given that i get a few hits every week or so from individuals searching for “male genetic counselors” or something or other, i thought it’d be an appropriate time to speak a bit more about how i’ve gone about getting where i am in my understanding of men in the genetic counseling field. i’ve had a few posts in the past that have addressed some of the important issues, but how did i go about absolving the myth that male genetic counselors are inept at the counseling side of GC? with experience of course!
those experiences started with my first year in my program. UofM allows its students to elect a summer rotation of their choice. my first thought that I ended up sticking with was finding a location, a clinical rotation, where I’d be able to work with a male genetic counselor and get some experience seeing how he would work. given that ann arbor didn’t have any genetic counselor men locally, i started with speaking to my directors and seeing who they knew, or who had been an alum of the program (UofM hasn’t had a guy since the early 90s…).
another step I took was to look at who was credentialed, holding the CGC desgination. these people were more likely to be practicing, vs. working in a non-clinical job (so i thought). i browsed through all the pages of ABGC diplomates, and then google’d any male-gendered names i saw to see where they worked, if it was clinical, if it was in a location in the country i wanted to travel to, etc. yes, i browsed through all 2500+ names looking and discerning for male-gendered first names. quite a task 😛
i ended up deciding on two locations that had a cancer focus, since i also had a particular interest in pursuing a fun, interesting, and involved cancer GC rotation. sent a few emails, got back a very welcome response and a second, polite decline (that was primarily due to the medical institution not being very appropriate to students), and i was set!
as the counselor who was my student liason first impressed on me (in our very first email exchange), it’s important to know that you can learn a whole lot from the counselors who are women that work there as well… and that basically sums it all up. it’s nice to work with another genetic counselor who’s a man, but when it comes down to learning the skills of GC, whoever it is that’s a good counselor will teach you tons and tons. some of my best counseling and career advice have come from those individuals at that rotation, so I absolutely lucked out (and made some great friends & professional relationships in the process!)
anyway, that’s been my experience. going to NSGC AEC is also an awesome way to scope out who’s a guy (it’s way easy, believe me, although i’m sure you don’t need to be convinced). there might even be guys that will address the topic too! (prominent example being Jeff Kopesky’s graduate research study and presentation at this year’s AEC on undergrad guys/girls in upper-level biology courses and their interest/knowledge of the genetic counseling field!)
not to mention, a lot of the training programs have at least a token guy (if not more!) maybe that’s a good place to start too. obviously, the bigger the program, or the bigger the city, the more likely there is to be a genetic counselor dude around, but, alas. hopefully this is can help someone out there.
here’s a funny video of Larry David’s experience with ancestry testing through the Ancestry by DNA test from DNA Diagnostics Center, as revealed on George Lopez. apparently their test uses 176 Ancestry Informative Markers, or AIMs. which ones these are and why they only test for European, Native American, Sub-Saharan African, and East Asian “BioGeographic Ancestry”, we don’t know without inquiring further. the references they cite are all from 2003 and before too..
Larry David is 63% European, 37% Native American.
“so I fail as a European?”
ain’t that interesting. it does make it seem a bit ridiculous/sensational, but funny indeed. their explanations of how these things work, however, aren’t the clearest thing:
also check out: DNA and Race FAQ via AncestrybyDNA
i doubt anyone genuinely follows this blog regularly, but i will be back soon! research, classes, clinic, responsibilities, social responsibilities, etc. have gotten in the way of being able to get my thoughts together and come up with posts, but soon, soon, once i’ve successfully navigated the IRB maze and am now over halfway through my last formal clinical rotation, i shall return!
I’m leaving today to attend the NIH State-of-the-Science Conference coming up next week. There’s an amazing list of speakers on the agenda (Guttmacher, Khoury, Acheson, Rubinstein, Sharon Terry, Colleen McBride) and in all their short speaking sessions, it’ll be interesting hearing the import of family history in primary care settings.
This’ll be an awesome experience seeing how to best expand and come to consensus on one of the best medical, clinical, genetic, public health tool, really across all disciplines, to assess extent of genetic disease and inheritance. I’m sure many other important people will also be attending.
