Genetic counsellor

Genetic counsellors help patients and their families understand and make informed decisions about a range of genetic conditions

As a genetic counsellor, your role is to interpret and explain genetic information to patients and to support them and their families to make use of this information. You'll help them to understand the medical facts, including how heredity contributes to their condition, and the options for dealing with the risk of recurrence.

Your support will be key for patients and their families to make decisions and to adjust to a condition, and/or the risk of recurrence of that condition.

Genetic counselling is a career attracting graduates with an interest in medical genetics and face-to-face patient interaction. Genetic counsellors are highly skilled healthcare professionals with training and expertise in genetic medicine and counselling.

Responsibilities

As a genetic counsellor, you'll need to:

• manage your own caseload of patients - through face-to-face interactions, over the phone and via video (virtual clinics)
• take and interpret family and medical histories to calculate the risk of condition occurrence or recurrence
• assess which genetic tests are most appropriate for each patient
• order genetic tests and arrange medical and/or diagnostic testing of patients as well as testing of relatives
• interpret genetic tests and explain them in easy to understand language to patients and their relatives
• educate patients about inheritance patterns, testing, management, prevention, resources and research
• use counselling skills to promote informed choices and help patients adapt to the risk or condition
• refer patients for appropriate screening relating to their condition
• deal with psychological and ethical issues raised by individuals and their families
• keep patient records and write letters to patients
• work with other medical and healthcare staff as part of a multidisciplinary team of genetic consultants, clinical scientists and other consultants to ensure appropriate follow-up of patients.

Experienced genetic counsellors may also need to:

• design and implement audits of clinical genetics
• undertake and present findings of research to colleagues
• mentor junior or trainee genetic counsellors and students
• mentor, train and offer clinical supervision to non-genetics medical and nursing staff who are using genetic technologies in their work
• use their skills to support genetic testing in specialist teams in areas such as cancer, cardiology, neurology, ophthalmology and reproductive medicine
• act as on-call specialist for urgent referrals to the genetics service.

Salary

• Salaries for trainee genetic counsellors typically range from £35,392 to £42,618 on Band 6 of the NHS Agenda for Change pay rates.
• Salaries for qualified genetic counsellors range from £43,742 to £50,056 (Band 7).
• In more senior roles, such as principal genetic counsellor, consultant genetic counsellor, lead genetic counsellor or head of service, salaries can range from £50,952 to £114,949 (Bands 8a to 9). At the most senior levels, you will usually have responsibility for areas such as management and service improvement or research and teaching.

The NHS offers a pension scheme and sickness and maternity benefits. Salaries in London attract a high-cost area supplement.

Genetic counsellors employed outside the NHS may not have the same terms in relation to salaries, pension provision or benefits.

Income data from Health Careers. Salaries vary depending on where in the UK you work.

Figures are intended as a guide only.

Working hours

You'll usually work a 9am to 5pm day within a 37.5-hour week. Start and finish times may be flexible depending on the department. You may need to do some out-of-hours work when necessary.

Part-time work and job share opportunities may be available.

What to expect

• You'll typically work as part of a multidisciplinary team that includes other specialist medical and nursing staff such as clinical geneticists, molecular geneticists and clinical scientists.
• Consultations usually last around 45 minutes (but can range from 30 to 90 minutes) and you're likely to see between seven and ten patients a day, depending on the complexity of the case and patient needs. It can get very busy, and a heavy workload is typical.
• The work can be emotionally demanding as patients may be distressed. It can also be rewarding, however, as you'll help patients get through a difficult situation.
• Jobs are available in most areas of the UK, usually in medium-sized or large hospitals. However, there's only a relatively small number of jobs available and you may need to relocate to increase your chances of career progression.
• Clinics may be spread across different hospitals in your region so you will usually need to travel during the working day.

Qualifications

Most new entrants to genetic counselling have a degree in genetics, biological/biomedical science or nursing, although other degree areas such as social sciences and psychology may also be relevant.

There are three qualification routes available to become a genetic counsellor in the UK. One option is to take a Masters in genetic counselling accredited by the Genetic Counselling Registration Board (GCRB). For an up-to-date list of courses, see GCRB-accredited courses.

After completing the course, you'll typically work in a Band 6 pre-registration genetic counsellor post in a genetics service for two years under the supervision of an experienced GCRB-registered genetic counsellor. You'll then be eligible to submit an intention to register as a genetic counsellor through the GCRB. The register is maintained by the Academy for Healthcare Science (AHCS), which is accredited by the Professional Standards Authority for Health and Social Care (PSA) on an annual basis.

