Reapplication: A Worthy Challenge

     There is a distressing feeling that accompanies finding out you have not been accepted to any genetic counseling programs. For months, you have agonized over every letter of your personal statement, typed and retyped answers to application questions, entered the basic details of your life on form after form, and paid fees in hopes of receiving an interview. This does not even account for the hours of shadowing, volunteering, working, studying, and soul searching that go into preparing for the application process.

Remember, Hercules may have suffered some defeats, but
he still persisted, and so can you!

     Then, as days stretch into weeks after hitting that scary “submit” button, you begin to receive messages from programs either telling you, “thanks, but no thanks,” or, “please, do come join us for an interview.” The interview process itself is its own Herculean labor. At the end of each one your jaw is sore from smiling, your mouth is dry from conversation, and your eyes are heavy from lack of sleep. Sometimes you leave feeling completely satisfied with your performance. Sometimes you nitpick the way you answered that last question when you were starting to feel tired.

     The next part is the long wait for Match Day. Some days you feel confident that you will be telling your family members all about class and clinic in a few short months. Other days you think that the chances of getting in are a million to one. The mind games seem worse when you need to re-explain that when you say you will find out April 25, you mean you will find out April 25, not next week, not tomorrow, not today. And yes, that is plenty of time to find an apartment. You are not the first to do it, nor will you be the last.

     After all of this work, to find out you did not make the cut feels devastating. But is it all for naught?
     The short answer is no. The long answer is a little more involved.

     Reapplying to a program that did not accept you the previous year does not “look bad.” If anything, it shows that you are willing to pause, reflect, and improve upon yourself, all qualities vital to a good genetic counselor. There are many students who do not make it in on the first try. From my experience, the unintentional gap year was a positive one, and getting accepted the second time

The path to success may not always be clear, so sometimes
we must forge our own way.

around made it all the sweeter.

     Before you begin reapplication, set aside time to feel sad. Spending months on a project that does not come to fruition is tough, and it is okay to acknowledge that.

     The next step on your journey is answering this question: Is genetic counseling right for me? Think about what you have learned throughout the application process and whether you can pursue it again. If your answer is yes, reach out to programs for pointers on how to improve your application. The most helpful question I was asked during this time is, “What is your plan for the next year?” Program directors like hearing your ideas because it shows you take initiative and that you care about the profession.

     Then, of course, you need to execute your plan. For everyone, this will look a little different, but here are some general pointers:

1. Learn everything you can about genetic counseling. One way to do this is shadow more. Reading is also very helpful. Some personal favorites are The DNA Exchange and Genome Magazine – both online, both free. NSGC has some great, free webinars too! The Journal of Genetic Counseling and Genetics in Medicine are both great resources that can be accessed through many university libraries. Many states also have genetic counseling associations with annual conferences you can attend, which is definitely something to include on your resume.
2. Update your personal statement to reflect changes you made since the previous cycle. You want to showcase the hard work you have put in for any programs viewing your application again. Make sure those writing your letters of recommendation receive an update on your additional accomplishments as well should some of them be the same people.
3. Practice interview questions. Being able to answer questions about your strengths, weaknesses, times you encountered conflict, etc., should become second nature. Having some stock answers you can build upon will help you with confidence on interview day.
4. Be open to new experiences. While learning a new skill or taking a trip may seem completely unrelated to the application process, everything builds upon who you are as a person. You never know what you may be able to relate back to genetic counseling, and it is more material to work with during interviews.
5. Be confident. Failing to get in once does not mean you are any less capable of becoming a genetic counselor. It simply means that you were not as well prepared as someone else. Remember: you can – and will – take steps to remedy that.

     To be honest, reapplying is hard. It is a sense of déjà vu that you are simultaneously more and less comfortable with. I came to deeply appreciate the reapplication process. Ultimately, it was a time for me to improve upon not just my application, but myself. And ultimately, the experiences I had during my unintentional gap year will make me a more capable genetic counselor. So, I challenge those of you reapplying to rise to the occasion and make this your best year yet. Good luck!

--Meg Hager, Class of 2018

Experiences of Working With Sickle Cell

For my hourly work position, I have the pleasure of working in two different, yet collaborative settings.  I am a student worker for the Pediatric Sickle Cell Department at the Children’s Hospital of Pittsburgh of UPMC, as well as a program assistant at Children’s Sickle Cell Foundation, Inc. (CSCF,Inc.) Working in a dual capacity allows me to learn about sickle cell disease in a clinical setting, as well as from a community advocacy standpoint.  Both perspectives have made for a valuable experience with regards to genetic counseling during my first year.  

