Trailblazing Genetic Counselors: Episode 12

This is the twelfth installment in our series, “Trailblazing Genetic Counselors”, in which we highlight genetic counselors who are pioneers in the field. Genetic counselors are health professionals with specialized graduate degrees and experience in the areas of medical genetics and counseling. Genetic counseling is a rapidly growing field offering professionals a wide range of opportunities, which we explore in this series. Learn more on the National Society of Genetic Counselors’ (NSGC) website, aboutgeneticcounselors.com.

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In this episode, we interview international genetic counselors to gain insight on the experience of genetic counselors around the world. 


What are some of the challenges you face practicing in India?

Awareness and acceptability of genetic counselors in medical practice is the biggest hurdle working in a developing country like India. Doctors are either unaware of the importance of genetic counselors or some they do not want anyone to challenge their opinion in patient diagnosis. However, the younger medical generation is supportive enough to understand genetics and accept it in routine OPD practice.

How many genetic counselors do you work with directly?

I work with 4-5 Genetic Counselors in my department directly.

Are there enough genetic counselors to meet patient demand?

No, we need more.

Do you collaborate with genetic counselors who are not local?

Yes, in certain outstation cases where we cannot make frequent visits we collaborate with counselors that are from the same locality. This actually helps in saving our time as well as better counseling as the patient feel more confident when they have someone from their own cultural group to help them out.

Are your/patient's resources limited?

Yes.

How did you become a genetic counselor?

With an aim to become unique, to stand in society I opted for human genetics. Gradually I came across so many practical exposures, I felt that in a country like India where medical attention is a prime necessity in so many departments we have less doctors and lesser genetic counselors for patient support. This triggered me to be a professional genetic counselor so that I can be helpful to people and create awareness about genetic conditions.

What projects/research you involved in?

Currently, I am working on the hereditary cancer project where we are targeting the family members of a cancer patient to undergo hereditary gene testing and making them aware of the importance of genetics in cancer etiology.

Do you specialize in any subfield(s)?

I am right now learning genetic counseling in neurogenetics abnormalities.

Do you serve on any committees/organizations?

I used to work with the Red Cross Society - counseling for B-Thalassemia patients, but as I have moved to a new location I am not serving anywhere currently.


What are some of the challenges you face practicing in Australia?

Lack of awareness of what genetic counselors are and what we do. Lack of resources, many hospitals employ genetic counselors but not enough. Our waiting times in the public sector are often very long and this can be challenging. As is the trend in North America, more and more genetic counseling positions are opening in the private sector for large companies or genetic counselors are working in more non-traditional genetic counseling roles like in research or in labs. One of our challenges is how to become certified. Certification is relatively easy to access if you are working in a public hospital genetic counseling role; however, it is hard to complete if you work in other areas of genetic counseling. Our research has shown that genetic counselors working in more non-traditional roles in Australasia still want to be able to access certification and become board certified, but this is difficult with our current system.

How many genetic counselors do you directly work with?

I live in a state in Australia called Victoria. Melbourne is the capital and there are about 100 genetic counselors in Melbourne. I work in a mid-size public genetic counseling unit with about 8 other genetic counselors. In my private practice, I am a sole practitioner but liaise with other private genetic counselors quite regularly. About 4 times a year we have a statewide genetic counseling meeting which usually about 30 to 40 genetic counselors attend.

Are there enough genetic counselors to meet patient demand?

There aren’t enough genetic counselors to meet patient demand. Genetic counseling is mainly still a discipline based on public health although more and more genetic counselors are being employed in the private sector. Currently, there aren’t enough genetic counselors to apply for the jobs currently available. In some centres, they are employing genetic counselors still studying at university as no one else is available. That is one of the reasons I went into private practice. I love public health. I am a public health advocate and genetics works fairly well in the public sector. However waiting times are still long. My private patients who are happy to pay appreciate that I can see them much sooner than in the public sector and that I am able to see people out of work hours.

Do you collaborate with genetic counselors who are not local?

I have been working in genetic counseling for over 14 years and know most genetic counselors in Australasia. I try to attend at least one genetic counseling conference each year and enjoy the chance to chat, network and mingle with genetic counselors when I can. In the past 5 years, I have also attended 3 genetic counseling conferences in the UK and have only just returned from the first World Congress on Genetic Counselling in Cambridge, England. In 2015 I attended the Asia Pacific Conference in Human Genetics and became a founding member of the Professional Society of Genetic Counselors in Asia and we published an article about the workshop in the Journal of Genetic Counseling this year.

Are your/patient's resources limited?

In my public sector job, there is a genetic testing budget, which is limited. There aren’t enough genetic counselors working, so our resource of time is limited. Our manager recently calculated that we are two genetic counselors lacking in the amount of work that we have. We have criteria that clients need to meet to have state-funded genetic testing. Clients who don’t meet these criteria are welcome to self-fund testing in the public sector. In Australia, like most other places around the world, we have seen the cost of genetic tests plummet and more and more people choosing to self-fund a test. In the private sector, people’s resources are greater.

How did you become a genetic counselor?

I found out about genetic counseling when I was 14 and my science teacher left teaching to enroll in the first genetic counseling course in Australia. I really enjoyed learning about genetics in high school science class and since this time I wanted to be a genetic counselor. After school, I was an exchange student to France and then enrolled into one university, changed degrees after a year then changed to another university and changed majors and picked up a diploma on the side all before finishing undergrad and starting grad school. It wasn’t the most linear path to genetic counseling. I also changed my mind and considered other allied health professions, but I went full circle and came back to genetic counseling. Genetic counseling training in Australia before 2008 was a one-year graduate diploma, which I completed at The University of Newcastle in 2004. After working full time for a year after finishing this course I enrolled in our certification program in 2006 and became board certified in 2009.

What projects/research you involved in?

About two years ago I had a desire to do more study so I enrolled in a Masters of Applied Positive Psychology at The University of Melbourne. It was great to study such an interesting, growing and positive discipline and with a genetic counseling mindset. I regularly supervise masters of genetic counselling students. I currently have a Lynch syndrome case report that I have written with colleagues and need to publish. A few years ago I conducted some research into compassion fatigue and mindfulness in Australasian genetic counselors, which I also need to publish. In my private practice, I hope to employ some research genetic counselors to help me in my quest to become more involved with genetic counseling research and to publish more.

Do you specialize in any subfield(s)?

I am really proud and feel really lucky that I am a great generalist. I started my genetic counseling career in an outreach position where when the phone rang, it really could have been anything. I obtained my genetic counseling certification in general genetic counseling without specialising and have experience in general, prenatal, cardiac, familial cancer and neurogenetic genetic counseling. I also have many years of working in large tertiary public hospitals, but I have worked in community health and private practice.

Do you serve on any committees/organizations?

I have been both a state representative and the treasurer for the Australasian Society of Genetic Counsellors (ASGC) in the past. I am a mentor in a mentoring program at the University of Melbourne. I also hope to become more involved with the new genetic counselling course, which is starting in a year or so at the University of Technology Sydney. I am also working with the Local Organising Committee of the Human Genetics Society of Australasia’s (HGSA) conference next year which will be in Sydney in August.


Check out all other episodes of our Trailblazing Genetic Counselors series here.

Want to recommend a genetic counselor that deserves the title of Trailblazing Genetic Counselor? Tweet us at @mygenecounsel or email at ellen@mygenecounsel.com!