My First Genetic Test - Alex Larson

In a high school science club, I isolated my DNA from a saliva sample (or at least I believed I did; there was no confirmatory test done) and the concept of a genetic code firmly gripped my curiosity. How could an invisible molecule in a teensy, tiny tube dictate the construction and function of my body? And humans have the ability to read, predict, and manipulate this code? I was hooked.

Eight years later, I am thoroughly enjoying my first year of genetic counseling training and have a soft spot for a class titled “Genetic Techniques”. In this course, we are treated to lectures detailing different genetic testing methods and other molecular techniques and then get to try our hand at them in lab. Even with a background in bench research, I have learned a lot and gained immense respect for the lab technicians. The professors are thoughtful in explaining the reasoning behind each step in a protocol and are thankfully quite patient as our clumsy hands attempt to execute the experiment. While I likely will not do much pipetting after graduating, it has been incredibly valuable to gain insight into the strengths, weaknesses, and requirements of different genetic tests that I could order for a patient someday.

Additionally, and unexpectedly, the class has offered a glimpse of some psychosocial aspects of genetic testing. Spread across several labs, we isolated our DNA from blood samples, amplified a gene of interest with PCR, and confirmed successful PCR products (my high school self would have exploded with excitement). We sent our products out for Sanger sequencing and when our results returned, we combed through the reads for a single nucleotide change. In the gene ABCC11, we were looking for a variant that, when inherited from both parents, is seen in individuals with dry earwax and mildly smelly sweat as opposed to wet earwax and sweat with a typical odor. I was happy to find that not only was sequencing of my sample successful, but I have the genotype of a dry-earwaxed-and-mildly-smelly individual!

When viewing my sequencing results, I felt…excited? Proud? Why did I feel proud? I had not done anything to achieve this genotype and quite honestly, I still felt just as smelly as anyone else. I felt kind of awkward talking about my genotype with my classmates, as if it may make someone feel bad about not having the same discovery in their results. As I reflected on these silly thoughts about my single nucleotide changes, I recognized that this was my first genetic test. I had peered into my genes and, in a little way, pulled back the curtain between my lived experience and my biological blueprint. If such a goofy, insignificant test could provoke an emotional response in me, what psychosocial cartwheels await someone who has just received results of a disease-related genetic test?

While I previously understood that patient distress can be associated with genetic testing results disclosure, I had acquired a new appreciation for the weight of this information. Even when presented with biological "good news”, people may still wrestle with how to relate to their genetic make-up. As a high schooler I held deep respect for the genetic code, and my genetic counseling training has only reinforced the power of this information. I am grateful for opportunities provided by the program like “Genetic Techniques” to craft myself as a knowledgeable, thoughtful, and sincerely considerate provider.

9 Things I Wish I Knew Going into GC Applications - Emily Hrach

The GC application process is a long and stressful one, and looking back there are a lot of things I wish I could’ve told myself now that I’ve been through it. Here are some of those things:

1. You do not have to be a GCA. When I was applying, I felt like everybody else was a GCA. Being a GCA is a great experience, but the vast majority of my classmates never worked as a GCA- it is not a requirement for graduate programs! These jobs are rare and competitive- I sent in dozens of GCA applications and never got an interview. I ended up getting creative with my gap-year jobs and these ended up being hugely rewarding experiences! If you’re like me and are getting rejection after rejection trying to find a GCA job, don’t sweat. There are a ton of other interesting, unique, and inspiring options out there.

2. You also do not have to work for Crisis Text Line. Crisis Text Line is great, but again, it is not the only option out there. If there is a specific cause or organization that you are passionate about, look into local or national organizations dedicated to the topic (I worked at a local center focused on youth housing and it was an incredible experience). Also, think about if you would prefer a text, phone, or in-person experience. Text is definitely the most convenient and accessible while phone/in-person experiences may help you get used to working with people in real time. I personally found in-person crisis management to be extremely challenging, but I learned a lot from the experience. Before setting your mind to one organization, think about what type of experience is right for you, your goals, and your schedule.

3. Check if the school wants your official or unofficial transcript!! I have a friend who forgot to check and spent a lot of money sending out her official transcripts when she didn’t have to. Don’t do that!!!

4. There is no common app. You probably already picked up on this if you’ve started applications, but if you haven’t, here is your warning: each application is separate, so be prepared to fill out a bunch of applications and ask your recommenders to submit letters to multiple different sites. This will take much longer than college applications, so be sure to plan your schedule accordingly (most of the people in my cohort started in late summer/early fall).

