About Genetic Counselors

Genetic Counseling Prospective Student Frequently Asked Questions

Disclaimer: This list of questions was put together by the students of the Student/New Member Special Interest Group of the NSGC. The members of the SIG are current students or new genetic counselors. The answers to these questions are not official positions or statements by the NSGC, program directors, or other professional genetic counseling organizations.

Choosing Genetic Counseling as a Career

Why go into genetic counseling?

There are many paths to genetic counseling, and the motivations for choosing genetic counseling are diverse. Many people start with an interest in genetics, but want something more personal than laboratory work. Some individuals desire to be in the medical field but do not think medical school is the best fit for them. Other students are drawn to the counseling side of genetic counseling, and enjoy the unique topics that genetic counselors cover (e.g. facilitating decision-making, reducing guilt, grief and bereavement, etc.). Other reasons for choosing genetic counseling include an interest in clinical research, genomic technologies, patient advocacy and education, and the desire to be in a field that is always changing!

What do genetic counselors do and where do they work?

Due to the rapid development of genetic technologies and the expanding need for genetic counselors, genetic counselors can be employed in a variety of settings. Many counselors work in the clinic providing face-to-face counseling to families, and some provide counseling on the phone or via video conferencing. Other counselors work in the clinical labs that provide genetic testing, writing and interpreting test results and answering questions for physicians, other genetic counselors, and patients. Roles that genetic counselors take on are constantly expanding. Other examples of settings genetic counselors may work include: government, education, industry, and research.

What training is involved to become a genetic counselor?

Becoming a genetic counselor requires completion of a master’s degree at an accredited genetic counseling program. These programs include rigorous didactic coursework, clinical training, and a research component. Accredited programs can be found here: http://gceducation.org/Pages/Accredited-Programs.aspx. After completing this training, graduates must pass a board examination to become certified. Some states require genetic counselors to have a professional license to practice in that state, and the number of stated with this requirement is increasing. More information about the licensure requirements in your state can be found here: http://www.nsgc.org/p/cm/ld/fid=19.

Genetic counseling degrees seem to have many different names, such as: Master’s in Human Genetics, Master’s in Genetic Counseling, or Master’s in Medical Genetics. Are there any differences between them?

All of the different degree names can be confusing. However, as long as you graduate from a program that is accredited by the Accreditation Council for Genetic Counseling, you will be eligible to sit for the genetic counseling board exam and become a certified genetic counselor. There is no real difference between getting a Master of Science in Genetic Counseling and a Master of Genetic Counseling degree.

Can I do a genetic counseling master’s degree part-time?

Part-time master’s degrees or other flexible attendance options are uncommon. If this is something you are interested in, ask individual programs about their flexibility or willingness to do a part time program.

Do most genetic counseling graduates find jobs after completing their programs?

There is no way to absolutely predict what the job market will be like in the future, but currently there are many more job openings than there are graduates. Genetics is a rapidly expanding field and therefore the demand is growing quickly.

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The Application Process

What undergraduate major is best for applying to genetic counseling graduate programs?

While many applicants have backgrounds in a biology-based field (such as biology, genetics, biochemistry) or psychology, as long as you fulfill a program’s prerequisites, there is no “best” major for genetic counseling. Be sure to check with each program for the most up-to-date application prerequisites.

What classes should I take before applying?

Program prerequisites vary somewhat; some schools require more prerequisite classes than others, but they most commonly include coursework in genetics, biochemistry, psychology and statistics. For the genetics requirement, most schools require that there is a human genetics component to the class you have taken. Please note that at many undergraduate institutions have prerequisites for their human genetics classes, so you may need to take a number of biology and/or chemistry classes before taking human genetics. Be sure to plan ahead! Other classes that may be helpful (or required in some cases) include embryology, anatomy, statistics, and cell biology. Check the website of the programs to which you are applying for the most up to date information on prerequisites.

Where can I find a ranking of genetic counseling programs? Which is the best?

Genetic counseling programs have collectively decided against rankings. The underlying philosophy uniting the genetic counseling programs is that each program has its own relative strengths, but that overall the programs consider themselves equals. It is recommended that prospective students choose programs based on their own intellectual, philosophical, and geographical preferences. All programs have clinical, research, and coursework components, but many programs handle these components differently. Students can research individual programs further in order to decide which programs would suit their needs best.

How does the application process work/timeline?

Application requirements and timelines differ slightly between schools, but generally schools require a personal statement, 3-4 letters of recommendation, and GRE scores. Applications typically open in the fall and close in early winter (December-February). Schools then invite qualified applicants for interviews, which typically take place February-April. Applicants are usually notified of application decisions by the end of April. Check the website of the programs to which you are applying for the most up to date information on application requirements and deadlines.