I’ll be taking notes and reporting back to my program for journal club. Should be exciting, plus I’ll get to see one of my old classmates who’s moved on toward real-life! Let’s hope they have internet so I can update as I go along!
Find more info at:
Supposedly the NSGC president, Steve Keiles, will be live-twittering during the event. Check it out:
Mr. Gene Sherpa has a few things to sy about this too:
Phew, okay, so after a day and a half of nonstop talks and discussions, sounds like there’s a whole lot of ways to look at family history in general practice settings, a whole lot of research that still needs to be done, and not a lot of research that has been done to effectively analyze the procedures, processes, and outcomes of the family history as a tool.
A few key remarks (among my 40 pages of typed notes..) that I thought stood out from the wonderful array of speakers included:
Per Dr. Maren Scheuner:
The Red Flags of Family History include:
- early age at onset
- multifocal disease or severe phenotypes
- 2+ closely related and affected family members
- 2+ generations with affected family members,
- disease in the less often affected sex (in the case of heart disease or breast ca.)
- and patterns suggestive of a known mendelian disorder
These are great and all, but they look awfully similar to the red flags that I talk about in genetic counseling when.. oh, right, evaluating a family history!
There was the idea of stratification of risk into multiple categories of Weak, Moderate, and Strong, that Dr. Scheuner brought up, and then many other speakers touched on. Finding algorithms for determining process outcomes based on each of these family history risk stratification levels seemed a key component of moving family history data into standardized care.
Dr. Paula Yoon made the important point that family history of common conditions, as a tool, performs well for populations, but poorly for the individual. This is, again, not too surprising given the risks we see aren’t quite as black-and-white as we expect, and, to bring it to a counseling standpoint, having disease and not having disease can sometimes be interpreted as very black-and-white to clients, patients.
Dr. Louise Acheson pointed out that good prevention, good surveillance, will over a short period of a few generations, render the family history potentially useless. While it may seem great that families may eventually no longer have manifest disease due to great prevention efforts, the multifactorial elements underlying disease will still be present (especially the genetic components) in future individuals and there’s a need to include biomarkers and disease precursors in the evaluation of family history as these assessments move forward.
Dr. Wendy Rubinstein, on a very very peripheral note, brought up her analysis of the CDC’s Family Healthware experience of using a family history screening tool, and emphasized the need to avoid the word “genetic” in communicating with consumers. I guess subconsciously I’d thought about this and the mental associations/implications with words that we as GCs think are simple, that can occur with any given word. Perhaps this is especially important when trying to create tools that will be applicable and can be related to mixed population groups as a whole.
Dr. Ted Adams talked a bit about the Utah State experience (that’s gone on for decades!) of using high school…. my lunch is here 🙂 more later!
i always get excited when i hear exciting analogies about genetics. they make explaining genetics in counseling sessions (or in other settings) so much easier. yeah, sure, there’s the ones i’m familiar with:
genes are like a recipe
chromosomes are like a library with the books as genes
autosomal recessive is like two lightbulbs in a hallway
dominant is like two wheels on a bike
translocations are like switching caps on pens
(credits to my instructors and classmates)
but hearing new and exciting ones about commonly discussed topics make my stomach flutter, such as the following quote from Kelly Ormond in a recent ACP Internist blog post by Jessica Berthold about “A brave new world of consumer gene tests” (link below):
Unlike conditions such as Huntington’s Disease, which a person will definitely get if she has a simple genetic mutation and lives long enough, complex conditions like heart disease are usually affected by many genes. And some are more important than others, said Kelly Ormond, program director for Stanford University’s Master’s Program in Human Genetics and Genetic Counseling, and a consultant for consumer genetic testing company Navigenics.
“For common medical conditions, I imagine genes as rocks in a glass. Some are really big rocks, and some are really little. And if you get to a certain point, that glass is going to fill up and push you over the threshold for the condition. Maybe you have two big genes that bring you to the threshold; maybe it’s 10 smaller ones,” Ms. Ormond said. “And maybe it also takes environmental impacts on top of those genes to cause you to develop a condition.”
rocks in a glass huh. simple and elegant, something easily visually imaginable, or for those who just like the visual part, easily recreated in a genetic counseling session..