Guest Post: Breaking the Glass Ceiling

By HEATHER HAMPEL and DAWN LANEY

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Do you hear that sound?  It is the sound of hundreds of genetic counselors bumping their heads into the glass ceiling that our Master’s degrees can cause, particularly in academia.

For Heather, her first experience with this occurred within 2 years of graduating when she was working on a research study in colon cancer genetics.  Their collaborator did not believe she should be listed as a co-author simply because she did not have an MD or PhD.  Her boss fought for her and she got the authorship she had earned, but their collaborator’s genetic counselor was listed only in the Acknowledgements section despite her contributions to the study.

For Dawn, the thump against the glass ceiling occurred again recently when she received an email notification from a large, NIH funded, genetic disease network announcing that student trainee travel awards were being granted to their annual meeting.  Dawn wanted her genetic counseling fellow and first year genetic counseling student to attend this meeting, as they were working on relevant projects.  Sadly, a follow-up email arrived…only PhD, MD, PharmD, or other doctorate program students would qualify for travel awards.

We are genetic counselors.  That is all we ever wanted to be.  But over time, after many bumps against the ceiling, it has become clear that sometimes our Master’s degrees are holding us back.  We both considered PhD programs early on, however, we would have had to get one in a field other than genetic counseling in which we were not really interested.  Later, after having kids, buying homes, and working 40-60 hours/week, we simply could not cut down on hours or move our families in order to obtain a PhD in genetic counseling at one of the very few institutions that offer this degree.

So, it was a major transformational event when we attended an Educational Breakout Session on the Clinical Doctorate at the 2009 AEC.  Until then, we had not noticed the revolution quietly going on around us as other allied health professions were either converting to an entry-level Clinical Doctorate or adding an advanced degree Clinical Doctorate option.  This includes pharmacists (PharmD), physical therapists (DPT), audiologists (AudD), nursing (DNP), psychology (PsyD), and occupational therapists (OTD).  In fact, to our knowledge, the only allied medical profession that considered a Clinical Doctorate and decided against it are physician assistants, mainly since “both physicians and PAs practice in the domain of medicine; therefore, the entry-level doctorate for the practice of medicine is the MD or DO.”  Some of the potential pros for a Clinical Doctorate include:

  • Opportunities to advance career progression or career ladders – Of note, only 35% of genetic counselors reported being satisfied with their advancement opportunities in the 2012 National Society of Genetic Counselors Professional Status Survey,
  • Ability to obtain faculty appointments,
  • Ability to apply for grant funding
  • Ability to serve as the PI on an IRB-approved protocol
  • Increased status in the health care team
  • Address new developments – expanded knowledge base in rapidly progressing field
  • Gain ability to advance knowledge and skills in clinical practice and health care delivery

So, why not a Clinical Doctorate in Genetic Counseling – a DGC?  A specially designed, genetic counseling specific degree created for practicing genetic counselors to expand their medical and clinical research skills.  Imagine the possibility of obtaining a Clinical Doctorate through on-line, distance learning programs that can be taken in the evenings and on weekends from anywhere in the world.  Imagine getting credit toward the degree for the cases you have seen in your own practice.  Imagine courses directed at clinical-translational research.  To us, this option seems so much more accessible, affordable, and possible to do while working full-time.  We became convinced.

Originally, we thought that maybe genetic counselors should convert to an entry-level Clinical Doctorate so that we did not create a two-tiered system where some counselors had an MS and others had a DGC (To directly download a .pdf  that clarifies the distinction between entry level and advanced degree Clinical Doctorates published by the Association of Schools of Allied Health Professions, go to: http://www.asahp.org/docs/ASAHP%20re%20Clinical%20Doctorates.doc).  However, it has become clear that this would be problematic at present as some programs might have to close causing a reduction in the number of genetic counselors being trained.  In addition, it could potentially hinder licensure and reimbursement efforts.  We understand and appreciate this concern.  The last thing we want to see is a decrease in practicing genetic counselors, especially during a time when there is a great demand and need for our services.