5. Don’t let your personal statement read like a robot wrote a resume, and give yourself lots of time to get it right. I’m speaking from personal experience here- my resume-esque first draft was boring, impersonal, and repetitive (they already had my CV!) Your personal statement is a chance to tell a story (not your whole life story, you only have a few hundred words), illuminate your personality, and show admissions directors why you are going to be an awesome GC. Writing an honest, impactful personal statement takes time, so make sure you give yourself plenty.

6. It’s okay to not be a genetics expert. This is what graduate school is for! It’s okay if you can’t name all the conditions on PA’s newborn screening panel or calculate residual risk after a negative CF carrier screening test. Some interviews have questions about cases, but the goal is for the interviewer to see how you think rather than test you. Don’t study for your interviews, but be prepared to think logically and articulate your thought process. Disclaimer: I obviously did not interview at every school, so I don’t know for a fact that this is true everywhere, but this was my experience and the experience of everyone I have talked to :)

7. Interviewers are really just people. Seriously. I actually had a lot of fun in my interviews. Don’t get me wrong- it was super nerve-racking, but I ended up having a lot of really informative and interesting conversations. Remember that you are talking to real people who do this job, at least in part, because they enjoy talking to students. You talk to people everyday, and interviewers are just more people to talk to. Take a deep breath, you can do it.

8. Have a couple really solid answers to common interview questions prepared- each school will ask different questions, and it’s going to be impossible to predict all of them. Some questions, however, are pretty standard (this is true for job interviews, too!) You’ll probably get questions like “tell me about yourself” and “why genetic counseling”. Take some time to think about these questions and find honest answers. If someone asks why you want to be a GC, you’ll probably want an answer that goes beyond just saying that you like science and helping people- dig deep and figure out why you really want to do GC. I’d recommend practicing your responses to these kinds of questions in advance (Katie Lee CGC on YouTube has some really good videos about this).

9. All the cheesy ones- don’t focus on what other people are doing, take care of your mental health, and remind yourself that this experience does not define you. Think of the things that have helped you get through stressful periods in the past and do those things again. Take deep breaths, prioritize your sleep, don’t be afraid to ask for help from your loved ones and/or a professional. Good luck, you’ve got this!

Genetic Counseling Assistant Experience - Grace Waldow

I work as a genetic counseling assistant (GCA) at the Children’s Hospital of Pittsburgh, and I think this experience has been one of the most formative in my decision to pursue genetic counseling. I went to the University of Pittsburgh for my undergraduate degree and graduated in 2022, and then began my time as a student in the genetic counseling program here at Pitt the same year. I have worked as a GCA since October 2020 and have had many different roles within my position, as it has evolved with the needs of the clinic I work for. 

Originally, my responsibilities were very similar to that of a traditional GCA role. The clinic included five genetic counselors, and so I helped them call patients about insurance authorization, obtain medical records, mail letters and scripts, and track test results. In addition, the genetic counselors also had a utilization management role. Utilization management involves working with providers and genetic testing labs to ensure that appropriate genetic tests are ordered and that these tests are cost and time efficient. As a GCA, this means that a critical part of my role includes managing a database of genetic testing ordered in the hospital, and tracking certain types of tests for results and subsequent disclosures. Over time, the clinic has been restructured and now primarily has a laboratory role. Since I mostly work with the genetic testing database, I am able to be a part of several different research projects through the clinic. For example, I researched hearing loss panels ordered through the clinic and presented these findings with a genetic counselor to the Audiology department at the hospital. Currently, I am helping in a project that looks at the utility of whole exome sequencing in an inpatient setting. I hope to continue my work in the utilization management space, and am planning to pursue a related project for my thesis. 

I have learned a lot and gained many skills from my time as a GCA. Before working at the Children’s Hospital, I had limited experience interacting with patients or genetic counselors. However, I have now had the opportunity to talk to hundreds of patients and shadow several genetic counselors in different types of appointments. In addition, I have learned a lot about genetic testing methods and have become familiar with genetic tests that are commonly ordered in a pediatric setting. Working as a GCA is also interesting because I am able to see and experience parts of a genetic counselor’s job outside of direct patient care – and there are a lot! For example, genetic counselors work with insurance companies to get testing approved for their patients, coordinate genetic testing with providers, work through challenging cases with their fellow genetic counselors, and lead research projects about genetic testing. 

