First Year GC Students Have Some Fun

While their second years were away at the NSGC Annual Education Conference, the class of 2016 got creative and made this fun video.  

GC Internship Experience in an Industry Setting

This summer I had the privilege of completing an internship with the company Counsyl for five weeks in San Francisco, California.  Counsyl is a medical technology company that made a name for itself with its Family Prep Screen expanded carrier panel, which screens for over 100 different autosomal recessive and x-linked conditions.  This was the first year that they offered a competitive genetic counseling internship.  They requested my CV and two personal statements followed by three Skype interviews: two with genetic counselors with directorial roles and one with the Chief Scientific Officer. I was excited to even be considered for this opportunity.

Overall, the internship was an amazing experience.  My main project was to update the Family Prep Screen, which involved looking into the current literature for any updates to gene and variant classifications.  I was also able to talk with several genetic counselors that work for Counsyl and learn about their roles within the company. 

Interning with a commercial lab allowed me to see all of the moving parts that I didn’t know existed.  From my past experiences and classes, I learned about the technology behind genetic testing, but I didn’t know about the numerous different disciples needed to keep a commercial lab like Counsyl up and running.  It takes an abundant amount of engineers, programmers, scientists, and more working together and constantly communicating in order for the company to be successful and profitable.

This internship really opened my eyes to some of the different roles genetic counselors can have outside of the clinical setting.  At Counsyl, career options for genetic counselors extend into positions such as project directing and marketing.  Talking with these individuals illustrated the diverse potential of my master’s degree, helping me to appreciate my experience at UC even more.

--Joe Jacher, second year student

Experiental Learning

On the last day of fall 2014 Orientation week, all of the students and faculty in the Genetic Counseling Program attended an all-day workshop known as Experiential Learning. The goal of Experiential Learning is to help members of a team learn about themselves and others, bond, and explore effective teamwork while going through a series of difficult problem-solving tasks. After each activity was completed, the team discussed what concepts we learned that could help us as a team throughout the coming year.

One of our activities was what I will refer to as the “jump rope challenge.” The task was to have every person present jump the rope once while two members were handling the rope – the trick was that the jumping had to be done in pairs and it had to be continuous, so as one pair jumped, another pair would simultaneously run under the jump rope. If any pair tripped over the rope, the whole team had to start over again. Given that we had 29 people, it was incredibly difficult for all of us to get through under the requirements. We called a team meeting and decided to modify the challenge so that we were allowed one “empty turn” of the rope in between pairs of people so as to help with timing. As we tried over and over to complete the task, we became aware of the value of encouragement and support among teammates. Instead of becoming annoyed when someone repeatedly tripped over the rope, we offered tips and reassurance that they would get it the next try. This task also affirmed the importance of a positive attitude – remaining optimistic and engaged in the process really helped our team towards our goal.

Fortunately, we managed to complete the challenge before the end of the allotted time and we were all ecstatic about our achievement. As a first-year student facing a challenging year of graduate school, I feel very grateful to be surrounded by such a supportive team. I can see similarities between the coming year and the jump rope challenge – at the beginning, it seemed overwhelmingly demanding and many of us did not expect that we would be able to complete it. As a team, we made a plan for the best strategy and modified that strategy when it was not working for us. We succeeded in the end by encouraging each other but also by pushing ourselves towards our goal and staying positive even when we were struggling. I feel that this is a metaphor for the year ahead of us and although I am nervous, I am also confident that we will all succeed because we have such an amazing support system in the UC Genetic Counseling Program.

Although I was exhausted by the end of Experiential Learning, I was very glad for the opportunity to get to know my classmates and supervisors. I believe that we bonded over the difficult tasks and learned a lot about our personal leadership styles and how we can be a more cohesive team in the upcoming academic year. I am confident after Experiential Learning that honoring the teamwork principles we learned will allow the UC GCP to conquer any challenge that comes our way.

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           --Hannah Balka  

Bereavement Training Conference

This summer I had the opportunity to attend the Resolve Through Sharing Bereavement Training on Perinatal Death conference with several other genetic counselors from CCHMC. Attending this conference allowed me the opportunity to expand my knowledge on the process and emotions that patients and families go through when experiencing a perinatal death. During the conference I was able to discuss practices and policies at other hospitals with other health care professionals, including social workers and labor and delivery nurses. I found it especially helpful to attend the conference with other genetic counselors. This allowed me to hear and learn from some of their experiences and reflect on how this will impact my own future genetic counseling career.

Although I am currently undecided on what I would like to specialize in upon graduation, I feel that this experience has the potential to translate into any specialty of genetic counseling. No matter what the age of the patients are that I am working with there is always the chance to be impacted by a loss. During my summer rotation I was able to put some of the information I learned into practice after two of my pediatric patients passed away. We were able to help the mother talk through difficult decisions she was going to have to make and then provide bereavement resources. Additionally during my summer rotation, I was involved with a case where a difficult loss had been recently experienced. During this particular situation I was able to include some of the information and knowledge from Resolve Through Sharing into my psychosocial counseling.

