What’s It Like to See a Genetic Counselor? Past GC patient Melinda McLain Answers

Today, November 8th is Genetic Counselor Awareness Day. Talk about a weird holiday no one knows about! Since this GC Awareness Day happened to fall on a Thursday, I wanted to do something special besides running my mouth about how cool and necessary genetic counselors are!

So this week I chatted with the wonderful Melinda McLain about her and her family’s experiences seeing genetic counselors and pursuing genetic testing. Melinda’s mother experienced both breast and ovarian cancer before being diagnosed with a BRCA2 genetic mutation. Several members of her family have since been tested for the mutation, each with a unique experience. I am excited she was willing to share with all of us her experience with genetic disease and genetic counseling.

As background for anyone new to cancer genetics, BRCA 1 and 2 are two of 20+ human genes which work to repress cancer. All people have the BRCA genes (and all of the cancer-fighting genes). When someone says they are “BRCA-positive” they mean they carry a mutation in one copy of either BRCA1 or BRCA2, a mutation that inhibits their body from fighting off uncontrolled cell growth. Mutations in BRCA genes have been associated with breast, ovarian cancer, and to a lesser degree, pancreatic and prostate cancers and melanoma.

Melinda first learned about her mutation risk during her mother’s treatment for ovarian cancer. Her mom had breast cancer in the early 2000s, and then ovarian cancer in 2015, at which point her oncologist pursued BRCA gene analysis. That testing revealed a harmful mutation in the BRCA2 gene. Melinda and her sister Angelique were present at their mom’s oncology appointment when she learned her BRCA analysis results, and both women decided to pursue testing that day. They both tested positive for that harmful mutation. Melinda’s daughter Hannah received testing later on, and she tested negative. Each of these women had a different experience with genetic counseling and testing, as well as the path they took from there. For Genetic Counselor Awareness Day, I wanted to share their stories of how they used or didn’t use genetic counseling, and what role that played in their care.

When Melinda tested positive and realized the implications of the results, she immediately knew she wanted to undergo a hysterectomy and mastectomy, to essentially eliminate her risk of breast and ovarian cancer. Still, her mom’s oncologist still recommended her post-test genetic counseling. She soon sought that counseling and reported that it helped her in a few ways. The genetic counselor’s extensive experience with hereditary breast cancer meant that she could recommend a surgeon who specializes in breast cancer and preventative mastectomies, with whom Melinda had a positive experience. The counselor also offered take-home resources and references which presented all of the information about BRCA-associated cancer risk in an organized fashion.

Melinda did share that she had gone into the appointment very informed and emotionally stable regarding the result, so she felt the GC session didn’t need to be as long as it was. Or, at least, she wished she had known it was billed by the half hour before allowing the counselor to talk so long! Still, she found her session somewhat helpful and noted that it could have been even more helpful if she’d seen the counselor before testing, or if she’d been less researched on or more frightened about the diagnosis.

She then shared the experience of her sister Angelique. Angelique decided not to pursue any surgeries or further intervention at that time, with the idea to potentially do those surgeries or seek more mammograms as she got older. However, in 2017 Angelique was diagnosed with stage 3 breast cancer and then underwent surgery, which led to some complications that made her recovery more difficult. Melinda shared how difficult it was to learn of her sister’s cancer diagnosis and then see her suffer through the challenges and complications that came with it, much harder than learning about her own cancer risk. Throughout that process, Angelique chose not to see a genetic counselor, a valid choice that many patients do make for a variety of reasons.

Melinda, who is also a florist, shared this bouquet on Instagram recently, in honor of her sister’s brave fight against breast cancer. (@utah.flowergirl)

We then spoke briefly about Hannah’s experience. After her mom tested positive, Hannah sought out genetic counseling and BRCA mutation testing. She tested negative, and she found that out through her genetic counselor. Hannah was the only member of the family to receive any pre-test counseling. Though Hannah tested negative, the genetic counselor still played an important role in pre-test education and consenting, as well as giving Hannah someone to open her results with and discuss them if needed.

We have Genetic Counselor Awareness Day, because it’s so important that healthcare providers and patients are aware of genetic counselors and the role they can play in a care team. Not all patients will choose to see one and not all will choose to make their GC a long-term part of their healthcare team. I do believe if everyone knew the breadth of what a GC could do for them, more patients would choose to look into seeing one. No matter what a patient chooses to do with their genetic testing results, a counselor can be a guide to understanding the mutation or lack thereof, and a resource if the patient’s health is ever affected by it.

It was so insightful to hear how each family member reacted to having a hereditary cancer syndrome in the family, and if/how they chose to involve a genetic counselor in their healthcare team. Not all aspects of genetic counseling are helpful for every patient. Still, many patients share, as Melinda did, that they are glad to have another person on their team, another good source of information, referrals, and resources, and someone to discuss results with if needed. I also enjoyed hearing what she found less helpful in her session. As a future genetic counselor, she opened my eyes to the importance of tailoring sessions to meet patients’ needs. A well-researched and emotionally stable patient might need a quick review of their situation, and encouragement to follow through on the choices they want to make for their health. Other patients may need much further guidance and potentially several appointments. There’s something for a genetic counselor to offer every type of patient with genetic disease at every phase of their journey.

