Is There Such a Thing as a Good Shadow?

One of the most important things an applicant can do to get into a genetic counseling program is shadow genetic counselors. That’s because so many bio majors can look at this career from the outside, and see reasons to go into it. In a genetic counseling career, you don’t have to spend 40 years at a lab bench, you get to constantly learn new things, you work with people, make a good salary, have high job satisfaction, and again, you don’t spend 40 years at a lab bench. Since so many students are interested from the outside, programs want their applicants to get the “inside” look and find out if the career is really for them. There’s a few different ways to achieve that, but for most of us, it’ll be shadowing!

Here’s one of my first shadow days, back in early 2017. It’s honestly crazy to think I was just barely starting to shadow in March of 2017 and I was applying 6 months later. What was I doing all through school? Still, I’m proud of the many hours of shadowing I’ve gotten since then!

Shadowing at Myriad Genetics in March 2017. Myriad employs about 10 genetic counselors who work in a non-patient facing role. They advise doctors and other genetic counselors all around the country regarding Myriad testing and result interpretation

Every applicant knows that they should shadow, but it wasn’t until recently that I learned there is a right way to go about shadowing. When other applicants talked about getting letters of recommendation from counselors that they had shadowed, I wondered how they could possibly be impressing those counselors enough for a letter. A shadow just, like, sits there doing nothing! Right? I only recently learned that you can be an exemplary shadow, without overstepping your bounds. Here I’ll share some tips I’ve collected and learned over time.

First, the cold email. There’s a temptation to just cold email a “hello, can I shadow you” to every practicing genetic counselor in your area. That’s actually similar to what I did before my very first shadowing experience (which was at Huntsman where I now work actually). Huntsman was the only response I got out of probably dozens of emails.

Since then though I’ve strategically reached out via email to specific clinics I’m interested in visiting, and I’ve gotten a much better response. For example, a few months ago I was interested in understanding the pediatric subspecialty better, so I searched for counselors working at Primary Children’s. I emailed all of them (three counselors) and said: 1) I’d never shadowed in peds before, 2) I volunteer with children and think peds could be a great choice for me long-term, and 3) I wanted to expand my exposure to a new specialty.

This time, two of them answered, both positively, and I was able to shadow three days with one of them in her peds clinic. The other turned out to be the local GC program director and when I later realized who she was I felt v embarrassed that I’d emailed her, but……. she actually responded that she’d meet me for lunch to talk about peds, since she doesn’t see patients very often. That’s a whole other story but we love a good mistake that turns out alright. 😅

So making your emails more specific concerning why you’ve reached out to that clinic in particular, I believe encourages the counselors to respond. They know you didn’t just send the same email to every GC in the state, so it’s not as easy to brush off as “someone else will take them”.

Next up, preparing to shadow. Before shadowing, I’d recommend learning a bit about the general types of genetic disease that are covered by that type of genetic counseling clinic. What I mean by that is, if you’re shadowing in cancer try reviewing hereditary cancer syndromes, if cardiology try learning what genes relate to cardiovascular development. You don’t have to know everything, but a little studying could help you understand the sessions you see. You could even ask the GC if they are able to share what genetic conditions they’ll be working with that day, though they may not yet know or be able to share. But, you can still ask if that’s something they could share with you.

Shadow Day. This part gets to the heart of our question: can you be good at being a shadow? You can! Shout out to one of the programs I’m applying to for having a genetic counselor shadowing feedback document on their application. I wish I’d seen something like it sooner, so I could have more quickly figured out what makes a good shadow. This form asks a GC to rate their shadow (the applicant) on several metrics including: professional appearance, positivity, appropriately working in a shadow role (not overstepping your bounds), asking questions, being helpful if needed, and handling clinical discussions maturely.

Sometimes I feel like I’m a bump on a log when shadowing I never thought to ask if there was any way I could be helpful. I also felt weird asking questions, until one time a few people from the peds genetics team gathered in the office while I was shadowing and discussed the upcoming patient’s unusual medical history. I decided to ask about something they said, and I actually became a tiny part of the conversation! If you have any thoughts about something discussed in the GC office between appointments, or questions about a case you’ve seen, it’s ok, even great to ask about it. On that note, I’d recommend reading the Journal of Genetic Counseling or taking an online GC class (available through U of South Carolina and U of Cincinnati) to stay current on genetic conditions and have more to discuss with the GC between appointments.

Post-Shadow Day. It’s common wisdom that you should send a thank you letter after shadowing (not that I’ve been perfect about that). I would say simply say thank you and share something you learned (not so specific that you’d break HIPPA, of course!). This post-shadow email is also a great time to ask if you’d be able to return sometime. I’d recommend suggesting a week that’s about a month away. That gives them some flexibility, but also is close enough for them to know their schedule. One of my biggest shadowing regrets is not asking to come back! I’ve repeat shadowed only one counselor, and I think others would have been open to it.

So there you have it, a full shadow experience outlined for you!

On one more note if you’re struggling to get offered shadowing experiences try these tips:

  • Specifying your reason for asking that clinic (as discussed above)
  • Asking if you can do an informational interview with one of the counselors
  • Volunteer at the hospital you would like to shadow in
    • This is a big commitment, but is sometimes the only way to get in as a shadow. The only reason I can shadow easily at Intermountain Healthcare Clinics was because I volunteer at Intermountain Primary Children’s, meaning I already had background checks and medical clearance, and I can wear my volunteer ID during the shadow day.
    • There are only 3 major hospital systems in Utah (U Health, Intermountain, and VA) and 2 of the 3 said I would essentially have to be a volunteer in order to shadow!
    • You can always ask if you can volunteer in the genetics clinic itself. I volunteer in the playroom at the Children’s Hospital, but in some hospitals volunteering with the GCs may be an option
  • Contact the GC program(s) in your general area and ask where their rotations are (or check their website). All programs need a hearty set of GCs willing to work with students, so they can point you in the right direction
  • Focus on asking for shadowing in the spring and summer. Local program(s) let out for summer, students head to rotate elsewhere, clinical supervisors may be more open to another body in their office at that point. Because when the school year’s in full swing and you’ve got a med student, resident, GC student, medical geneticist, and a GC in one room, adding a shadow can feel like too much!

So much shadowing advice, so little time! I’m shadowing in pediatric cardiology soon, and I’m really excited to see this new subspecialty. Scheduling this experience has taken like 4 months and we still don’t have an exact date, so I guess my last tip for getting shadowing is patience.

In just about six or seven weeks I may start hearing back from schools and I can’t wait! Shadowing has been a huge influence on my decision to stick with this career, and I hope it also helps me earn that coveted spot in school.

-Laura Cooper-Hastings

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