However, this still leaves the open the possibility of the advanced degree Clinical Doctorate where those who wish to pursue the degree could do so. Just to be clear, we are not advocating for an advanced degree Clinical Doctorate instead of a PhD in genetic counseling – we are advocating for it, in addition to the PhD in genetic counseling.  We believe that there is need for both degrees as they serve different purposes and should be complementary as is the case in the nursing profession and psychology.  As to our prior concerns about a two-tiered system, we realize now that this already exists as some genetic counselors have PhDs and others do not.  In fact, this option seems to allow the most flexibility since counselors who do not want or need an advanced degree such as a Clinical Doctorate, would not need to obtain one.

So, what is the problem?  Well, it seems to us that the advanced degree Clinical Doctorate option is getting lumped in with the entry-level Clinical Doctorate and not being given due consideration.  In the survey from the Genetic Counseling Advanced Degree Task Force to the membership last month, it was difficult to respond if you support advanced degrees for genetic counselors.  The motion stated:

“A. Maintain the current standard – master’s as the sole entry-level degree/terminal degree; or

B. Move toward an entry-level clinical doctorate with elimination of the entry-level master’s degree.”

The use of the word “terminal” in option A seems to imply that there would be no opportunity for advanced degree options such as the Clinical Doctorate or PhD.  As a result, those supporting advanced degrees may have felt compelled to answer this item “B” even though they do support an entry-level Master’s degree, or to not answer at all.  In addition, the plenary session at the 2012 AEC was really focused on the entry-level CD and did not include much information about the option or impact of an advanced degree CD on the profession.

Afraid that the advanced degree Clinical Doctorate option was not being given enough consideration and that those of us who support it could not adequately convey our opinion to the Genetic Counseling Advanced Degree Task Force (GCADT) before they vote on this topic later this month, a small group of us designed a petition to offer those interested an opportunity to express their opinion:

https://www.change.org/petitions/support-an-advanced-degree-clinical-doctorate-for-genetic-counseling

Why a petition?  It seemed like the easiest way to obtain multiple signatures on a single document and much more considerate to the GCADT than an individual letter writing campaign which would have caused a barrage of e-mails or letters to members of the GCADT.  As of today, 129 individuals have signed the petition and the number continues to grow as the petition gets passed along informally from one genetic counselor to the next.  There have been many lovely responses but we’d like to share this one from a former genetic counselor in Australia:

After completing my masters at UCHSC I worked in Canada for 7 years then wanted to further my knowledge and skills. There were no advanced GC programs so instead I quit genetic counselling and returned to school to study medicine. Now a doctor, I miss genetics but will likely not return to it.

And so, as we close, we hope that the clinical doctorate, as an advanced degree, stays on the table in future discussions about advanced training for genetic counselors.  We also hope we begin to hear a new sound – the sound of us tap, tap, tapping away, trying our best to break that glass ceiling.

Heather Hampel, MS, CGC is the Associate Director of the Division of Human Genetics and Professor in the Department of Internal Medicine at The Ohio State University Comprehensive Cancer Center.  She is a former member of the Board of Directors of NSGC (Region IV Representative in 2003-4) and of ABGC (2007-2011) where she served as President in 2009 and 2010.  She received the Region IV Leadership Award from NSGC in 2006.  She works in cancer genetics and her research interests involve universal screening for Lynch syndrome.  She and Dawn Laney just met in 2012 due to their shared interest in an advanced degree Clinical Doctorate option for genetic counselors.

Dawn Laney, MS, CGC, CCRC is the Lysosomal Storage Disease Program Leader and an Instructor in the Emory University Department of Human Genetics.  She is an active member and past co-chair of the NSGC metabolic and lysosomal SIG.  Dawn has just joined the research SIG and thoroughly enjoyed attending the meeting at NSGC.  In her work life, Dawn specializes in clinical research and the lysosomal storage diseases.  She loves being a genetic counselor and finds that is entirely consistent with her long-term thirst for knowledge.  In the usual “one degree of separation” genetic counselor way, Dawn has enjoyed meeting and discussion advancement opportunities with Heather Hampel and all the other GCs pondering the topic.

