

   

Pizza and gelato at Mercurio’s in Shadyside

 

Chicken cashew dinner at Nicky’s Thai, downtown 

 

Grilled salmon with mashed potatoes and asparagus at Jason Aldean’s in North Shore

 

Sweet potato glass noodles at City Kitchen in Bakery Square

 

Crème Brulé at the Porch in Oakland

 

Pancakes at Square Cafe in Shadyside

In conclusion, my journey navigating gluten-free options in Pittsburgh as a student in the genetic counseling program has not only been an exciting adventure, but also a vital aspect of my self-care. Whether exploring new restaurants or indulging in homemade dishes with classmates, like our memorable Friendsgiving feast, the experience of sharing meals has provided a much needed rest from the rigors of our curriculum. I've embraced the profound value of taking time to savor moments spent eating, preparing, and conversing around food. It’s a simple, yet powerful, form of self-care that’s not only essential, but delicious as well.