Preparing Students for a New Era in Genetic Counseling

By Gail Short

1113 reeseUAB genetic counseling students such as Rachel Reese are part of a rapidly growing field that rates high in opportunities and job satisfaction. Ever since high school, Rachel Reese has wanted to be a genetic counselor. "I loved science, but I knew I didn't want to be in a lab all the time," she says. "I liked the challenge of having to be a knowledgeable health care provider and an empathetic listener who helps people make tough decisions."

Once she found her career match, Reese pursued it with a passion, majoring in biomedical science as an undergraduate while shadowing genetic counselors and working at a local crisis center.

A Field in Flux

The Memphis native knew there were no genetic counseling programs in her home state. Researching online, she heard "great things" about UAB's Genetic Counseling Program, including its interdisciplinary teaching philosophy and inclusion of career-building skills, such as courses in Spanish and phlebotomy.

The two-year program is based in the School of Health Professions and includes faculty from the School of Medicine and School of Education. Since it was launched in 2010, the program has attracted highly motivated students such as Reese from across the country, says interim director Christina Hurst, M.S., CGC. The program currently accepts six new students a year, which is comparable to class sizes of other programs across the country, Hurst says.

Job prospects are strong, Hurst adds—a fact U.S. News and World Report noted when it listed the profession among its "10 Hidden-Gem Careers for 2013 and Beyond." Medical advances are leading to an explosion of new genetic tests, along with a subsequent demand for professionals to interpret the complex results to patients—and to their physicians, who often don't have time to stay abreast of the latest advances in the field.

sm genetics-infographicGet the lowdown on a genetic counseling career—from starting salary to job satisfaction—in this infographic. Click the image to expand."There is so much more testing now than there was even a year ago," Hurst says. "We now have noninvasive prenatal testing for certain conditions early in pregnancy," for example. Tests on the market can identify risk factors for common diseases such as diabetes, dementia, and macular degeneration. And techniques like whole exome sequencing can reveal a massive amount of genetic material at once, "where we used to just test a single gene at a time," Hurst says. All that information, she emphasizes, "has to be interpreted and reported in the context of the patient's medical and family history."

Foundation for the Future

During their first year in the program, genetic counseling students at UAB get a rigorous education in the fundamentals of genetics, learning about the inherited nature of everything from breast cancer and diabetes to sickle cell anemia and cystic fibrosis. They also participate in a two-week laboratory rotation to learn how genetic tests are performed and how results are generated. Reese says the curriculum gave her the foundation she needed for her clinical rotation at a Memphis cancer care center last summer.

Meagan Cochran, M.S., CGC, a 2012 graduate of the program, says she was most impressed with the caliber of scientists who taught classes. These faculty include Bruce Korf, M.D., Ph.D., chair of the UAB Department of Genetics and a leading expert in the rare inherited disorder neurofibromatosis, and Ludwine Messiaen, Ph.D., director of the UAB Medical Genomics Laboratory. "Experts at the height of their professions were the ones giving us our daily lectures," Cochran says.

Learning to Relate

Besides their science classes, first-year students take courses in the School of Education's Counselor Education Program, including hands-on classes with the school's Community Counseling students. With volunteers playing the role of patients, the students gain the skills needed to explain complex test results in layman's terms—and with empathy.

"The genetic counseling students come to us with a very strong background in the science of what they're learning," says Larry Tyson, Ph.D., program coordinator for the Counselor Education Program. "We add to that knowledge additional tools that help them communicate better with their patients" in what are often "very stressful situations," he says.

In their second year, the students participate in clinical rotations in the Department of Genetics, Children's Hospital, the UAB Women's and Infants Center, and other areas within the medical center.

Close cooperation with UAB's numerous specialty clinics helps students "gain exposure to many rare conditions," says Hurst. "We have students who go to the Huntington's Disease Clinic, the Cleft Lip and Palate Clinic, the Muscular Dystrophy Clinic, and the Adult Down Syndrome Clinic, in addition to the general prenatal, cancer, and pediatric clinics."

New Career Possibilities

The program's interdisciplinary courses include Spanish for Health Professions, Phlebotomy, Research Methods, and Scientific Publications (all offered by UAB's Department of Clinical and Diagnostic Sciences). The skills covered in these courses make graduates more competitive in the job market, Hurst says.

The majority of the program's graduates have gone on to counseling careers. But an increasing number have found employment in nontraditional settings such as diagnostic laboratories, public health programs, and genetic testing companies, Hurst says.

Cochran, for example, works in UAB's Medical Genomics Laboratory, which provides testing for rare genetic disorders for patients around the world. Her duties include reviewing test samples and explaining the results to physicians and other counselors. It is a career, she says, that is always evolving.

"To be constantly learning about new technologies and new disorders is very interesting to me," Cochran says. "There are new diseases and new ways to do the testing. Our lab is constantly in the process of trying to develop new and better tests for these disorders; it's exciting to be a part of it."

Reese, who will graduate in 2014, says she hopes to someday counsel patients at risk for hereditary cancers. "UAB is such a good fit for me because there's so much variety here, and that's invaluable for students," she says. "You see things that many doctors only see once in their careers and things you only read about in textbooks. That's a great opportunity."

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Answers in the Genes

The UAB Department of Genetics provides a wide range of genetic counseling services, including evaluation for hereditary cancer syndromes, recurrent pregnancy loss, family history of a specific genetic disease or syndrome, family history of congenital anomalies and intellectual disability, ethnic-based carrier screening, and prenatal diagnosis of genetic syndromes. Patients whose condition involves a genetic disorder receive testing and counseling to help them understand the meaning of the condition for them and their children.

The Undiagnosed Diseases Program is a new clinical offering designed specifically for patients with extremely rare conditions. A panel of UAB specialists reviews each case. Learn more about the clinic and referral process here and in this story from UAB Media Relations. To contact the clinic, call (866) UAB-4DNA or (205) 934-4983.