I am very grateful for the opportunity to attend this conference. I’m glad that I have the foundation and framework to build relationships and comfort patients and families when going through difficult times related to perinatal death. This was invaluable experience that I highly encourage other genetic counseling students take advantage of in the future. 

--Katlin Allsbrook

Pharmacogenomics Rotation

In follow-up to our series on elective rotations, Krista Qualmann writes below about her experiences rotating at a Pharmacogenomics Company.  Though this was not an elective rotation, Krista was the first person to participate in this opportunity.  Also check out our previous elective rotation posts about the International Adoption Center, Starshine Hospice, and Bioethics.

One of the things that drew me to the University of Cincinnati’s Genetic Counseling Program was the wide variety of clinical rotation opportunities.  I think that it is important to gain experience both with different supervisors and in different settings in order to gain a full picture of the variety of roles that genetic counselors can participate in during their career.  This spring I had the opportunity to be the first genetic counseling student to rotate through a newly added pharmacogenomics and industry rotation at Assurex Health (http://assurexhealth.com). 

Assurex Health is a personalized medicine company that uses their “GeneSight” testing panels to combine an individual’s pharmacogenetic testing results with knowledge of drug metabolism pathways in order to help physicians determine which psychotropic, ADHD, or pain medications may work best for patients.  During my rotation, I participated in weekly Science Team meetings, which included company leaders, employees, and other rotating students, such as PharmD candidates and undergraduate co-ops.  There, various team members shared their progress on individual research projects and received critique in a collaborative working environment.  I was assigned my own research project in which I investigated the merit of adding an additional gene to one of the company’s panels.  I presented the results of my research at the Science Team meeting at the conclusion of my rotation.

In addition to my research, I practiced customer service responsibilities by participating in physician and patient consults via telephone.  I also worked with the marketing team to help create physician and patient-friendly education material to be added to Assurex’s website.  As an added bonus, I received my own GeneSight test results and was able to experience first-hand what it is like to learn those results and incorporate them into my personal identity.

During this rotation, I was able to explore many of the non-traditional roles that genetic counselors are taking on in laboratory and industry positions.  I think that this is an important opportunity for students to have, especially as the demand for genetic counselors in industry increases.  Genetic counselors are trained in a unique skill set that can be applied to many different situations.  As our field expands, we also need to be able to apply those skills to new environments.  I had a wonderful experience working with everyone at Assurex Health and highly recommend the rotation to future students.

--Krista Qualmann

Elective Rotations: Bioethics

This is the third in our series about student elective rotations.  Second year students in the UC/CCHMC GCP who are on track to complete their clinical logbook requirements are given the option to develop their own elective rotation.  Students choose these rotations based on their interests or on skills they would like to obtain.  Along with input from program faculty, they develop the learning objectives and outcomes for their rotation.  Previous elective rotation posts were about the International Adoption Center and Starshine Hospice.

Throughout my education I have made a conscious effort to supplement my science background with opportunities to engage in critical thinking from outside a scientific perspective. I feel it is important for me to remain well-rounded and I think developing myself in and out of hard science will help me better serve my patients in the future. During my undergraduate education, I achieved this by obtaining a minor in Philosophy to balance out my major in Human Biology. UC’s Genetic Counseling Program has allowed me to continue this personal development with an elective rotation in Bioethics at Cincinnati Children’s Hospital. Aside from rounding me out as an individual, my rotation in Bioethics has allowed me to critically examine ethical dilemmas and understand how an Ethics committee works through cases to come to their recommendations. As with any medical specialty, ethical dilemmas arise in genetics. In fact, NSGC has an ethics advisory committee, made of up Genetic Counselors with an interest in this area, which I hope to one day be a part of.

I was fortunate enough to rotate with the Cincinnati Children’s Hospital Ethics Committee for the entire academic year, steadily increasing my involvement as the year progressed.  The Ethics Committee is an interdisciplinary team made up of doctors, nurses, pastoral care, social workers, lawyers, and even parents and families from the community. Ethics consultations can be requested by any hospital employee, patient, or family member. When an ethics consultation is requested, that request is first reviewed by a committee member to ensure that it is within the scope of practice for the committee. Next, the consultation is assigned to two committee members and they begin gathering information. Once all information is gathered, the consultation is presented to the consult team (a subcomponent of the Ethics Committee) for discussion and development of recommendations. 

I began my rotation by observing the committee meetings, where we discussed cases that were at or near their resolution. These meetings are opportunities to get a wide array of opinions on a topic and take the time to learn important lessons from each case. I later began attending the consultation meetings, in which new and ongoing consultations are discussed among the smaller consult team. Here I was able to get a glimpse into the process of coming to a recommendation on difficult cases that are currently developing.

