Q&A: Elena Kessler, Pediatric Genetic Counselor

 

Elena Kessler is a graduate of the Pitt Genetic Counseling Program and now works at the Children's Hospital of Pittsburgh (CHP). In addition to seeing regular pediatric patients, she began the Pediatric Cancer Predisposition Program and sees many oncology patients. Pitt genetic counseling students have the opportunity to rotate through this program during their second year!

 

Why did you decide to become a genetic counselor?

I was in my junior year of college taking a genetics class as a bio major, and at the time I had no idea what I wanted to do after graduation. I loved all my psych classes, and considered some jobs in that realm, but I was deep into the bio path at that point. I considered physical therapy and athletic training, but after shadowing those professionals, the careers did not click for me. I really liked my genetics class, and one day we learned about the field of genetic counseling. We were assigned a case to present to the class, and I played the role of GC with my lab partners playing a couple with a family history of fetal alcohol syndrome. Everyone’s cases were really interesting! After class, I asked some questions and my professor told me more about the field. He mentioned that he knew a GC in my hometown of Youngstown, Ohio, and thought it could be a career for me to consider. After learning more about peds genetics, I thought back about many kids and families I spent time with as a child while my parents officiated the Special Olympics. I knew I wanted to work with and help people in some way, and many aspects of the field achieve that, so I found my path towards GC!

 

Why did you decide to specialize in pediatric genetic counseling?

After completing my rotations in grad school, I had interests in both peds and oncology. I spent the first 3 years working in the GI genetics clinic, and then moved to CHP when a position became available. I love that in peds specifically, you often have a long-term relationship with the family and can continue helping them and updating them for years.

 

What is an average day like for you?

Fast-paced and unpredictable. I see patients 2-3 days per week, and other days are spent calling out results, and doing other patient-centered tasks.

 

What is your favorite part about being a genetic counselor?

Helping families understand the child’s test results and connecting them with valuable resources. Many of the conditions we deal with are ultra rare, and newly discovered. We have a unique role to empower families in this learning process with us. I think I learn something new every day in this job

 

What inspired you to develop the Pediatric Cancer Predisposition program, and what has that experience been like?

After my experience working in adult genetics, I naturally became the point person at CHP for oncology cases. But we rarely saw the oncology patients in genetics, both due to low referral rates and the numerous other priority visits these families frequently have. And many oncologists weren’t as up to date on pediatric cancer syndromes, so they didn’t think genetics was needed. Our currently graduating hem/onc physicians are trained extensively on genetics, mostly due to the many somatic changes that occur in tumors. One day, I had the opportunity to present at the hem/onc staff meeting about genetics, which was great, and physicians would periodically contact me about patients, but it was still rare. Over the years, more large institutions developed pediatric cancer genetics clinics, so I expressed interest to Dr. Vockley in teaming up with hem/onc to see these patients. In 2016, the hem/onc department hired a new physician, Dr. Wendy Chang, and she had experience during her fellowship working with genetic counselors. We started from scratch developing every aspect of the clinic until we launched officially in 2017. We presented information about our new clinic and gave an educational seminar to 7 different departments around the hospital, and we created pamphlets for the hem/onc waiting room and survivorship clinic appointments. Currently I run the program with Dr. Julia Meade, who is a neurooncologist. I now spend the majority of my time in oncology, with a few patients in medical genetics every week or so. In the next year or two, I will likely move over there full time!

 

Is there anything that surprised you when you first started working as a genetic counselor?

You can be as knowledgeable and prepared for a case as possible, but psychosocial issues and unexpected questions will continue to challenge you. Those are fun things though 😊

Student Spotlight: Madalyn Charnego

 

    When I received my offer to join the Pitt master’s of public health program for fall of 2020, I was a few short days away from Match Day. At that same time, I was coming to terms with the fact that I had lost the end of my undergraduate career to the COVID-19 pandemic. The blur of excitement that should have been the spring of my senior year was overtaken by virtual classes, virtual interviews, and lost opportunities. When Match Day came, I was left without a program and unsure of where my next chapter would take me. Looking for a sense of purpose, I chose to accept the offer from Pitt’s MPH program.

              Receiving my MPH was always something that I had been interested in and was a big factor of why I had applied to Pitt in the first place. The chance to learn more about how genetics impacts populations was intriguing. I knew that there would be a lot of new opportunities for me that would open up by completing an MPH. I was still thinking that genetic counseling was the career for me but starting this MPH would give me the chance to explore some more avenues. Although this was not the path I had intended for myself originally, I tried hard to keep myself focused on the positives. I had a new plan of action and was excited to get started.

              When the fall semester began, I was immediately shocked by how supportive and welcoming the School of Public Health and the Human Genetics Department were—even over Zoom! I fell in love with the department and the culture at Pitt. I broadened my horizons from genetics into health equity and health literacy. I was able to take classes that explored those topics on a deeper level. Through my MPH coursework, I found a new passion for advocating for better access to health care information and materials written and presented at appropriate levels for all patients, instead of only for individuals with high health literacy. I ultimately chose this topic to focus my thesis around.

              As the application cycle for 2021 began to open up, I struggled with what to do. I knew I wanted to finish what I had started with the MPH, but I knew that genetic counseling was really where my career goals were. I chose to apply to only Pitt for the 2021 cycle. Although applying to one school could be considered a gamble, it was a chance I was willing to take. Similarly, I found comfort in the fact that no matter what, I could always apply again, and I was still going to finish my MPH. I updated my application materials to reflect all that I had accomplished since starting the MPH program and spent time learning more clearly what the Pitt GC program had to offer. The application cycle moved fast, and soon I was interviewing and submitting my very short rank list. When Match Day brought me the news that I was going to finally accomplish my dream of not only becoming a genetic counselor, but also receiving my MPH at the same time, I was overjoyed.

              Matching meant I get to stay in Pittsburgh for three years total, instead of only two. With this comes extra time to complete my thesis, more chances to take courses in areas that interested me, and more opportunities to explore the city I now call home. On top of all of this, completing a full year of course work before starting the GC program proved to be incredibly beneficial to my success. Because I had already been in many of the courses that first year GC students take, I was able to focus more effectively on the GC-specific courses that I still needed to take. Plus, I could use the knowledge I had already acquired the year before to inform my learning in other classes. While this path is not necessarily the ideal for everyone, it has turned out to be the perfect fit for me. Taking three years to complete my two degrees has given me space to follow my passions and grow as both a student and a future genetics provider.

-Madalyn Charnego