So You Want to be a Genetic Counselor?

Q: What type of personality do I need to become a genetic counselor (GC)?

A: You are a calm person who is able to put people at ease. You are both empathetic and sympathetic, and you enjoy working with people. You are able to impart complex information, and you are capable of dealing with the strong emotions (e.g., extreme sadness or anger) it may elicit. You are non-judgmental and are able to keep your opinions to yourself, even when you feel very strongly about a particular issue. And you must be pro-choice.

Q: What type of skills do you need?

A: GCs are like detectives trying to solve mysteries: you must be very observant and able to search for any hidden clues in the information patients give you, both verbal and written. You must be able to work independently, as you will have to research disorders and new tests that you are unfamiliar with. The majority of the time, this research will require using a computer. You must understand complex medical and scientific information and, most importantly, impart sensitive information to your clients in a way they are able to comprehend. Above all, as every day is different, you must be adaptable.

Q: Snapshot of a Genetic Counselor

A: The following description was composed using the Professional Status Survey 2002, conducted by the National Society of Genetic Counselors (NSGC) in the summer of 2002. There were 856 surveys submitted, representing 53% of NSGC's full members.

If you were to meet a GC today, she would likely be a Caucasian (94%) woman under the age of 40 (71%) with less than five years experience in the field (51%). She has a MS/MA in Genetic Counseling (71%) and is working in a university medical center (43%). She counsels patients (87%) and sees an average of eight new patients and three returning patients each week. Her primary role is clinical (86%), but she also teaches and supervises students (56%). She works full-time hours in one position (73%), but regularly logs overtime (76%), averaging about six hours per week and doesn't receive compensation for it (66%). Her salary is US$50,130 and, fortunately, it doesn't depend on grant funding (66%). She is satisfied with her job (83%), specifically the autonomy it affords (85%) and the interaction with other clinicians (77%).

Q: Where do genetic counselors work?

A: Most GCs work as a member of a healthcare team in traditional environments such as university medical centers, laboratory settings, or in private practice. However, GCs can be found in such diverse environments as pharmaceutical companies, public health departments, and health consulting.

Areas of specialization include prenatal, pediatric genetics, cancer genetics, adult genetics, neurogenetics, public health, and molecular/cytogenetic testing.

Q: What is the relevance of accreditation?

A: When considering where to apply, you should keep in mind that in order to sit the ABGC certifying examinations, you must have attended an ABGC-accredited program (note: Recognized New Program Status qualifies as being accredited). This is not the case, however, for Canadian certification with the Canadian Association of Genetic Counsellors (CAGC). The CAGC requires that you received your Master's or PhD from "a program established for the training of genetic counselors." Nonetheless, beware of non-accredited diploma mills. (Also see Accredited Schools – What Are They?.)

Q: How difficult is it to get accepted into a training program?

A: Class sizes of Genetic Counseling programs are extremely small. On average, Genetic Counseling programs accept six candidates per year. Although some programs accept up to eight candidates, some accept as few as four. As a result, competition can be fierce, and it is likely that a qualified candidate will not get accepted into their first program of choice.

Q: What kind of background/experience would help me get accepted into a training program?

A: GCs have a variety of undergraduate degrees including genetics, biology/biosciences, nursing, psychology, and social work. Successful applicants to the program have had diverse work-experience such as being nurses, librarians, public health education specialists, molecular biologists, teachers, fundraisers, and counselors. Most GC programs require at least some experience in a counseling setting.

In order to determine if genetic counseling is the correct career choice for you, the NSGC recommends you shadow or intern with a GC. If you're not able to do so, however, you should at least try to interview one or more GCs.

Q: What does the application process involve and what are the general application requirements?

A: General applications requirements include:

1. Two completed application forms: Usually one to the Department of Graduate Studies and one to the program itself.

2. Baccalaureate degree from an accredited university:

• Science prerequisites that may be required: biology, statistics (or another mathematics course), genetics, chemistry, biochemistry, etc.

• Social science prerequisites that may be required: developmental psychology, abnormal psychology.

3. Transcripts: Of all relevant undergraduate courses.

4. GPA/GRE scores:

• Most programs have a minimum GPA requirement of 3.0.

• Most programs require the general GRE exam and suggest a GRE score in the 70th percentile; some programs also require specific specialty GRE exams (e.g., biology).

5. Counseling experience:

• Most programs require a minimum of one year of experience working in a counseling environment (e.g., domestic violence shelters, hotline services, clinical genetics settings, and homeless shelters).

• The counselor experience should include some direct contact with patients/clients.

6. Personal statement or essay: Generally answers the question, "Why do you want to be a genetic counselor?"

7. Letters of recommendation: Most programs ask for three letters of recommendation.

8. Additional information: Some programs require submission of a résumé detailing relevant work experience.

9. Interview: Most programs invite candidates to in-person interviews; interviews are generally held between February and April.