My next step is to attend consultations when they are called, which would be an opportunity for me to follow a case from start to finish and see the evolution of ideas as the case is discussed in the meetings.

Overall this rotation has been a wonderful learning experience and has allowed me to push myself to continue my well-rounded education and to grow as a professional. I know the principles I learned in this rotation will allow me to better understand the process of ethical decision making and make more informed decisions when faced with an ethical dilemmas as a practicing genetic counselor and I will be able to understand when I need to get a hospital committee involved in the decision-making process.

--Sara Fernandes

Elective Rotations: Starshine Pediatric and Perinatal Hospice

This is the second entry in our series about student elective rotations.  Second year students in the UC/CCHMC GCP who are on track to complete their clinical logbook requirements are given the option to develop their own elective rotation.   Students choose these rotations based on their interests or on skills they would like to obtain.  Along with input from program faculty, they develop the learning objectives and outcomes for their rotation. 

When applying to graduate schools I found myself scouring program websites to learn about special aspects each school offered.  When reviewing the University of Cincinnati’s website I read about students who had proposed new ‘elective rotations’ in clinics or services that didn’t typically involve a genetic counselor.  The University of Cincinnati recognizes that everyone has diverse interests and encourages you to explore these.  During my second year, after recognizing my love for prenatal genetic counseling, I realized that a specialty rotation through Starshine pediatric and perinatal hospice would give me a unique perspective into what receiving and dealing with a terminal diagnosis is like for families.

During my five week rotation I was able to be involved in many different aspects of the Starshine program.  I attended a weekly case conference with the Starshine team which included nurses, social workers, physicians, music therapists, child life specialists, bereavement coordinators, holistic health specialists, and chaplains.  At the case conference, we discussed the health status of current patients and shared stories to remember patients who had recently passed away.  I was also able to accompany nurses for hospice visits in the patients’ homes.  I was fortunate to be able to participate in quite a few bereavement visits as well, which is a visit offered to help families cope with a family member’s death, and celebrate their life.  During all of my visits, I was able to listen to the parents and siblings tell their stories about receiving the diagnosis, learning to cope with the diagnosis, and experiences dealing with the loss of a child. 

Through this elective rotation I gained insight into the many psychosocial issues that go along with receiving the devastating news of a terminal diagnosis.  All the families I met with were wonderful and were very receptive to my questions.  They were eager to share advice with someone who, in the near future, might have to deliver and help families cope with the news of a terminal condition or diagnosis. 

Not only did this rotation give me deeper insight into the multiple roles of perinatal hospice and how a genetic counseling might be involved.  It also taught me a great deal about resources available to these families.  Getting to know the caring members of Starshine’s team, and hearing parents talk about how instrumental hospice was in helping them deal with their child’s diagnosis have made me feel very comfortable referring future patients to similar services. 

--Kate Heraty

Elective Rotations: International Adoption Center

This is the first entry in our series about student elective rotations.  Second year students in the UC/CCHMC GCP who are on track to complete their clinical logbook requirements are given the option to develop their own elective rotation.   Students choose these rotations based on their interests or on skills they would like to obtain.  Along with input from program faculty, they develop the learning objectives and outcomes for their rotation.  

One of the reasons I was particularly interested in the genetic counseling program at Cincinnati Children’s Hospital was the sheer magnitude of unique and exciting opportunities available to students. When offered the chance to participate in an elective rotation to gain more experience in an area of interest to us outside of our typical studies, I enthusiastically decided to try and rotate with the International Adoption Center (IAC) at CCHMC. Although adoption has long been an interest of mine, I found that my experience with the psychosocial concerns (challenges and successes!) of adoptive families was limited. Additionally, as some children available for adoption may have special healthcare needs (some of which can be attributable to a genetic syndrome) I knew that this rotation would make for a well-rounded learning experience. In the end, I felt that I was better able to appreciate the needs of adoptive families while learning more about issues unique to the adoption process.

                Throughout my 5-week rotation, I was able to observe a number of families at different points in their adoption process. At the IAC, families considering adoption are able to discuss the details of their referral while those who have arrived home can receive specialized care for their children in a setting designed to meet their unique needs. Most children receive comprehensive evaluations from all of the specialties in the clinic, including:  infectious diseases, nursing, social work, and occupational therapy. Addressed were the child’s healthcare management needs, recommended immunizations, necessary referrals to other specialists, and so much more. Common psychosocial concerns discussed included: attachment, ongoing behavior concerns, and general adjustment to the new environment and family. I thoroughly enjoyed my time rotating with the IAC and learned a great deal about the adoption process, multidisciplinary clinics, and working with families during a period of great change and, at times, high stress.

--Jule Diaz