Although having a work position as a student is a considerable time commitment, it is an invaluable addition to the process of becoming a genetic counselor. My time as a GCA has allowed me to gain confidence in talking to patients, learn how to navigate clinical information, and nicely complements my coursework where I learn about genetics and genetic counseling. I am excited to continue in this position, and would recommend the experience to anyone interested in the field!

Entering Grad School with Different Work and Education Background - Gabi Slizewska

 

Applying to graduate genetic counseling programs can be incredibly overwhelming. It is a very lengthy, expensive, and stressful process. Unfortunately, spots are limited and many qualified candidates are unable to secure a spot. With all this in mind, it’s easy to understand why many prospective students focus on perfecting their resume. I remember scouring the internet for the best resources and hounding current genetic counseling students for advice. However, my resume was far from perfect, and I couldn’t help but worry that I was never going to match with a program. Now, as a first year student, I am finally starting to realize that a good candidate does not have to fit a certain mold.

We all need to meet certain academic requirements to qualify for a program, but you don’t need to have all A’s. In fact, it’s even okay if you failed a class or two the first time around. I did! Just because you struggle with a certain class, doesn’t mean you’re not intelligent enough or cut out for this field. STEM courses are difficult for many of us, and life can sometimes make academic success even more challenging.

I also remember focusing on checking off the boxes in terms of experiences; getting the right job, the same opportunities, and the same experiences as everyone else. One example of this is research. The truth is, I came into this program with no research experience. I was very open about this during interviews, and during the start of the program. The program leadership has been very understanding about this, and I’ve received a ton of support and guidance as I began brainstorming ideas for my thesis project.

Another area where I struggled was in obtaining counseling experience. Unfortunately, with the onset of the pandemic, many in-person opportunities became scarce and online opportunities became over-saturated with volunteers. There are a few organizations that are particularly popular with applicants, but they became exceedingly difficult to get in touch with. It is perfectly fine to look for other options and to explore opportunities that are local to you! Having unique experiences may even make you stand out more against other applicants!

Lastly, I spent a lot of time searching for a GCA position. It seemed that just about every current student I talked to had one. I was very anxious about the fact that I did not have this experience on my resume. What I learned is that a GCA position is a very good experience to have on your resume, but it is absolutely not necessary. There aren’t a lot of these positions available, and even fewer in rural areas. Program leadership knows this! There are lots of other ways to learn more about the field. Talk to genetic counselors, talk to current students, talk to program leadership, and look into online resources. There are also plenty of other job opportunities that relate to patient care, counseling, or education. Not to mention, it is perfectly okay to work in an unrelated field, as long as you can learn something applicable to genetic counseling. This can even be something like leadership or communication skills!

What I want to convey is that it really does not matter if your resume looks just like mine or any other genetic counseling student’s. Focus on doing things that you are passionate about, and make sure that passion comes through in your personal statement and during interviews. I was so happy to meet my cohort and learn that they all came from different backgrounds and with many unique experiences. We all have our own strengths and weaknesses, but what we discovered is that we all complement each other. There really is some sort of magic involved when this program’s leadership makes their choices during the match process!

Faculty Spotlight: Christine Munro

Christine serves as the Director of Recruitment and Admissions at the Pitt Genetic Counseling Program and as a genetic counselor with the UPMC Primary Care Precision Medicine Clinic.  We asked her some questions about her and her role, and here are her responses.

1. How did you find out about genetic counseling?

During my undergraduate degree, genetic counseling was briefly brought up in a genetics class. After doing some research on my own it truly felt like the perfect merge of my interests but I had always thought I would apply for a public health degree as my next step. When I learned of  the University of Pittsburgh’s dual degree option in Public Health Genetics and Genetic Counseling, I could not have been more excited and knew that is where I wanted to land.

2. What does your current role in the program entail?

My current role is Director of Recruitment and Admissions for the Genetic Counseling program. I lead the holistic applicant review process with the program’s admissions committee and develop recruitment strategies. I am also involved with students through research mentorship and I work as a clinical site supervisor in our Primary Care Precision Medicine rotation.

3. What made you decide to work to develop the Primary Care Precision Medicine Clinic?  What is the mission of this clinic?