Children's Hospital of Pittsburgh.

In the clinical setting, I have had the opportunity to shadow the pediatric sickle cell team members during their clinic days. I have learned about the clinical management of sickle cell disease and other hemoglobinopathies. The department is responsible for sending out letters for positive newborn screen results for sickle cell trait. This is one of my primary tasks along with managing the clinic’s sickle cell database, and keeping our patients’ clinic visits, medications and referrals up to date. This summer, I had the opportunity to provide pre-test counseling for University of Pittsburgh student athletes for the mandatory NCAA sickle cell trait testing. My supervisor and mentor is Dr. Cheryl Hillery.  She is enthusiastic and open to my participation in any and all clinic activities.  She is currently guiding the development of my thesis topic, which focuses on the medical transition from pediatric to adult care for young adults with sickle cell.  This transition occurs between the ages of 18 and 22 and is often a busy and challenging time for this age group. Having a potentially life-threatening, chronic illness to manage can be a source of anxiety for these teens and young adults and it can be intimidating to meet and interact with a new set of care providers in the adult setting.  

In addition to working in the clinic, I typically work one day a week assisting the Program Director, Heather Tucker, with providing programs for children and adults with sickle cell disease through Children’s Sickle Cell Foundation, Inc., a non-profit, community-based organization in Pittsburgh. We work as a team to plan and execute programs and activities for children with sickle

An image depicting normal and sickle-shaped red blood
cells. Photo from the Mayo Clinic.

cell disease and their families. Our most recent event was the annual Sickle Cell Fun Day at Kennywood amusement park.  Earlier this summer, we spent the day with our families, provided a catered lunch for the families along with fun activities like bingo and raffles for those who were not as interested in going on amusement rides.  Our Saturday SMASH Sickle Cell Wellness Program, (SMASH stands for Stay Motivated, Active, Smart and Healthy) is growing steadily.  One activity we made available to families during the summer months was the Learn2Swim program that provides children and their families access to swimming in a heated pool(This is important for individuals with sickle cell disease; exposure to cold water can trigger a sickle cell crisis.).  During the school year, the focus is on education and coping along with various physical activities. Year round, we provide free tickets to plays, sporting events and museums around the city and all of these programs are open to children with sickle cell disease and their families, providing much needed family time.  I enjoy meeting the families and getting to know them. In this role, I am also able to learn administrative skills by managing our Facebook and Twitter pages and by designing the monthly calendar that is sent to families who are part of our community.

Through interacting with the staff and families of CSCF, Inc. I have learned how sickle cell disease affects kids and adults from a personal standpoint. I get to hear their stories and work for an organization that works to provide them the resources they need in order to succeed and continue “Living Well with Sickle Cell®.”

-- Emily Mazzei, Class of 2018

Advice to Soon-To-Be GC Students

Starting a genetic counseling program can seem a little scary, but it's also a new opportunity to grow and make new friends. The Class of 2018 has some advice for incoming first years:

There’s a lot of stuff going on in graduate school between class, rotations, writing your thesis and taking care of yourself. I would definitely say invest in a good planner to keep yourself organized during the hectic times that will inevitably pop up. - Meg Hager

Don't forget to set aside time to relax.

I recommend setting some time aside each week for grocery shopping and meal prepping to ensure you’re well fed, even on the weeks when you have exams, assignments due for rotations, or deadlines at work. Eating right is an important part of self care! - Emily Spoth

Take out your phone right now and download the apps Transit and Busgazer to help you track the buses in Pittsburgh. Also, don’t be too hard on yourself. Graduate school is hard. It’s supposed to be. But it’s also rewarding and, on occasion, fun. - Emily Mazzei

Don’t forget to enjoy the process! Graduate school, especially genetic counseling programs, can be hectic and busy at times, but it’s also an amazing time to connect with 11 other people who are experiencing some of exact same things that you are. Take a little bit of time off to explore Pittsburgh, try new restaurants or just nerd-out with your classmates on all things science! - Joya Petersen

Buy an umbrella you can keep in your bag at all times!  You will be glad you have it. - Seth Lascurain

The best thing I was told when I was going into my first year is that grad school is what you make of it. There are plenty of opportunities out there, but it is up to you to take advantage of them, so don’t be afraid to get involved and explore areas that excite you. - Julia Stone

 

Keeping yourself organized can be helpful during grad school.