How many schools should I apply to?

The more schools you apply to, the better your chances are of receiving an interview and ultimately being accepted. However, many applicants are limited by finances, geographic preferences, and time in considering how many schools to which they can reasonably apply. On average, students apply to 5-6 schools, however, some students choose to apply to only a few, while others apply to many more. It is important to apply to schools at which you could ultimately envision yourself.

What experiences should you have before applying to graduate school?

There is no one right or wrong set of credentials to have before applying. Many schools require you to have counseling or crisis intervention experience as well as experience shadowing a genetic counselor. That being said, programs understand that genetic counselors may not always be available for shadowing in an applicant’s location. Having telephone conversations or interviewing genetic counselors about their job may be ways to bolster your experience to the field if shadowing is difficult.

Beyond those, experiences that students have before applying are varied and many. Advocacy work or working with people with disabilities, leadership experience, volunteering, tutoring, lab work and research, working in the healthcare field, holding employment, working with children, or just being involved with things you are passionate about all can be valuable experiences to have. Every applicant is unique and has a different story!

Can I shadow or otherwise observe a genetic counselor? Are there other ways to get first-hand experience with genetic counseling before applying to programs?

Sometimes it is possible to shadow a genetic counselor. It often depends on individual hospital/clinic policies and in following HIPAA regulations. Shadowing a genetic counselor is a great way to become more familiar with the profession and to gain practical experience. There are also alternatives if finding a shadowing opportunity is too difficult, such as having a 1-on-1 meeting or interview with a genetic counselor to ask him/her about the profession and his/her personal experiences. You can find a local genetic counselor through the NSGC website http://www.nsgc.org/page/find-a-gc-search. Some genetic counseling programs and labs have information sessions about genetic counseling that might be helpful as well.

I have a low GPA or low GRE scores. Can I still get into a genetic counseling program?

Applicants are assessed as a whole, and it is entirely possible to have a strong application in spite of a weak area. That being said, areas of weakness should be addressed in your application and you should ideally show evidence of improvement. However, it is important to note that some genetic counseling programs have minimum GRE or GPA requirements so it is best to check with individual program requirements if there are any concerns.

Do I need to complete a subject GRE exam to apply for a genetic counseling program?

Some programs will accept subject GRE scores. However, at the time of this guide being written, no programs require it. A subject GRE exam does not replace a full GRE score. Check with the individual programs to which you are applying for the most up to date information on application requirements and deadlines.

What are some tips for the application process?

Do not procrastinate! Applying takes a lot of organization and you have to send many different pieces of information to multiple schools. The writers of your letters of recommendation need plenty of time to write and mail their letters. Documents may get lost in the mail or end up in the wrong location at the university, so you should consider sending in documents well before the deadline in case something gets lost. Take the GRE early as well so if you aren’t satisfied with your score, you have time to re-take it before applications are due.

What are some tips for writing my personal statement?

Giving yourself plenty of time for revisions, and ask your friends and colleagues to give you feedback. Do not simply regurgitate your resume; this is your chance to tell your story and show your passion for genetic counseling. Use your experiences as anecdotes to reinforce what you are saying, but concentrate more on telling your unique story. Put your personality into it and really let the programs know why you are passionate about the field. Elaborate on how your personal background makes you a good fit not only for the school, but for the field as a whole. Check with individual programs to get the most up to date information about what points to address in your personal statement.

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Preparing for the Interview

Are interviews required for acceptance into a program?

Yes, interviews are required for acceptance into a program. The interview process varies by program, but typically involves discussions with the program director, assistant director, or other program faculty regarding your experiences and goals. Many programs also provide an opportunity to meet with current students during your scheduled interview date. The interview gives the program faculty an opportunity to get to know you better, but is also a great way for you to learn more about the program and determine if it’s a good fit for you.

Do programs allow for Skype or other virtual interviewing so I can avoid needing to travel?

In-person interviews are typically required for all applicants. Certain programs have been able to arrange virtual interviews for international applicants or special circumstances, but this is not common. Please inquire with the program directly about the possibility of virtual interviews.

What should I wear to interviews?

When in doubt, it is better to be overdressed than underdressed. Typically interviews require business professional dress unless specifically stated otherwise. For women, it is best to wear a suit (either pants or skirt), a professional dress, or something of a similar caliber. For men, this means a suit or dress pants with button-up shirt with a tie.

Any other interviewing tips?