Graduates with a relevant degree can apply for a place on the NHS Scientist Training Programme (STP) in genomic counselling. Successful applicants will be employed in a three-year, full-time, workplace-based training post on Band 6. As part of your training, you'll complete a Masters degree in genomic counselling. After successful completion of the STP, you'll be eligible for registration as a clinical scientist with the Health & Care Professions Council (HCPC) and will be able to work as a Band 7 genetic counsellor in a genetics service. HCPC-registered genomic counsellors may also apply for AHCS registration through the GCRB if they want to.

A third option is open to professionally qualified and registered nurses or midwives with previous senior experience, who have completed training in counselling skills and human genetics. As with the Masters route, you'll be expected to work in a Band 6 pre-registration genetic counsellor post for two years, after which you'll be able to apply to register with the GCRB.

Skills

You'll need to have:

• communication skills to gather sensitive information from patients
• interpersonal skills to empathise with patients and to communicate sensitive information
• counselling skills
• analytical skills and the ability to use your judgement to interpret family history and risk factors
• the ability to interpret complex scientific papers and genetic test results, and make clinical decisions based sometimes on conflicting information
• report and writing skills
• planning and organisation skills to manage a caseload of patients
• research skills to inform practice development
• the ability to reflect on your own practice
• hand-eye coordination to carry out venepunctures
• the ability to work autonomously and in a team
• numeracy and IT skills
• a flexible and collaborative approach to work.

Work experience

You'll need relevant caring experience to get a place on a course/training programme. Relevant experience can be gained through:

• healthcare work (e.g. nursing/social work)
• work in a care home
• working in a school with children who have complex needs
• volunteering with a counselling service or in a genetic counselling clinic
• charity work involving patient care
• supporting a vulnerable child or adult.

If your degree did not include modules on genetics and/or counselling, it's recommended you get basic training in these disciplines before applying for courses.

You can contact your local NHS hospital to ask about work shadowing opportunities.

For free mentoring resources and experiences designed to support aspiring healthcare and legal professionals - including virtual work experience that is accepted by medical schools, see Medic Mentor.

Find out more about the different kinds of work experience and internships that are available.

Employers

There are around 330 genetic counsellors in the UK and approximately 7,000 worldwide.

Most genetic counsellors in the UK are employed in the NHS and are based in clinical genetics departments in medium-sized or large hospitals around the UK. There may be some opportunities in the private sector as well.

It's also possible to follow a research career, working in a university or research institute.

If you work in private practice, you must ensure you have a sufficient level of indemnity cover.

• AGNC Jobs
• NHS Jobs
• NHSScotland Jobs
• Jobs in HSCNI

Professional development

Continuing professional development (CPD) is an essential part of continuing registration with the GCRB and HCPC and helps develop your professional knowledge and competence as a genetic counsellor. You'll be expected to undertake a certain amount of learning activity relevant to your area of practice each year. Some examples of learning activities are:

• relevant courses and conferences, e.g. the annual conference organised by the AGNC
• seminars and online learning modules
• study days, journal clubs and lectures
• regional or national meetings held to discuss and agree on the functioning and organisation of genetics services
• time spent writing publications or policy documents
• undertaking research.

In addition, you must also undergo clinical and genetic counselling supervision. Clinical supervision involves reviewing and discussing cases and working practices. During counselling supervision meetings you'll meet a trained and experienced supervisor for guided reflection on your work and exploration of the interaction between you and your patients. The aim is to improve your practice and enhance the quality and safety of patient care.

It's also possible to take further qualifications in areas such as counselling or teaching, or to take a research PhD. You could also do training in leadership and management.

Career prospects

There is a structured career path within the NHS from pre-registration genetic counsellor to genetic counsellor, principal/lead genetic counsellor and, ultimately, consultant genetic counsellor. Once qualified, you can progress through the grades by gaining experience and taking further training. Promotion is based on merit, and you may need to move to other hospitals to make the most of available opportunities.

Principal genetic counsellors are experts with substantial experience and training beyond that of a genetic counsellor. Consultant genetic counsellors have a lead role locally and nationally in a field of expertise. Opportunities to become a consultant genetic counsellor are rare and only available in some clinical genetics departments.

You can also develop your career by becoming a committee or board member for professional bodies such as AGNC or the GCRB.

Some genetic counsellors choose to pursue careers as researchers on psychosocial issues of genetic counselling, either combined with their clinical practice or exclusively doing research.

There are also opportunities in areas such as education, policy, private practice, professional regulation and service management.