Teaching genetic science, empathy and communication

Sanford Health is committed to the future of genetic counseling through a master's graduate program.

By: Megan Baldridge .

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When Kaitlyn Burns answers the typical “What do you do?” question, she sometimes gets puzzled looks.

“Many people have never heard of genetic counseling and really have no idea what it is,” says Burns, a pediatric genetic counselor at Sanford Health and 2018 graduate of the Augustana-Sanford Genetic Counseling Graduate Program (ASGCGP).

Genetic counseling is a growing field that primarily works with patients and families in hospital and clinic settings. They meet to discuss things like inherited conditions, genetic tests and risks, and information to help make health care decisions.

“I think genetic counselors make a huge difference in the lives of their patients,” Burns says. “We are trained professionals in both genetics and counseling, so we can provide a great service by bridging the medical system and the patient’s feelings and needs.”

Sanford Health has had great success with the genetic counselors on its staff in several specialty areas, creating positive health care experiences with patients, providers and professionals. The organization sees the potential of the role in the future of health care and plays a pivotal role in educating future genetic counselors through its partnership in the ASGCGP.

Getting a genetic counseling program started with key guidance

The ASGCGP—based in Sioux Falls, South Dakota—is one of only about 45 accredited programs in the nation for genetic counseling. The master’s program is a collaboration among Sanford ImageneticsAugustana University and several institutions in San Diego, California.

Dr. Gene Hoyme was instrumental in helping create an initial bridge to build the ASGCGP program around the relations he established in his work with genetics professionals in San Diego,” says Quinn Stein, director of the ASGCGP and a genetic counselor at Sanford Health.

Sanford Health has a long relationship with Augustana University, also located in Sioux Falls, in a variety of projects. Combined expertise from Sanford Health, Augustana University and professionals in San Diego laid substantial groundwork for a new master’s program for genetic counseling.

Dr. Hoyme helped guide how to get the ASGCGP started several years ago, and he continues to provide valuable input from his current roles as a genetic researcher, senior adviser for Sanford Imagenetics, and medical director of the Sanford Children’s Genomic Medicine Constortium.

Limiting the class size expands the opportunities

Eight students were accepted to the ASGCGP in 2016, its first year of accreditation. Another eight started in the fall of 2017, and 10 started in the fall of 2018.

The class size is kept small on purpose—partly because of the intense time commitment it takes to train students in clinical settings, and partly because of the scope of topics covered in the curriculum.

In addition to the classes and rotations led by genetic counselors, the program also features content experts who speak to students about their specialties and the role genetic counseling plays in those areas.

“We have a wide range of experts come in, including pediatric cardiologists, pharmacists, clinic administrators, oncology surgeons, radiologists, OB-GYNs and geneticists,” Stein says.

“Getting that personal attention, practical examples and sample exercises to do with patients really make an impact with students. The small size of the class also really helps drive discussion and people’s willingness to speak up about technology or ethical issues.”

Looking for the perfect match

The limited size of each year’s new ASGCGP class isn’t a reflection of interest in the program; in 2018, 140 applicants vied for the 10 open slots of the 2019 class.

Stein says he and the other program instructors look for candidates who are the best fit for the program and profession, which covers more than what appears on paper.

“We’re not necessarily looking just for 4.0 (GPA) students, or students who aced their GRE exams or have the most advocacy experience,” Stein says. Empathy and communication skills are just as important as academics.

“We do a lot of educating patients about genetic tests and what they can and can’t tell you. We interpret family histories. We help patients find support and resources and other local individuals to talk with. We address the psychosocial dynamic of if you get a genetic test done how it might affect you or your family,” Stein says.

“So where other programs may feel like they’re interviewing applicants to find physicians, we’re interviewing to find genetic counselors—people who want to talk to patients and really do everything a genetic counselor does.”

Highlighting what makes the program special

Current ASGCGP students, who Stein says are the best ambassadors and advocates for the program, meet with applicants who interview for open spots. The students can give realistic perspectives about the coursework, rotations and specialties the program covers—which consistently appeal to applicants.

The location has been helpful, too. “We interview everyone at the Sanford Imagenetics building, where a good portion of the program’s work takes place, including rotations, classroom work, research and student work areas,” Stein says. “Applicants are amazed at the building, and it’s almost like another recruiting tool for students.”

Stein himself is also a big draw to applicants. His enthusiasm and passion for the field is palpable. He was on the nationwide search committee to find a director for the program before it started, when fellow committee members encouraged him to apply for the position himself.

“Quinn Stein was the first person involved with the program that I met, and afterwards, I instantly could see myself here,” says Dylan Platt, a 2019 graduate of the ASGCGP who will start as a genetic counselor at Sanford Imagenetics this summer. “Something that this program does well is that it’s incredibly inviting, mainly due to the people involved, and you feel like you can be yourself.”

Learning beyond the textbook

While there are some online discussions and interactive video from professors, most of the ASGCGP classes are in person. Research, bioethics, hands-on lab experience and clinical rotations are integral parts of the program.

“We thought Sanford Health was doing clinical genetics in a great way,” Stein says, “and we wanted to give back and teach a new generation about it.”

That exposure to how genetic counselors are integrated into clinical settings begins in the students’ first semester—much earlier than other programs tend to incorporate clinic rotations.

“That really helped us as we learned from our textbooks in class, and from real-life experience in the clinic at the same time,” Burns says.

The laboratory staff at Sanford Imagenetics also play a significant role in students’ training. “The lab directors, PhD lab geneticists and lab techs all work with the master’s students and genetic counselors,” Stein says. “They’re all involved in the students’ rotations, and they help teach skills, advise on roles and assist in research projects.”

Stein adds that the openness and encouragement from Sanford Health staff across the board has made a huge impact. “From administration, to the physicians, to everyone in the Imagenetics building, students feel really supported from all sides throughout the program.”

The structure and approach of the ASGCGP seems to be working exceptionally well. In the 2019 graduating class, all eight students passed their board examinations on the first attempt. “It’s a very difficult test,” Stein says, “and it shows me as a program director that we’re teaching them the right things and setting them up for success.”

Filling needs in a variety of roles

The ASGCGP instructors make sure students know about the many fields looking for genetic counselors, including oncology, prenatal and pediatric clinics; internal medicine and primary care practices; commercial, insurance and biotech companies; community education; and research laboratories.

Platt says this range of opportunity drew him to the career path. “You can’t fit the profession into one box—your definition of genetic counseling is dependent on if you’re in the clinical, lab or commercial space,” he says.

Burns did her master’s research project on a job market analysis of the genetic counseling career field.

“I found there is a larger number of job openings than graduates each year, but there is also increased variety in the jobs genetic counselors are being asked to fill,” she says. “This evolution is happening at Sanford Health as well, where we have an increased demand for genetic counseling from the many providers we work with, and from patients and their families.”

Most ASGCGP students are getting job offers six to 12 months before graduation, Stein says, which is encouraging for people looking to get into the field.

Creating leaders

The enthusiasm from new and soon-to-be genetic counselors is what inspires Stein about the future of the program and its graduates.

“Our mission statement commits to ‘developing genetic counselors into astute communicators, scholarly professionals and engaged members of their communities.’ Mission statements can be cheesy, but I thought a lot about it,” Stein says.

“When I ask employers about our alumni, and I ask if they’re doing all these things—communicating effectively, being scholarly not just in research but in studying for their next patient, and being active in the community through lectures or support groups or talking with physicians or outreach programs—I want the answer to not just be yes, but that they’re leaders in all those areas. That high standard of quality is what I want our program and our students to be known for.”

Read more about genetic counselors at Sanford Health.