The Primary Care Precision Medicine clinic was created to bridge a current gap in genetic service delivery. There is an increasing awareness and uptake of genetic testing and Primary Care clinics find themselves at the forefront of genetic risk assessment and appropriate triage but physicians have expressed a lack of confidence in their genetics knowledge. Genetic counselors (GC) embedded in primary care is one potential solution to scale genetic services. When we take a look at the services that primary care physicians (PCP) provide in areas like preventative care, prescription management, routine screenings, prenatal care, newborn care, and chronic disease management, there is a great deal of overlap and connection with subspecialty genetic services such as risk assessment, pharmacogenomics, cancer risk assessment, prenatal carrier screening and testing, newborn screening, and polygenic risk scores. This highlights the potential for a complimentary relationship between PCPs and GCs. Additionally, individuals will have genetic needs throughout their lives and a single genetics visit is unlikely to be enough. There are multiple points where an individual might require genetics care and this unique clinic model allows for that follow-up loop. Lastly, we know there are barriers to appointments and disparities in referral practices. This clinic model has the potential to decrease logistical barriers, meet patient’s where they are at, ensure appropriate referrals for all, decrease wait times for specialty clinics and reduce costs for specialty appointments. The goal of this clinic is not only to scale genetic services but to improve equitable access to these services. I am very proud to work with such an amazing and innovative team. I am also so happy our genetic counseling students get an opportunity to rotate with us in this unique space.

4. What does your role in clinic look like?

In my clinical role, I work with a multidisciplinary team seeing patients for a variety of indications. We also work on research projects and genetics education initiatives for physicians.

5. What is your favorite part of your job?

It is really difficult to choose one “favorite” thing about my job so I will list a few: the field of genetics is constantly evolving which is stimulating,  the ability to mentor students and witness their progress and contributions is so rewarding, and lastly the opportunity to guide and advocate for patients and families during a difficult time is extremely fulfilling work.

Michelle Takemoto Leadership Seminar Reflections

Michelle Takemoto, a genetic counselor with the Hawaii Department of Health and MGPN coordinator, spoke to our students on November 4 about a broad range of topics as part of our Leadership Seminar Series.  Our students reflected on her talk:

I am thankful that I had the opportunity to meet Michelle and listen to her phenomenal presentation about public health genetics. It was great to learn about her own personal journey to genetic counseling and how she became a leader in the field. From working on projects that increase accessibility to genetic services for underserved populations to starting the Minority Genetic Professionals Network, I am incredibly appreciative of all the work she has put in to advocate for marginalized identities. From one member of MGPN to another, thank you for providing me with a community of shared experiences and a sense of belonging in the profession! - Leann To

I am so grateful that we all got to meet Michelle for our leadership seminar! It was interesting to hear how her work ties in both genetic counseling and public health, and learn more about the genetics services in Hawaii. As a member of the Minority Genetics Professional Network, I was excited to learn more about her role in the creation of the organization and how she envisions its future. It was inspiring to see how passionate she is about serving underserved populations and advocating for underrepresented minorities in genetic counseling. I feel very lucky to have had the opportunity to talk to one of the leaders in the field, and I am looking forward to hearing her speak at NSGC! - Impana Shetty

It was so awesome to hear from Michelle for our leadership seminar! She really brought forth a lot of barriers that need to be addressed in the field of genetic counseling, but also talked a lot about the intersection between public health and genetic counseling. It was wonderful to hear from a GC who plays a role in her local public health initiatives, which as a dual degree student was so inspiring because she is doing the dream that so many dual degree students want to accomplish. She was so real with us about our goals and I honestly loved her advice of making space for ourselves in these public health spaces, because GC’s are needed there. It was fantastic to have Michelle come speak with us and I cannot wait to hear her talk at NSGC. – Samantha Runa

Meeting Michelle has been one of the biggest highlights of my graduate career thus far. She shared not only her immensely important perspectives on inspiring and growing inclusivity within the field, but also connected with us all on the importance of the interplay between public health and genetics (specifically, the importance of building relationships). This talk could not have come at a better time in my journey to becoming a genetic counselor. I felt like I learned so much about how to better expand my own opportunities as well as how to become involved in making the field more equitable. Her talk at NSGC is going to be incredible, and I’m so thankful to have gotten to know her on a more personal level. - Ariel Breeze

What a refreshing experience. I appreciated the straightforward and genuine presentation given by Michelle, having firmly planted feet in both public health and genetic counseling worlds. It was a privilege to speak with her about inequities in healthcare, and it has lit a fire in myself to do my part. I am looking into the Minority Genetics Professional Network to connect with other professionals and hopefully make a difference. Thank you, and I look forward to seeing you at NSGC! - Daniel Brennsteiner