Be yourself! Programs want to know that you will fit in with the culture of their program. Be passionate about your strengths and interests, and honest about your weaknesses. If you were invited for an interview, the program thinks you are a qualified candidate. They don’t expect you to know everything, otherwise you wouldn’t be going to school in the first place! Ask questions, and write thank you notes or emails afterwards. Some people find it helpful to make a list of questions before the interview and take it with you. Having copies of your CV can be helpful as well. Take notes of what things you liked and didn’t like about each program that you visit. This will be helpful when it comes to deciding where you want to go.

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Life as a Genetic Counseling Student

What kind of classes do you take in genetic counseling graduate programs?

Every program handles classes differently, but classwork tends to focus on a combination of general genetics, clinical genetics and clinical applications, and psychology/psychosocial skills. The classes focus on the skills and topics that you will need for your job as genetic counselor. Of course, you will have to learn basic scientific and genetic principles to build your foundation for a career in this field.

What kind of clinical training is involved?

Programs all require that you are trained in the three core genetics specialties: prenatal, pediatrics, and cancer. Most, if not all, programs offer the opportunity to integrate or participate in specialty clinics outside of or within those three domains, such as neurology, cardiology, or pediatrics specialty clinics. As genetic counselors become more involved in a diverse range settings outside the clinic, programs are offering more opportunities to rotate or train in non-clinical roles such as industry and research.

Can you tell me more about the research requirements in genetic counseling programs?

Some programs require a thesis in which the student designs a research project, carries it out, and writes up the results. Some programs ask that each student do a thesis, while others allow students to work on a thesis project as a group. Other programs have a capstone project, where the student writes a research paper or develops a project related to genetic counseling, but do not necessarily do a formal research project. The research/capstone requirements for each program are different, so be sure to check the websites for the program you are applying to for specific information.

What is the search for jobs like?

The job search is extremely variable between people. Being open to multiple specialties and locations throughout the country will certainly make the job hunt easier. Being limited to a certain city and/or specialty will narrow your choices, but it isn’t impossible to get everything you want. Especially with today’s job market, there are bountiful opportunities. Many graduates have jobs lined up before they leave school. If the job hunt is something that is already on your mind, make sure you find a school that provides ample professional development opportunities and mentorship throughout the job hunt process!

Can I have a life in grad school?

Yes! Genetic counseling graduate programs demand lots of time and will challenge you. However, many students hold jobs, volunteer, participate in hobbies, and have time for friends and family outside of school. Grad school is what you make it - if you want to get extra involved, that is absolutely an option, but if you want to have balance, that is an option, too. Making sure that you attend a program that feels right, supports you as an individual, and makes you feel comfortable is a big part of achieving that balance.

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Resources

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What Is Genetic Counseling?

Genetic counseling is a process to evaluate and understand a family's risk of an inherited medical condition.  A genetic counselor is a healthcare professional with specialized training in medical genetics and counseling.

For more information on genetic counseling please see the following FAQs found elsewhere on the NSGC website for more information about what genetic counseling is and who genetic counselors are.

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Where Do Genetic Counselors Work?

Genetic Counselors work in hospitals, doctor's offices, genetic testing laboratories, research studies, public health, insurance companies, and many other areas of health care.  Individuals and families are referred for genetic counseling to evaluate their personal and family history and to understand their chance for being that they, or their relative, may be diagnosed with or develop a medical condition.

Genetic counselors working in clinical settings, such as hospitals or doctor's offices, see people in a variety of different areas including prenatal, pediatrics, adult/general, cancer, and a number of specialty areas including metabolism, cardiology, and neurology. 

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Who Goes to See a Genetic Counselor and Why?

Prenatal Setting

Women/couples who are pregnant or planning to become pregnant may see a prenatal genetic counselor for reasons including:

  • Personal or family history of a known or suspected condition
  • Abnormal ultrasound findings
  • Discussion of testing options and types of tests available during pregnancy
  • Discussion of positive and negative test results
  • Advanced maternal or paternal age, as the chances for chromosome abnormalities such as Down syndrome or single gene disorders such as Achondroplasia increase with parental age
  • Exposures during pregnancy which may cause birth defects

Pediatric Setting

Genetics counseling is appropriate for children with:

  • Developmental delay
  • Autism spectrum disorders
  • Multiple health problems or birth defects
  • Abnormal physical features
  • Family history of a genetic condition
  • Suspicion of a genetic condition

Establishing an underlying genetic cause for these problems can provide information on what to expect in the future, prognosis of the condition, the chance of having additional children/family members affected with the condition, and access to support groups and services.