A huge thanks to Melinda and her family for sharing their story with me! And a shoutout to her daughter and my friend (and fellow genetics grad) Ellie McLain for helping me set this interview up for me!

It’s been super fun to learn from a patient’s perspective this week! Thank you for reading! In doing so you’ve celebrated Genetic Counselor Awareness Day– probably for the first time ever! (IMO you should all definitely take yourself out to dinner for GC Awareness Day).

‘Til next week!

-Laura Cooper-Hastings

If you are worried about a genetic disorder or a family history of a disease in your family, check out findageneticcounselor.com to see if there’s a genetic counselor near you who could help!


Staying Sane: Mental Health as an Applicant

Sometimes I think about just how much effort it took to be rejected from GC school. Between applications, interview travel, the GRE, and sending transcripts / scores, my first cycle cost about $3000. It also took about 9 months. But more than anything it was extremely taxing on my mental health. As a crisis counselor, I know just how much people in counseling and healthcare fields experience challenges with their own mental well-being. The other GC applicants and I are certainly no exception.

That mental exhaustion has started to rear it’s head again as I’ve been wrapping up my applications this week. It reminded me that I need to get ready to be kind to myself and maintain self-esteem through this grueling process. So I wanted to write about the parts of the process that are most stressful, and some ways to self-care.

Things that are stressful about the process:

  • Every school charging you like $70 to look over your app
  • Wanting the personal statement to be perfect
  • Having to pester busy recommenders several times (!!!!)
  • Still keeping up with work / school / whatever your daily grind is
  • INTERVIEW OFFER (+ rejection) SEASON
  • Mentally calculating your odds of matching, by several different complex algorithms
  • Traveling to interviews (see below)

I took this selfie onboard the first leg of my flight to my Rutgers interview– my flight from SLC to Detroit. It landed at like 10 pm, and hour behind schedule, and by all accounts I should have missed my flight to Newark. Life Pro Tip, btw: If you are connecting between two flights on the same airline, they will almost always hold the second plane until all of the connectors make it on. It’s cheaper than rebooking you.

Continuing the list:

  • People asking if you’ve gotten accepted yet but it’s February
  • Interviewing with v important people! (Current / former members of the National Society of Genetic Counselor’s Head Leadership, Program Directors, Other nationally recognized GCs)
  • Waiting to hear anything
  • Other application and interview disasters not otherwise specified 😂

So I’m saying it’s pretty easy to get burnt out. Last cycle interview offer season was really hard for me. I started off with an interview offer, then two days later, two rejections. As rejections and awkward waiting limbos piled up, I found it harder to sleep, eat, and generally care for myself. With so many stressful parts of the application process, I wanted to share some things that I did and want to do to maintain balance and self-care. I hope someone out there going through the same thing finds this helpful! Rather than a comprehensive list of activities, here’s 3 principles I use for building a grad school app season self-care plan– no matter what program you’re applying to. (Or even if you’re not an applicant at all, rather a caring friend or family member who reads this blog to support me. I see you and I thank you.)

#1: Plan Not-Related-To-Grad-School Events to Look Forward To

Especially in the interview and waiting for Match half of the application process, it can really feel like your whole life waits upon Match Day. Living that way can decrease hopefulness about the future and make life feel empty post-match. To combat this, last year I calendared a couple of fun events for after Match Day, including Disneyland, our family trip to see a musical in St. George, and the Utah Valley Half Marathon. These events gave me something to look forward to, even if it wasn’t grad school. This year, I’d also like to plan some good events for January-March so that it’s not like my life is completely devoid of adventure beyond trips to interviews. Who wants to take me to try skiing or snowboarding for the first time before I maybe move away from the snow??

#2: Build a Caring Community

You can find an online community of struggling applicants for basically any grad school admissions type. Med, Dental, PA, and yes even GC have forums and subreddits devoted to talking about the field and getting through the stress. These forums are not right for everyone though! The opportunity they offer to compare yourself to other applicants can be more stress than it’s worth. At the same time, they offer the support of others in the same situation. My recommendation to anyone applying to any grad program: if you’re feeling alone try these communities. If you’re already feeling stressed stay away haha. I used to be a pretty active poster in those GC applicant communities, but I’ve tried to stay away more often this cycle. I am friends on social media with several of the people I met on the forums though, so I still don’t have to feel alone. These communities and the people in them can be great resources if used effectively.

#3: Always Be Improving

Counter-intuitive, right? Push yourself to remain unstressed? What kept my stress down most last cycle was having new activities I was doing that I was proud of, including starting at Primary Children’s and at Crisis Text Line. Even taking on more responsibilities at work made me feel like I could see myself being happy and fulfilled even if I had to stay another year. Always be on the lookout for ways you can better yourself and find fulfillment in your current situation. Then, getting in won’t make or break your future, just momentarily change your path.

