If you read my last blog post, you are aware that I recently applied to the Genetic Counseling Fellowship in ReSearch Training (GC-FIRST) Program, a two-year fellowship opportunity is designed to provide four genetic counselors the advanced training needed to become genetic counseling research leaders.
The application required both a personal statement and research statement. Below, I am sharing the prompt for the research statement as well as the statement I submitted as part of the GC-FIRST application.
I decided to share about the psychiatric genetic counseling clinical rotation I was awarded during grad school as the introduction to my Research statement. I lived in Vancouver for just over a month during the 4-week rotation with the Adapt clinic. Here is a picture of me whale watching on the way to Vancouver Island. Whales are my favorite animal and Vancouver is one of my favorite cities.
Research Prompt:
How did you become interested in research in genetic counseling?
What are your past research experiences and how do they influence your current desire to pursue a research fellowship in genetic counseling?
How do you envision using the GC-FIRST fellowship to contribute to the development of the growing genetic counseling field in academic genetic counseling programs, in their clinical settings, industry, public or population health settings?
Review the list of research topics and rank your top three with 1-2 sentences to describe why you believe the topics are important to the field. Then choose one of the topics to create an example of a primary question that you would like to address over the course of the fellowship.
Research Statement:
In 2014 I sublet Rob’s apartment. His place was a short walk from British Columbia Women's Hospital which housed the Adapt Clinic, the world’s first psychiatric genetic counseling clinic, and the site of my upcoming rotation. When I first saw pictures of the apartment, I envisioned myself basking in the sun shining down from the skylights and enjoying the walkability of neighboring restaurants and parks. Once there, I found myself fingering through the books on his shelves and attempting to make sense of the eclectic collection of posters, knickknacks, and yogurt containers that adorned the apartment. Though I didn’t realize it at the time, the month in Rob’s apartment was a limited case study; I developed a sense of who Rob is without ever meeting him. Like most, I am curious about the people my life intersects with, whether it be a sublessor, colleagues, mentees, or the patient population I counsel.
Prior to arriving in B.C., I attempted to get acquainted with the founder of the Adapt Clinic, Jehannine Austin, PhD, CCGC, by reading and researching her work. When my psychiatric genetic counseling rotation began, the importance of genetic counseling research became evident. Research Jehannine's team conducted directly led to the development of the Adapt Clinic and the genetic counseling approaches used with their patients. Most importantly, her papers measured the effectiveness of the clinic’s genetic counseling services and patient outcomes. Jehannine’s publications provide evidence of the need for psychiatric genetic counselors around the world.
When I returned home, a curious classmate asked, “What genetic testing did you coordinate for the psych patients?” “None,” I replied. A supervisor asked, “Did you calculate recurrence risk for relatives?” “Only if the patient requested it after learning more about the etiology of mental illness,” I responded. I was well-prepared for the next question, “Is psychiatric genetic counseling even beneficial?” Thanks to Jehannine’s qualitative and quantitative research the answer is a resounding yes; her research demonstrated that patients find genetic counseling useful, as it increases knowledge and empowerment for individuals with psychiatric conditions and their families (1, 2, 3, 4). This experience spearheaded my interest in academic research, as it exemplifies why research can be so powerful: in a specialty where genetic testing is limited, research proved that genetic counseling is still beneficial in many ways. As genetic counseling expands into new specialties and settings, genetic counseling research is imperative to determine precisely how genetic counselors impact their patients, customers, and/or employers.
To date, my research experience includes varying levels of involvement in preconception and ART-related research projects. My first research project was in graduate school, when I completed my capstone on Jewish genetic disease screening practices amongst OB/GYNs and midwives, learning that both groups of providers were misinformed about carrier screening guidelines. While working in clinical practice at the Colorado Center for Reproductive Medicine, I performed literature reviews, data collection, and drafted abstracts and posters under direction of the Scientific Director, Mandy Katz-Jaffe, PhD, but I desired a deeper understanding of study design and data analysis. More recently, I served on research committees for two ART-related student thesis projects: a qualitative study analyzing the decision making process and utility of genetic counseling amongst LGBTQ+ couples pursuing ART and a case report on two novel variants impact on sperm morphology. While my knowledge base in ART and genetic counseling is strong, I feel that my understanding of the research process is still limited.
I am very interested in the GC-FIRST Program because I would like to better understand the intricacies of research planning, design, and execution so that I can conduct my own research in the space of ART genetic counseling, help promote a more diverse next generation of genetic counselors, and act as a stronger mentor. Similarly to Jehannine, I hope my future research could lead to more genetic counselors in ART by demonstrating the benefits of genetic counseling in this area as it pertains to patient empowerment and treatment decision-making. Additionally, I hope to research ways to improve diversity in the genetic counseling profession. Many of my YouTube videos are designed to help GC hopefuls – especially those who are unable to regularly job shadow or intern – develop competitive application materials for genetic counseling graduate school, and I hope to promote this further by researching barriers to entry and how they can be overcome. Lastly, I absolutely love supervising current students and would enjoy contributing to research on the topic of supervision to improve students’ psychosocial skills, utilization of the counseling model, performance anxiety, and supervisor provision of feedback. Upon completion of the GC-FIRST Program, I will use newfound skills to promote genetic counseling as an important aspect of patient care and as a career.
Of the listed research topics, I found the following three examples to be most captivating:
Universal and Cascade Screening Research using Familial Hypercholesterolemia as a Model
Genetic counselors across specialties regularly communicate that, unlike most labwork, genetic testing can have broad familial implications. Patients and providers may assume that provision of genetic information is the primary role of genetic counselors, but I believe modifying a patient’s behavior to improve their outcomes (whether health-related, cognitive, or emotional) is actually the hallmark of genetic counseling.
I am interested in applying motivational interviewing to facilitate cascade screening in the gamete donor population. Using expanded carrier screening, I frequently identify donor applicants who are carriers at risk for symptoms or at risk for autosomal dominant disease with reduced penetrance (e.g. ATM, NBN, RYR1, and F11). These donor applicants are typically disqualified from donating, however their results have implications for family members.
I would be interested in researching the impact of motivational interviewing during genetic counseling sessions of sperm donor applicants who are found to be at risk for symptoms/disease via carrier screening; specifically, I am interested in exploring if motivational interviewing improves the rates of sharing results with and cascade screening of at-risk family members.
2. Genetic Counseling Practice Research
The practice-based competencies for genetic counselors include provision of evidence-based and current approach to genetic counseling practice and an understanding of the process of clinical supervision of trainees. Up-to-date genetic counseling practice research helps both new and experienced genetic counselors improve their genetic counseling skills and understand current approaches to genetic counseling backed by evidence.
3. Genetic Counseling Checklist (GCC)
As genetic counselors merge into all areas of health and wellness, there are new opportunities to measure the outcomes of genetic counselors in their expanded roles. To improve patient care and demonstrate the value of genetic counselors in different roles and settings, I am interested in researching tools such as the GCC and FOCUS and applying these tools to determine how genetic counselors can best impact not only the patient care experience, but also changes to patients’ health behaviors and familial impacts.