Feel out your professors before you pass this on, but remember that your grades matter much less than what you are getting out of the experience to become a successful and thriving genetic counselor (and person overall). If you focus on doing things that help with that end goal, prioritizing can become a bit easier as not every assignment or test is going to carry the same weight. You also can’t possibly give 100% of yourself to every class, every assignment, every extracurricular opportunity, every job responsibility, and every social outing. It’s okay, and often necessary and encouraged, to say no at reasonable times! - Jenni Peck

Take advantage of Robin and Andrea’s open door policy- they really are such a wonderful resource throughout your time in the program (as well as after you graduate)! - Claire Leifeste

It is very helpful to make a schedule and to try to stick to it, but don’t beat yourself up or panic if you fall behind. Everything gets finished eventually! Also, taking breaks to allow yourself to regroup is an absolute necessity! You always think more clearly and interact more effectively with patients if you give your brain the break that it needs. - Jackie Amurgis

Have a space you go to regularly, whether it’s a room in your apartment, a friend’s place, a coffee shop, anywhere, where you do absolutely nothing school-related. Being able to have a place you can totally remove yourself from school, work, or rotations helps with making everything less overwhelming and keeps it exciting. - Julia Verbiar

-- The Class of 2018

Biting into Research: Research Experience with Craniofacial and Dental Genetics

Like some of the genetic counseling students from years past, I am a graduate student worker at the Center for Craniofacial and DentalGenetics (CCDG), part of the School of Dental Medicine here at Pitt. My first experience with the CCDG was through the Summer Institute for Training in Biostatistics, when I was able to work with data from the first cohort study of the Center for Oral Health Research in Appalachia (COHRA1). Currently, I am a research assistant for the second cohort of the study, Factors Contributing to Oral Health Disparities in Appalachia(COHRA2). The goal of these studies is to examine the genetic, environmental, behavioral, and microbial components of the disproportionately increasing rate of dental caries, or cavities, in children in Appalachia, a region in the eastern United States spanning from western New York to northern Alabama, Mississippi, and Georgia. We are looking specifically at children in Northern Appalachia, from western Pennsylvania and West Virginia, as they demonstrate a high level of poor oral health with elevated rates of caries early in life.

A map depicting the Appalachian region of the United States.

My job involves working with a team of other research assistants and dental hygienists to perform study visits and maintain contact with the research participants. Collaborators at West Virginia University also carry out these visits, with West Virginia being the only state entirely within the Appalachian region. Female participants were able to enroll when they were in their first or second trimester of pregnancy and we are now following the mother and baby pairs up to the baby’s 6^th birthday, with visits at specific times throughout the years.  The visits involve collecting saliva and other oral samples from the mothers and babies enrolled in the study for DNA and microbial environment analysis. We also document the child’s growth and survey behavioral, environmental, psychosocial, and socioeconomic factors of the mothers, both at the visits and with short and long phone interviews at other times of the year. Other aspects of my position involve helping with general office duties and processing the samples received at both sites for subsequent analysis.

Center for Craniofacial & Dental Genetics logo.

A significant benefit of my position is the wealth and breadth of data available from which I can develop my thesis project, which is allowing me to make it a project I really enjoy. I have a strong interest in cardiovascular health, so I am currently looking into developing a thesis project that examines the possible genetic link between heart disease, hypertension, and periodontitis. Research has shown that there may be a similar underlying inflammation process in these diseases and, through CCDG-lead studies and collaborations throughout the years, there is extensive data I can use to further study this connection.

Although I was not sure how relevant it would be when I began, this position has helped me cultivate my genetic counseling skills. Conducting the study visits has facilitated my comfort with patient interaction and adapting to changing situations, as patients and sessions can be unpredictable, just like the toddlers we see. Through the phone interviews we conduct with the mothers to track the diets and general health of their babies, I have also developed my ability to go through series of seemingly random questions in a targeted manner to stay on topic, like is necessary when collecting personal and family medical histories.

For these reasons, and many more, I have really appreciated the experiences and opportunities I have had while at the CCDG and am excited to continue working here through the rest of my time at Pitt!

-- Julia Verbiar, Class of 2018

Optional Rotation: Cambridge, England

For my optional clinical rotation, I had the unique opportunity to spend four weeks in the United Kingdom.  Since I am dual degree student also pursing an MPH in Public Health Genetics, my main goal for this rotation was to observe the differences between UK and US genetics services.  My rotation took place in Addenbrooke’s Hospital, a teaching hospital that is part of the U.K.’s National Health Service (NHS) and is affiliated with the University of Cambridge.  The clinical genetics department at Addenbrooke’s is made up of 10 genetic counselors and 11 clinical geneticists with varying specialties and professional interests. 

