Transitioning from Student to Genetic Counselor

During the spring semester of my second year of graduate training, I accepted a position at the University of Iowa Holden Comprehensive Cancer Center (UIHC) as a cancer genetic counselor. From the time I first interviewed it was evident that a number of exciting things were on the horizon for genetic counseling at UIHC. I was recruited along with five other new genetic counseling hires for various positions across the hospital, breaking a national recorded for the most new clinical genetic counseling hires at an academic medical center institution.

Since starting my job just over seven months ago, I have had the opportunity to attend the National Society of Genetic Counselors Annual Education Conference in Seattle and the Iowa Cancer Consortium in Des Moines, as well as give a number of presentations at tumor boards, other specialty meetings, and conferences. The most memorable activity I have participated in, to date, was on my third day when we took part in one of the official satellites for former Vice President Biden’s  Cancer Moonshot. The Cancer Moonshot was a call to action for all those involved in cancer care and research to help end cancer as we know it. During the event we heard from a local panel including physicians, researchers, and patients as well as a moving and powerful speech from Vice President Biden as he shared the story of his son, Bo.

One of the most significant changes I noticed when starting my genetic counseling career was that I was now in charge. I was the expert in the room and had to be prepared to answer any question the patients may have. I was also seen as the expert in tumor boards, often fielding questions about appropriate referrals to our clinic. This was both exhilarating and overwhelming. Fortunately, I quickly overcame these feelings and became an integrated part of the patient care team. I found it important to remember that I may not know everything, but I am still the genetics expert. It is okay to say you do not know the answer, but you will look into the question to find the answer. I also found myself using the counseling strategies my supervisors used in clinical rotations, whether that is to get a patient to open up more, facilitate decision-making, or to help refocus a patient to get the session back on track.

Pitt did a wonderful job preparing us for our genetic counseling careers.  The only thing I was probably not prepared for is not being around the 10 wonderful classmates I spent so much time with for two years! This was a significant adjustment but luckily we keep in touch and are available to each other to discuss ideas and provide support after having a difficult case. We also make plans for class trips so we can see each other stress-free. Although it has been hard not seeing these wonderful friends every day, there is a great group of genetic counselors across UIHC who help provide support. I was hired at the same time as other new graduates and we areable to support each other and studied together for the ABGC certification examination.  I was thrilled to pass the exam!

At my job, we have a social chair who plans monthly activities for genetic counselors to get together, which helps foster a strong relationship and friendship with the other genetic counselors at our institution. There is a monthly book club that includes genetic counselors as well as other cancer center staff. I also have the opportunity to work with two (soon to be three) wonderful genetic counselors in the cancer center, that we endearingly refer to as “the dream team”.

With all the changes that are coming to the UIHC and the excellent training I received at Pitt, I know I will be able to take my career down whatever path I choose, whether that be teaching, research, or clinical work. Coming to UIHC has been a wonderful transition into the workforce that provides me with endless opportunity to grow.

-Kristin Gambin, Class of 2016

Thoughts for Interviewees from Current Students

1. Congratulations!

You have an interview! Take a moment to celebrate this achievement. Applications take significant time and effort – writing personal statements, getting recommendations, and sending out copies of your transcripts. All that work has paid off and has resulted in an interview, make sure to enjoy it before tackling the next steps.

2. Come with questions

The interviews are a way for you to learn more about the program than you can read from the website. You are interviewing the program just as much as they are interviewing you. Are any of your interviewers alumni? Ask them why they chose the program, how it has changed, and where they see it going. Some of our favorite questions were:

• What makes the program unique?
• How can I personalize my learning experience?
• How many cases do students typically see?

3. Talk to current students

Current students can give you an important perspective of what life in the program would be like including activities outside of classes and rotations. Find out what’s everyone’s favorite hangout spot. Where do students live? How affordable is the area? Do students work? In addition, it’s fun to meet future colleagues!

4. Explore the city

Especially near campus. You’re going to spend at least two years wherever you decide to go. Are there interesting things to do? Is it easy to get around? Try out some of the public transportation. Check out some of the local parks and unique sites.

5. Keep a list 

And update it as you complete your interviews. It’s handy to have a priority list before Decision Day arrives.  You can keep in mind factors that are important to you when making a decision.

Our biggest advice would be to just breathe, be yourself, and have fun!

Best of luck,

Classes of 2017 and 2018

Mulling Over Ethics as Genetic Counseling Students

I find that one of the unique aspects of the Pitt Genetic Counseling Program is the strong focus on ethical principles in the curriculum.  For example, students participate in a course entitled, “Ethical Issues in Clinical and Public Health Genetics,” in their first and second year. The purpose of the course is to discuss genomics and genetic counseling topics within an ethical framework.

For the course, each week, a first and second-year student pair up to present a topic on which they lead the class discussion. The topics that I have had the pleasure of discussing have been equally intriguing and challenging; they are always pertinent to current issues in the field as well as conundrums that may be faced in the future, especially as genomic technology advances so rapidly. Some examples of topics from my favorite discussions include: post-mortem genetic testing, language barriers and the use of interpreters, prenatal whole exome sequencing, the addition of diseases to newborn screening, and population screening for BRAC1/2 mutations.

Although we touch on ethical principles in many of our classes throughout the program, this course is different due to our instructors. We are lucky to have Dr. Lisa Parker co-lead the class with our program director, Dr. Robin Grubs. Dr. Parker is a philosopher-bioethicist whose research focuses on genetic research, genetic counseling, and pharmacogenomics. She brings a nuanced ethical insight to every class and can play a perfect “devil’s advocate”, which allows us to see a situation from multiple perspectives. I feel that her background and expertise help to encourage us to grapple with the ethical quandaries that we tend to find ourselves in during these discussions.

Overall, I find the ethics course extremely beneficial as a genetic counseling student. As a first-year student, I was fascinated by the insight of our second-year students. It was amazing to see how much they had learned from their rotations and how personal experiences with patients gave them unique insights into certain ethical situations. Now, as a second year, I feel that the ethics discussions allow me to think critically about my patient interactions and to learn from the experiences of my classmates. It doesn’t matter how much I think I know about a topic prior to the discussion, I always come away with a more refined view.

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 -Emily Griffenkranz, Class of 2017