Written by Barry Waldman
The human genome was laid out in its entirety in 2003 after a two-decade effort that cost $5 billion. The importance of this effort cannot be overstated: it unlocked our understanding of genetic interactions and their impact on disease development and progression.
In the intervening 18 years, the price of sequencing an individual’s genome has dropped to about $1,000, with the cost of common clinical genetic tests often lower. These tests allow the integration of DNA with personal and family history to diagnose a variety of conditions and suggest courses of action.
Genetic testing can be used to screen for birth defects in fetuses and newborns; to identify or rule out inherited conditions like Huntington’s Chorea, Hemophilia, and Sickle Cell Anemia; to determine disease-carrying status, and to detect gene mutations that confer future risk and may require prescriptive attention.
The Genetic Counselor
Since genetic testing has become widespread, a new type of health care provider has become increasingly critical to the functioning of many health care facilities – the genetic counselor. These educated professionals help individuals and families determine how genetic conditions might affect them and help them make personalized health care decisions as a result.
For example, a person with a mutation in a BRCA gene has an increased risk for certain cancers, including breast and ovarian cancer. An at-risk individual may choose early and aggressive cancer screenings to catch and treat any cancer at an early stage, or may choose prophylactic surgery – a surgery to remove the breasts and/or ovaries before cancer ever develops. Children and other relatives of people with such mutations may also be at-risk, so identification of a mutation can help multiple people in a family live healthier lives.
As genetic testing has increasing applications across all areas of medicine, the supply of genetic counselors is lagging demand. The problem is expected to intensify as demand grows three times faster than for other careers, according to the Bureau of Labor Statistics.
The average annual pay for genetic counselors, according to BLS, is $85,700.
Upcoming MUSC Genetic Counseling Program
As the current capacity of master’s degree programs in genetic counseling is insufficient to meet current demands, much less the rapidly growing future demand, MUSC has begun the accreditation process to open its own genetic counseling program in its College of Health Professions.
With the help of a Lowcountry Graduate Center grant, MUSC is on the path to admit its first 20 students in the fall of 2023, says Dr. Nancy Carson, Associate Dean for Academic and Faculty Affairs at MUSC’s College of Health Professions.
Kim Foil, a genetic counselor and assistant professor with the College of Health Professions, says only three core professors will be required to establish the program. It will also engage the help of the 10 other genetic counselors at MUSC and others working in the field as adjuncts.
Foil expects the curriculum to be taught remotely and asynchronously, allowing for maximum flexibility for professionals returning to school. It will allow students to access the course from anywhere in the country, but clinical rotations will be arranged in Charleston over the course of the five-semester program. Students must have at least 50 cases of hands-on experience spread across a variety of practice areas in order to earn their degree and subsequently take the national board certification exam for genetic counselors.
“Genetic counseling programs historically have drawn a mix of graduating undergraduate seniors and those embarking on a change of career,” said Foil, who does not expect filling seats to be an issue. Other genetic counseling programs around the nation have found that there are three-and-a-half applicants for each available slot.
Only 52 Genetics Counseling Programs Vs. 199 Law Schools
It would be the second in South Carolina, after UofSC, and only the fifth program in the Carolinas and Georgia combined. The director of the University of South Carolina’s Genetics Counseling Program endorsed MUSC’s effort and the scope of its program. “The projected number of students is bold and would impact the genetic counseling workforce in the near future,” said Janice Edwards.
Applicants will need a bachelor’s degree and all the usual college-level science requirements, including statistics. The degree requires a balance of skills – both a strong grasp of basic scientific concepts with strong interpersonal relationship skills.
Students apply to enter any of the nation’s 51 master’s programs and are matched with their preferences through a national match system similar to the one that places medical residents.
The biggest obstacle to standing up for the program is time. The MUSC effort still requires approval from the SC Commission on Higher Education and the Accreditation Council for Genetic Counseling. Advancing through the accreditation process is expected to take a year. After that the main work of organizers involves finding space for classes and labs, establishing the curriculum, and arranging fieldwork. Simultaneously, MUSC will continue work to establish the curriculum and arrange fieldwork rotations. The MUSC Genetic Counseling Program anticipates accepting applications in fall 2022 pending new program accreditation.