Genetic counselors are health professionals trained in genetics, genetic disorders, genetic testing, molecular biology, psychology and psychosocial issues, and the ethical and legal issues of genetic medicine. Most genetic counselors have a master's degree from a genetic counseling training program. The very first class of genetic counselors was graduated from Sarah Lawrence College in 1971. There are about 2,000 genetic counselors in the United States. Most are women under the age of forty, but the field is becoming more diverse.
Genetic counselors are board-certified by the American Board of Genetic Counseling. Board eligibility or certification is required for employment in many positions, and some states are beginning to license genetic counselors. While salaries vary significantly by geographic location, years of experience, and work setting, according to a Professional Status Survey conducted by the National Society of Genetic Counselors, Inc. (NSGC) in 2000 the mean salary for a full-time master's-level genetic counselor was $46,436. The NSGC, incorporated in 1979, is the only professional society dedicated solely to the field of genetic counseling. Its mission is "to promote the genetic counseling profession as a recognized and integral part of health care delivery, education, research, and public policy."
The role of the genetic counselor has evolved greatly since 1971. Initially, genetic counselors worked almost exclusively in the clinical setting under physician supervision, seeing clients who had been diagnosed as having a genetic disorder, were at risk for developing a genetic disorder, or were at risk for having a child with a genetic disorder. They would assess genetic risk, provide information, discuss available testing options, and provide appropriate supportive counseling. The variety of patients and the information and testing options offered by genetic counselors was greatly restricted by the limited technology and genetic knowledge of the time.
Today, as a result of the Human Genome Project and other advances, genetic counselors are now able to offer more services and options. They are able to specialize in a particular area of interest, such as cancer, prenatal, pediatric, assisted reproduction, and metabolic or neurogenetic disorders. Most genetic counselors (more than 80 percent) still work in the clinical setting, either in a hospital or in private practice. However, advances in genetics have enabled genetic counselors to work in a variety of other settings including research, public health, education, and industry.
As a patient advocate, the genetic counselor also remains informed of ethical and legal issues regarding the use of information generated by the Human Genome Project and incorporates pertinent information into the counseling session. For example, the decision to undergo genetic testing may involve controversial issues. Depending on the type of test and the disorder present, testing may have implications for other family members, insurance eligibility or coverage, employment, and quality of life. It is the role of the genetic counselor to ensure that clients are aware of concerns relevant to their situation.
Opportunities for the genetic counselor also exist to consult on research projects, guest lecture, publish articles and books, and teach. Broad training makes genetic counselors highly adaptable to virtually any setting where genetic information is utilized. Overall, genetic counseling is a dynamic and evolving profession.
Susan E. Estabrooks
Baker, Diane L., Jane L. Schuette, and Wendy R. Uhlmann, eds. A Guide to Genetic Counseling. New York: Wiley-Liss, Inc, 1998.
National Society of Genetic Counselors, Inc. <http://www.nsgc.org>.
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