Adult Setting

Individuals with a personal/family history or symptoms of an adult-onset genetic condition may benefit from genetic counseling to learn about:

  • The risk that they or their children may be diagnosed with/develop an adult-onset condition
  • Genetic testing options available for diagnosis or predictive testing

Cancer Setting

Cancer genetic counseling can help an individual determine whether or not they have inherited an increased risk for cancer.  People who see a genetic counselor include individuals with a personal or family history of:

  • Cancer, such as breast or colon cancer, under the age of 50
  • Two or more first-degree relatives on the same side of their family who have been diagnosed with cancer
  • More than one primary cancer in the same individual (such as two primary breast cancers, or primary colon cancer and primary stomach cancer)
  • More than one type of cancer in the same individual
  • A rare type of cancer or tumor pathology
  • A known genetic mutation in a cancer susceptibility gene in their family
  • An ethnicity associated with a higher frequency of hereditary cancer syndromes (e.g. Ashkenazi or Eastern European Jewish descent)

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What Does a Genetic Counselor Do?

Genetic counselors have many responsibilities and perform a wide variety of tasks:

Seeing patients

Most genetic counselors work in a clinical setting, whether it be prenatal, cancer, pediatric or other area. These genetic counselors spend a large part of their day meeting with their patients.

  • Family history: We take a full family history in every session. We ask about significant medical diagnoses, individuals with intellectual disabilities, autism, birth defects or genetic diseases. Often times, these discussions will lead to more questions about ages, physical features and other symptoms
  • Reason for referral: Patients are referred to genetics for a wide variety of reasons. Some of these include a strong family history of cancer, a pregnancy with an ultrasound abnormality, a family history of a genetic disease, or abnormal blood testing in a pregnancy. Individuals are also referred to genetics to determine if they have a genetic disease. Before any genetic testing is ordered or a physical exam is performed by a physician, genetic counselors offer detailed explanations about the specific issue, the tests that are available, and the inheritance patterns
  • Decision making: Genetic testing is often a very personal decision that carries many emotional consequences. Often we are in a position to help individuals decide what level of information is right for them. In other situations, individuals must make decisions regarding their medical and/or pregnancy care as a result of genetic testing, and the choices can be difficult to navigate
  • Emotional support: Genetic counselors don't just provide information - another very important part of our day is providing emotional support to individuals and families during what can be a challenging and confusing time. Genetic counseling is one of the few medical professions that includes extensive training both in the science and the psychosocial impact of healthcare on our patient community.

Phone calls

Genetic counselors spend a lot of time on the phone. Who do we talk to?

  • Patients: We notify patients of test results. We follow up to gather more information. Wen contact patients to see how they are coping with difficult information. Patients call us to follow up with results, to ask additional questions, and to provide additional information about the family history or condition.
  • Laboratories: We communicate often with laboratories. We call labs to find out what tests they offer and what type of sample is required. They help us help patients with billing and insurance questions. We often call to check the status of laboratory results or add on additional testing.
  • Insurance companies: Genetic testing can be very expensive. We speak with insurance companies on behalf of our patients to determine the cost of testing and try to advocate for insurance coverage.
  • Other health care providers: Genetic counselors are specialists. That means that we work with a patient's health care provider as a part of a patient's complete care. We always communicate what testing is done and what these results mean.

Ordering genetic testing

These aren't just routine blood tests. How can we help make sure the right one is ordered?

  • Genetic tests can be complex, and not just the paperwork! It can be difficult to know which tests are appropriate for patients based on their personal and family histories. Technological advances in testing are making the choices even more difficult, and genetic counselors are experts to make sure the right test is ordered.

Follow up

  • As most genetic disorders involve lifelong care, genetic counselors often serve as the touchstone for our patients. We coordinate their care amongst numerous specialties and support them across the lifespan. Some of the most rewarding aspects of genetic counseling can include watching our patients grow up, visiting with patients in their next pregnancies, or meeting with family members to help disseminate genetics information to those at risk.

Consultation letters

  • Genetic counseling visit notes are longer than a typical doctor's note, and with good reason. Our letters outline nearly everything that is spoken about in the counseling session, including the personal and family history, explanations of genetics basics and disorders, recommendations for medical management or future testing, and a summary of the relevant counseling issues. This letter can be an invaluable resource for other providers as well as for the patient, who may wish to share this information with his or her family members and loved ones.

Research

  • Many genetic counseling positions involve the opportunity to participate in research. Genetic counselors are trained in gathering information that is very helpful to researchers, like detailed family histories, pregnancy information, etc. Genetic counselors also have unique access to and relationships with special populations of individuals that may be of great interest to the research community. By participating in a team of researchers, a genetic counselor brings his or her valuable, patient-centered perspective and expertise, all while furthering the advances in the care of individuals affected by genetic conditions.

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