Unlike most of my classmates, I hit the ground running
with clinical rotations in specialty – a unique, largely observation-based
rotation that provided me with opportunities to see a wide array of clinics in
which genetic counselors work. The first look at the schedule made me a little
overwhelmed and excited with each and every clinic day varied in its title and
often locations. With this being my first rotation, I was also thinking about
how to organize such a variety of information/clinic settings and get the most
out of observing. I did not yet experience what a “traditional” structured
genetic counseling session should be (aside from stimulated patients), and here
I was, already preparing to be exposed to the non-traditional, specialized
sessions. Excitement grew inside me with the anticipation that every clinic day
is a unique learning environment, where I could meet different experienced GCs
and learn from them in specialized fields. A few names of my clinic days
include ophthalmology, pediatric oncology, adult Down syndrome, and
cardiogenetics.
One thing I was glad that I started early on was to
reach out to the GCs in each clinic a week or more before the clinic day. Each
clinic has a different set of expectations for which a GC intern should prepare
in advance, along with prior or follow-up assignments that consolidate the
student’s takeaways. Every week, I also chose a memorable case on which to
write chart notes and create my own outline. To systematize our observations, I
was also provided with an “Active observation form” from the program to do
brief case prep and fill out sessions’ information.
Although the specialty rotation is considered not as
intense relative to others, initially I was a little overwhelmed with such a
variety of information. Furthermore, with all the clinics being very
specialized, I found myself not being able to come up with specific testing
options or strategies. Despite spending a whole year in the classroom,
observing the functioning of specialized clinics had actualized in me the gap
between classroom and practice, with the recognition that a genetic counselor’s
roles are fluid and flexible within a hospital or even a specialty. An example
would be the Muscular Dystrophy Association (MDA) clinic, where Kelsey Bohnert,
my GC supervisor, took turns with other providers in the multidisciplinary team
to see patients. This streamlining approach is to enable the muscular dystrophy
patient’s convenience in their new, follow-up, or routine appointments to see
all the specialists at once, including Dr. Hoda, the director neurologist, the
PA, the physical therapist, the rehab doctor, and the genetic counselor. It was
eye-opening to see how Kelsey counseled patients with needed contents conveyed
and proper informed consent achieved but in a very time-efficient manner,
allowing time for other specialists and for a constant clinic flow. Fresh from
the classroom with the idea of a 30–40-minute session, I felt the need to learn
the ability to greatly customize sessions. It seemed like a daunting task, but
it was necessary to incorporate genetics into patient’s care.
Slowly, I practiced seeing that gap as the room to grow.
It was exciting to realize that as long as I kept the growth mindset, I could
mold my professional development to focus on a deeply specialized sub-specialty
or condition I am interested in. Such appreciation came from the great support
I had from clinics’ supervisor. I had felt the eagerness to help me learn from
every genetic counselor, doctor, and coordinator I came across, who wrote
helpful summaries or handouts, provided me with recommended readings, and
always gave me time for debrief and Q&A. I found clarity and interesting
stories when asking questions from cases, clinics, testing options, patients’
programs, to career paths of how my supervisors came to participate in such
unique clinics. For example, it was a wise search for a fast-paced, specialized
practice setting that helped Michelle Alabek to land her job at the eye clinic,
where she served as both a genetic counselor and a coordinator. After the
patient saw the optometrists and had ocular imaging, the attending physician,
Dr. Sahel, would see the patient to review medications and testing options, for
which Michele would counsel. The eye clinic at UPMC housed cutting-edge
technologies and clinical strategies especially for inherited retinal
degenerations. Dr Sahel, the director, is a worldwide-renowned expert for
development of vision restoration techniques. Michelle remarked on her
experience seeing impressive bench-to-bedside approaches utilized to benefit
the patients. When asked about her journey, she guided me with helpful tips and
questions to ask in job interviews such as the position’s role, peers’
interaction, and past experience working with GCs, in order to tailor job
search and form your development.
There are many other unique, by no means less
interesting learning experiences in the specialty rotation to fit into one blog
spot, so I will leave it here to not spoil all the excitement. I ended this rotation
with a great appreciation for my mentors, the exposures, and the hope of
experiencing more of such a variety and expansion of GCs roles in the future. I
hope that my experience leaves you, the readers, some sneak peeks into this
one-of-a-kind rotation, as I prepared myself for another unique one that Pitt
has to offer – the primary care/genetic testing rotation.
Best of luck to everyone this summer!
Phuc Do