Addenbrooke's Hospital of Cambridge gave one Pitt student
the opportunity for an optional rotation.

During my four-week rotation, I had the opportunity to observe and participate in patient encounters across a number of genetic specialties such as prenatal, pediatrics, and cancer.  For the most part, the genetic counseling sessions are handled in the same manner as they are in the US.  They contract with their patients the same way that we do, provide the same basic genetics information, and offer emotional support to patients and their family members.  The greatest difference, I found, was in the type of genetic tests and screenings that were offered to patients.

In the US, if a patient meets clinical criteria for genetic testing, the type of test offered, the testing laboratory selected, and subsequent health screenings recommended often depends on the patient’s insurance.  In the UK however, the vast majority of patients utilize the NHS, a single-payer system, which somewhat streamlines the genetic testing process.  However, because the NHS provides healthcare to so many people, the challenge of conserving resources is very real.  The clinical criteria for genetic testing and health screenings in the UK are stricter than they are in the US, and there is a more formalized process for getting an appointment with a geneticist or genetic counselor.  After having spent time in two very different healthcare systems, I am now more aware of the variety of medical services in the US and have gained an appreciation for the straightforward nature of the NHS.

An important historical message about the discovery of DNA
from a local pub in Cambridge.

In addition to participating in genetic counseling appointments, I also had the chance to observe a number of other genetics-related services.  I got to spend a day in the von Hippel-Lindau (VHL) clinic, working with patients living with this syndrome and helping to coordinate their other specialist appointments.  I spent another day sitting in with men who had a BRCA2 positive test result who were participating in a prospective prostate cancer research study.  I also had the opportunity to observe mammograms and colonoscopy procedures.  These experiences allowed me to appreciate the downstream impact of genetic services on patients, doctors, and research.

Although my rotation kept me quite busy, I was able to set aside some time on the weekends to explore Cambridge and other parts of the UK.  Much of Watson and Crick’s contributions to the discovery of DNA happened just down the road at the University of Cambridge’s Cavendish Laboratory, and it was exciting to feel a little closer to that important history.

My optional rotation in Cambridge was an amazing way to round out my clinical training.  Not only was I able to utilize the skills that I had honed up until that point, I also got to learn a great deal about the applications of genetics to other areas of medicine and its impact on public health.

-- Leslie Walsh, Class of 2017

Summer Plans for the Class of 2018

This summer, our second-year students are not only working hard in their clinical rotations, but they’re also taking time to experience more of Pittsburgh!

When I’m not working at improving my skills as a Genetic Counselor at my rotations, I plan on enjoying the running trails at Schenley Park, trying some new restaurants, and -above all else- getting some wonderful iced tea from Gryphon’s and Bantha! -Meg Hager

Enjoying some tea while working at Bantha
Tea Bar in Bloomfield.

A few of us have decided to take on the Tough Mudder this fall! This summer I will be training for that. -Seth Lascurain

I have been slowly working my way through a list of bakeries, cafes and restaurants in Pittsburgh that I’d like to try. I’ve also been seeing a lot of movies at Row House Cinema in Lawrenceville, which has a new movie theme each week. -Emily Mazzei

I am taking advantage of every farmers market and food truck event I can get my hands on this summer! Pittsburgh has some sort of fun food event going on every weekend, and I am making an effort to experience as many of them as possible. -Julia Stone

This summer I am going to take advantage of the warm weather and do one of my favorite things: go to a Pirates game and enjoy the view of North Shore! -Joya Petersen

One of my favorite summer activities in Pittsburgh is talking walks around the many beautiful parks and petting all of the cute dogs! I also enjoy biking on the trails that run along the rivers. -Jackie Amurgis

A shot of Pittsburgh from the Three Rivers Heritage Trail on
a cloudy, summer day.