I hope someone out there finds all of this helpful, and I think it was so needed for me to remember these principles of self-care as well. Talk to you next week, and seriously drop me a comment or DM if you want to teach me how to do a winter sport this winter!

-Laura Cooper-Hastings

What Happened Last Cycle: A Quick Breakdown

Before we embark too far on my journey into my second year applying, I thought I should share what happened last time, in brief.

Last cycle I applied to genetic counseling schools while I was still an undergraduate. I knew I for sure wanted to be a genetic counselor and I didn’t want to take any gap time before getting my Master’s of Genetic Counseling degree. I applied to 10 schools and interviewed at 2, one in New Jersey and one in South Dakota. That means I received 8 (!) rejections without an interview!

However I had the most wonderful and interesting interview experiences like this

This was coincidentally my first time in a bar. The bar was also a Chinese restaurant on Times Square.

And this

Did they steal BYU’s Motto?!

A medical school interview tip book I’m reading states that many students overestimate their ability to interview and that is so the truth for me. I thought if I’m just confident and show my love for GC, they will love me back. Not the case! The whole process was fun and new and it made me come off excitable. I was so excited to be there, I didn’t ask questions showing that I wanted to find out if it was the right program for me. Even though I showed enthusiasm, I didn’t show the kind of thoughtful, collected maturity these schools look for. Having interviews and feedback last cycle played in huge role in knowing what I want to improve this cycle.

As I said, I was thrilled to visit both of my schools. Beyond that, I won’t speak to my particular impressions of these schools or any schools I will visit this cycle, because they are only my personal opinions based on limited experience. I will say that I am very lucky that I got to experience two completely different programs with different values and culture, and I developed a better idea of what types of programs I should apply to this year. Even the schools I didn’t interview at gave me feedback about what they were looking for. I learned what to improve, and whether I wanted to try for that school again.

As I previously mentioned, last Match Day happened on my graduation day. Getting notice that I hadn’t matched, while trying to celebrate graduation, wasn’t easy. There were advantages to this set up though. My whole family found out at once, so there was no repeating the bad news, at least not to them. Also Match Day really can never get worse than ruining graduation, so it’s all looking up from here. I’m also quite grateful that we scheduled a self-care Disneyland trip for the weekend immediately following Match Day.

Now that you’re caught up, I’m planning on expanding the scope of my posts from my own story to topics covering everything about prepping for genetic counseling and graduate school. I’m hoping to not only keep my own friends and family updated, but also share my blog widely to become a resource for other pre-GC students. In a world where there are hundreds of books, YouTube channels, blogs, and Instagrams about pre-med / med school life… We need at least one speaking for genetic counseling amiright?!

So for the next few months I’ll share weekly posts of both personal updates and info that could be helpful for others like me. Then starting in January there might be news about interviews (and rejections haha!)

I hope you’ll all stay along for the ride!

-Laura Cooper-Hastings

“When Do You Hear Back?!” : Life as a 2nd Year Genetic Counseling Applicant

I am a second year applicant.

In the genetic counseling applicant community, that statement is a badge of courage. Yet it’s one that no one wants. First year applicants look to second year applicants for wisdom… but it’s mostly hoping that maybe they can avoid the same awful fate. I have tried for months to hide my rejection from my first round applying to genetic counseling schools. But now I want to invite others into my story as we journey together to find out what the next chapter will be. This cycle, from now until next April, I will share here my highs and lows, interviews, rejections, awkward limbo waiting games, and more. I’m not ashamed of the struggle to reach this goal.

To be a genetic counselor is to take genetic knowledge out of the lab and straight to the people who need it most– patients with genetic disease in the family. The daily work relies heavily on principles of counseling and psychology as they help families cope with the genetic world. As a genetics-lover and a longtime crisis counselor, I am still in awe every day that somehow there is a perfect career for me.

When something’s so perfect, there’s always a catch. The catch in this case is the 8% acceptance rate to each genetic counseling program. In any given year about 70% of applicants will not receive offers of acceptance from any school. Beginning last year, genetic counseling schools began participating in The Match, which uses a computer algorithm and rank order lists to find the best possible “matches” between schools and applicants they interviewed. I’ll write a post all about it here soon. It’s an 8-month long process from start to finish and many applicants repeat the process 2-3 times before acceptance.

It’s been 5 months since I found out I didn’t match last year, and I still have people ask me when I’ll hear back from the schools I interviewed at, when and where we are moving, etc. It’s a struggle for people to understand that I could be rejected from every school. Luckily, now I can tell them: Next April! Last year I got rejected from GC School at my college graduation. Like literally standing in line to walk across the stage. Check out the #sadgrad picsadgradhaha.jpg

Me and my husband at my grad, featuring my completely faked smile.

It was the worst day! But this year I’m going to make Match Day the best day, or at least write a lot of blog posts as a try to. My message is: it’s okay to struggle to reach your goals, it’s okay to own your roadblocks, and it’s a great time to try to become a genetic counselor.

I’ll post updates weekly, even before anything really happens! I’ll talk about applications, shadowing, Match, interviews, counseling experience, and more. Thanks for joining me.

-Laura Cooper-Hastings