I appreciated hearing the perspective of a genetic counselor outside the "bubble" of Pittsburgh.  Hearing about Michelle’s journey to genetic counseling and her passion for the field was energizing.  She touched on the intersection between public health and genetic counseling, which is helpful and inspiring to a dual degree student like myself.  Newborn screening processes and accessibility of testing sites/clinics are things we may take for granted in places like Pittsburgh.  Working on an island like Hawaii, Michelle has had to be flexible and advocate for patients and counselors alike.  Hearing first-hand how I can be a leader in the field using both my degrees adds focus to a world of opportunity. - Megan Zieber

Michelle gave a wonderful talk in Leadership Seminar that included her role in MGPN and the incredible work they do to connect underrepresented minorities in the genetic counseling profession to each other.  She addressed some important barriers that genetics services in Hawaii face and described some ways to move forward.  I appreciated the time she took to speak with us at different points throughout the day.  She was so down-to-earth, and I cannot wait to hear her speak at NSGC!  - Rebecca Oberschmidt

It was wonderful having Michelle as our Leadership Seminar speaker. Her talk was compelling and motivating. I enjoyed hearing about her roles with MGPN and Regional Genetics Networks. Most interesting to me was her work in telegenetics training and increasing access to genetic services. Michelle and I had a conversation after her talk about some of the many barriers to genetic services, including the ways in which telegenetics is not always the answer. Looking forward to hearing more from Michelle at NSGC and in the future! - Madalyn Charnego 

Student Spotlight - Daniel Brennsteiner

Returning to school as a graduate student? Feeling a little rusty? Perhaps you have fresh notecards kept safe and pristine in a location you forgot all about. Locate your supplies and gather your courage. Strap yourself in because grad school is a long rollercoaster ride with many bumps, turns, and fancy new inversions. This blog post contains pieces of advice for incoming genetic counseling students who share similar concerns of transitioning to grad school after having gap years.

For context purposes, I am currently a dual degree-seeking student, projected to graduate this year with both an MS in Genetic Counseling degree and an MPH with a specialization in Genetics degree. I took five years off after undergrad due to various reasons, one including a profession change. That story, however, is for an entirely separate blog post.

First off, you are not alone. Feeling nervous about returning to school with or without gap years is perfectly normal. Though genetic counseling programs tend to be smaller, ranging between 3 and 30 students, someone in your cohort will relate to you on some level. The field of genetic counseling is filled with professionals that would readily hear your trepidations. Debrief with them. I would recommend reaching out to your fellow genetic counseling students and leadership. Allow them to listen and share with you their own perspectives and advice surrounding this major lifestyle adjustment.

Those preserved notecards will come in handy, be sure of it. However, be prepared to adapt to your graduate level courses and adjust accordingly. What do I mean by that? Times have most likely changed since you walked across the stage dressed in your cap and gown. Studying methods from previous undergraduate courses may not be as effective now. Anecdotally, I can remember holding on to my archaic handwritten notetaking ways throughout my first year as a grad student, exhaustively attempting to keep up with energetic genetic professors and boundless PowerPoint presentations. Let go of your pride and adapt your studying techniques to best fit each class and do this early. The sooner you adapt, the easier your life will be. Second-year genetic counseling students will have their own thoughts on which methods worked best.

Adapting to the workload of a graduate student is just as important, and time management is key. You have an advantage. After undergrad, you most likely entered the work force bright eyed and bushy tailed. Treat genetic counseling school like a 9AM-5PM job. You know what it’s like to wake up, make breakfast, work, eat lunch, work through the tryptophan, and head home. Going back to sporadic college schedules might include having odd breaks throughout the days and evenings. Temptations to nap throughout these days and putting work off will be thrust upon you. Sticking to that workday mindset can help maintain healthy sleep schedules and sanity while managing your workload and life balance as a genetic counseling student.

Lastly, imposter syndrome exists, and it exists in everyone. That feeling of doubting your own abilities can overtake your mind and consume. Knowing that others in your cohort experience similar thoughts can help normalize your own. Share your thoughts and feelings, you are in safe company. Remember, getting into the genetic counseling program is proof enough that you are fully capable of succeeding in your program and afterwards as a practicing genetic counselor. Hold on to that achievement - you can do this!