These general requirements are subject to change. For information about a specific program for a specific year of enrollment, contact the school directly. The application deadline for most programs is February 1st of the year for which you are applying. Some program deadlines, however, are as early as mid-January. All ABGC-accredited programs have agreed to notify applicants on the same day, which usually falls in late April or early May.

Q: How long is the course and what does it involve?

A: Most Master's of Genetic Counseling programs are two years in length and include the intervening summer. Programs generally include theoretical classroom work, laboratory work, research experience (usually in the form of a research project/thesis), and clinical placements in ABGC-approved medical genetics centers.

Coursework encompasses both the sciences (e.g., genetics, disease prognosis, treatment) and the social sciences (e.g., psychology, ethical issues, counseling, bereavement).

Q: What are my chances of getting a job after I finish the course?

A: The genetics field is rapidly expanding, and the need for genetic counselors will continue to grow. In the Professional Status Survey 2002, conducted by the NSGC, in the summer of 2002, 73% of respondents were employed in one full-time position. Less than 2% of respondents reported being unemployed, and, of these, unemployment was due to family/personal reasons or returning to school.

Q: 12 What are the certification requirements in the US, and how do I become certified?

A: In the United States, certification is through the ABGC. Applicants must first apply for Active Candidate Status; once Active Candidate Status is achieved, candidates then sit two certification examinations, which are held every three years.

The certification process:

First you must apply for Active Candidate Status, which requires:

• A graduate degree in genetic counseling from an ABGC-accredited training program.

• A logbook showing participation in 50 supervised cases (logbook must adhere to the requirements for the year in which you are applying).

• A non-refundable application fee.

Once approved for Active Candidate Status: ABGC certification requires the successful completion of two examinations – a general examination and a specialty examination in genetic counseling. The general exam consists of 150 multiple choice questions and is developed and administered by both the ABGC and the American Board of Medical Genetics (ABMG). It is three hours long and is taken by certification candidates of both boards. The specialty exam in genetic counseling consists of 125 multiple choice questions and is developed by the ABGC only. It is 2.5 hours long and is taken by only those candidates seeking certification in genetic counseling. Both exams are computer-based and are administered on the same day.

Candidates have two consecutive exam cycles within which to successfully complete both exams. Therefore, if a candidate fails one or both of the two exams or withdraws from one or both of the two exams in one cycle, they can retake the failed or missed exam in the following exam cycle only. If they are unsuccessful or withdraw again, they must reapply for Active Candidate Status and start the process over.

ABGC certification is valid for a maximum of 10 years. There are two pathways to obtaining recertification:

1. Reexamination Pathway:

• Requires submission of specific applications, but does not require submission of a logbook or letters of recommendation.

• There is no application fee, but there is an examination fee.

• Both certification examinations must be passed in the same examination cycle.

2. Continuing Education Pathway:

• Submission of documentation showing the accumulation of a total of 25 CEUs (one CEU is equivalent to 10 contact hours) over the 10-year period following certification.

Q: 13 What are the certification requirements in Canada, and how do I become certified?

A: In Canada, certification is through the Canadian Association of Genetic Counsellors (CAGC). Applicants must apply to sit the certification examination (see the CAGC Certification Examination Candidate's Handbook for certification information and application forms), which is held every two years. The frequency of examinations can be altered, however, depending on the anticipated number of applicants.

There are two pathways for obtaining certification:

Pathway A:

• Master's or PhD from a program established for the training of genetic counselors.

• Case logbook listing 50 genetic counseling cases. The logbook must specify the roles the candidate performed in each case.

• Two letters of recommendation. Referees must be certified by the CAGC, ABGC, ABMG, CCMG, or the Royal College of Physicians and Surgeons of Canada (Genetics).

The CAGC can grant eligibility to applicants who do not meet the education requirements as per Pathway A. Special Consideration candidates must submit a formal application and the Special Consideration Supplement Forms and should have at least a Bachelor's, Master's, or PhD in a related field such as nursing, social work, or public health. Also, candidates should have worked at least one year of the past three years in genetic counseling in a medical setting.

Pathway B (Special Consideration):

• All documents/fees listed in the application checklist.

• Copy of the most recent diploma/degree in a field closely related to genetic counseling.

• Special Consideration Supplement (Forms A and B).

• Official transcripts documenting coursework in human genetics and behavioral sciences (e.g., counseling theory, crisis intervention, psychological assessment, grief/bereavement counseling, interviewing and counseling techniques, psychosocial/ethical/cultural issues).

There is a C$50 application review fee and a C$350 examination fee for either pathway.

The certification examination consists of 175 to 200 questions.

Scoring is determined not by candidates being compared to each other, but, instead, being compared to a set score determined by the CAGC.

Certification is valid for 10 years; recertification requires proof of continuing education and continuing practice credits.

Want more information about Genetic Counseling?

• National Society of Genetic Counselors

• American Board of Genetic Counseling, Inc

• Canadian Association of Genetic Counsellors

Read about genetic counselor, Shelley Kennedy.

So You Want to be a Genetic Counselor?

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Lee Ann McGillivray

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