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Genetic counselor discusses evolution of the field


“We are now doing more testing on the RNA side,” says Brittany M. Szymaniak, PhD, CGC.

In this video, Brittany M. Szymaniak, PhD, CGC, discusses how genetic counseling has evolved over time and also gives advice for those considering a career in genetic counseling. Szymaniak is a genetic counselor in the urology department at Northwestern University in Chicago, Illinois.

Video Transcript:

How has the field of genetic counseling evolved in recent years?

The clinical germline side of things started around early 2000. Now, in 2023, our testing looks so different than it did 20 years ago. Now, we're doing more broad testing, when it comes to a lot of our patients, so being able to do testing not just for organ-specific cancers, but offering the possibility of doing more comprehensive testing, touching on other genes related to other cancers. We are now doing more testing on the RNA side. Historically, we're looking specifically at DNA, but being able to look at that intermediary RNA piece gives us more information about classification, about potential functional outcomes for some of these genetic changes. So it's really enhanced the interpretation that we're getting for this genetic testing. But then also we can't overlook the fact that this is becoming more and more useful when it comes to determining treatment implications for patients. That's really become the biggest thing that I've seen over the past 5 years - how can we use this information to help inform a patient's care? And so I think, with as broad as we're getting with the testing, and more and more people are qualifying for testing, I think we're going to see a lot of changes in terms of what we know about these genes and the cancer risks associated with them, the spectrum is really going to widen as we're starting to test more and more people.

What advice would you give someone considering a career in genetic counseling?

I finished the Northwestern program in 2018. Even when I was applying, I feel like from then till now, things have gotten very competitive. We have more schools that are opening up, more slots at different schools, trying to support the fact that we need more genetics expertise. So I feel like any medical professional that's really interested in transitioning into more of this role is really trying to get those experiences with either, I would say, on the medical provider side, there's different coursework and things that are available to help enhance that knowledge base for them, because usually a lot of the medical education is still fairly limited. I feel like now it's probably very different than even 5 years ago, but on the student side, really trying to get those experiences if they can with working with genetic counselors or getting some exposure to the genetic counseling field. Genetic counseling assistants are really big. And I would say that that's been a real expansion for our field over the past couple of years. Those experiences are really great for students as well. And if there's any other kind of different exposures that they can get. Sometimes we have patients that will do different hotlines, we'll work with different patient populations to try and get as much exposure as they can before they come into the field.

This transcription was edited for clarity.

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