Summer weekends are for camping and hiking! I’m looking forward to continuing exploring the state parks in the area. I got started over Memorial Day weekend with Fernwood State Forest (which is actually in Ohio!) and Raccoon Creek State Forest in PA. -Emily Spoth

In addition to enjoying the change of scenery from classes to clinical rotations, I am going to get back into running outdoors; enjoy some cafes around Pittsburgh that I have yet to try; attend some summer festivals and street fairs; and despite the humidity, still be relieved about the summer temperature differences between my Arizona home and my Pittsburgh home. -Jenni Peck

Along the lines of some of my classmates, this summer, my goals are to improve my cooking skills and my 5k time! I am working on trying out a new recipe every week, using ingredients from the farmers markets around the city, and running at least one race each month, finishing in front of a faster pacer each time. -Julia Verbiar

My summer bucket list includes going to a Pirates game, visiting a lot of parks, and hopefully making it out to Frank Lloyd Wright’s Fallingwater. We are also continuing our second year’s tradition of going to a different happy hour every Thursday after class! -Claire Leifeste

I’m spending as much time as possible finding nice places to read outside, cooking with fresh farmer’s market foods, and checking out fun festivals! My mom, sister, and I went to Mattress Factory art museum, Randyland, and the Cathedral of Learning over Memorial Day, so I’m inspired to do more sight-seeing again. -Kaitlin Sullivan

The Class of 2018

Student Work Positions: TRiNDS Clinical Research Assistant

For my student work position, I have the pleasure of working for TRiNDS, a full-service CRO specializing in neuromuscular disorders (DMD, BMD, FSHD, etc) that also runs the coordinating center for the CINRG network. Confused by the alphabet soup? Don’t worry, I was too when I first started. I learned very quickly that the clinical research world  is full of acronyms. Let me break them down for you.

TRiNDS stands for Therapeutic Research in Neuromuscular Disorders Solutions. TRiNDS is a contract research organization (a CRO), a type of company that can support pharmaceutical or academic centers for their clinical research needs. TRiNDS does not directly conduct the clinical research, but helps support the clinical operations, data collection and management, and analyses of research studies. TRiNDS is a unique CRO in that it specializes in neuromuscular disorders, including (but not limited to) Duchenne Muscular Dystrophy (DMD), Becker Muscular Dystrophy (BMD) and Facioscapulohumeral Muscular Dystrophy (FSHD). These are rare, debilitating diseases that cause progressive loss of muscle function and mobility starting in early childhood. Several individuals at TRiNDS have worked with the Cooperative International Neuromuscular Research Group, or CINRG for short. CINRG is a network of professionals and institutions around the world that have partnered together to study these rare neuromuscular disorders. Through inter-clinic and international collaboration, CINRG aims to improve the quality of life for individuals and families dealing with neuromuscular disorders through clinical research investigations. TRiNDS grew out of the CINRG coordinating center (CC), and now continues to coordinate the network activity.  So, to sum it all up, TRiNDS is a CRO specializing in disorders like DMD, BMD, FSHD, etc that also runs the CC for the CINRG network.

As the TRiNDS Clinical Research Assistant, I help with the day-to-day and clerical activities at TRiNDS. Some of my responsibilities include managing company files, scheduling meetings, and coordinating supplies and equipment needed by the CINRG sites to collect strength and function assessments. I also help draft company documents, and I was involved in the development of both the TRiNDS website and the recently-updated CINRG website. These activities have allowed me to peek inside the world of clinical research trials and learn about the ins and outs of developing therapeutics for rare disorders. I have gained an appreciation for how much time and effort goes into completing a successful clinical trial, and for the dedicated professionals and brave families who devote their lives to furthering knowledge about these disorders. While TRiNDS specializes in many neuromuscular disorders, I have mostly been exposed to trials related to DMD, which has given me an insight into the amazing Duchenne community. I am in awe of the courage and optimism of the DMD community, and the more I learn about DMD, the more inspired I am to get involved and to work to my fullest potential. I am excited knowing that I will be able to devote my graduate thesis project to furthering knowledge about DMD.

I also work with a wonderful and diverse team at TRiNDS, and it has been a joy to collaborate with and learn from my growing group of coworkers. Two TRiNDS employees are actually genetic counselors, so it has been very eye-opening to see how their careers have progressed so far and how they use their skills as genetic counselors in the world of clinical research. Going into graduate school, I knew that I wanted exposure to as many different genetic counseling roles as possible, so I feel incredibly lucky to have the opportunity to learn from these genetic counselors working in unique positions.

Working for TRiNDS is shaping my professional identity and helping me grow into the genetic counselor that I want to be. No matter where I end up after I graduate, I will continue to utilize the knowledge and lessons learned through this position, which I know is setting me up for my best future. To say I am grateful for this experience is an understatement, and I am looking forward to seeing how the company grows as I continue to work through my second year.

-Julia Stone, Class of 2017

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