Also, see a previous DNA Exchange posting about the clinical doctorate in genetic counseling.

18 Comments

Filed under Guest Blogger

18 responses to “Guest Post: Breaking the Glass Ceiling

  1. Jessica

    I completly agree with your post that an advanced degree really should be an option for those of us who are currently practicing in the field of genetic counseling. I was under the impression that a seperate task force was being created to explore the option of an advanced degree for us, and that the current task force is solely focusing on the issue at hand that many program directors have brought up- They are simply exhausting their options on ways to include new information and curriculum into programs while staying within the Master’s Level credit-load. There really are two seperate issues at hand here and it was my understanding from the breakout session and discussions going on currently in our field that both needed to be addressed seperately vs. together. I just have yet to see any information on this seperate task-force that was going to be addressing the issues you mentioned!

  2. Maki

    As a genetic counselor working in the healthcare IT field, I’m concerned that it would be too difficult for me to earn a CD without returning to/somehow getting back into clinical practice. I don’t see patients as part of my daily work, but my credentials are important and I have conducted IRB-approved studies, served as an industry expert, etc. I would be very interested in a CD but hope that GCs like me, working in industry without patient contact, are considered and provisions provided to ensure we have a fair shot at going to the next level.

  3. MAD, CGC

    *clink clink* Do you hear THAT sound?? That’s the sound of my nearly-empty piggybank, after paying for a 4-year undergraduate, 2-year Master’s degree, board exam fees, and ongoing membership and certification maintenance fees.

    While I applaud Heather, Dawn, prior commentors, and the petition-signers for having the gumption to express their opinions, I have to revisit this article’s own words:

    “Later, after having kids, buying homes, and working 40-60 hours/week, we simply could not cut down on hours or move our families in order to obtain a PhD in genetic counseling at one of the very few institutions that offer this degree.”

    How would this concern not apply to a CD? How many institutions could feasibly offer an advanced practice clinical doctorate? Genetic counseling Masters programs are few and far between as it is. Also, if this is a CLINICAL degree (as the name implies), how could we possibly justify making it an online/distance ed endeavor? Could institutions recognize/count clinical cases handled during the course of your paid work (in many cases at another institution, no less?) as counting towards a degree? Why are people suggesting this as a means to increase their ability to be recognized for research when this would not be a research degree? There are still so many questions to be answered.

    • Jacqueline

      I was having all of the same thoughts while reading this post.

    • Kristin

      I totally agree with these concerns. And, as a genetic counselor with a Masters, I can still apply for faculty appointment, apply for grant funding, gain clinical experience in specialty care, and I thought the whole reason we participate in CEUs was to stay current on new advances in genetics. My daily work and contribution to our high risk team is what has elevated my status. I am still not sure why we need to have an advanced degree.

    • Anon, CGC

      I absolutely agree with this post. Until someone can prove that the CD will actually benefit the profession I am not interested. At this point all the talk about benefits is speculation based on other fields. Those other fields were different from us from the very beginning. Why should we waste our time pursuing extra degrees and such when we can’t even bill for our services now? Have any insurance companies said that having a CD would suddenly make a difference? For those in academia have your bosses actually put it in writing that you’d be able to advance with a CD? If not getting a CD means that you’d have just spent a lot of time and money to be in the same place. I’m sorry that some counselors feel limited by their MS, but if they really want to be in academia and not doing patient care they should have considered a PhD in the first place. I personally want to stay in clinical care for my career, and I know that having a CD would not grant me any extra privileges or extra pay, because there is no data to support that GC’s with CD’s need to make more or have any changes to their scopes of practice. I really think that this is an unfortunate distraction from more pertinent issues like billing reimbursement and licensure.

  4. Courtney Berrios

    I second the comments and questions of Jessica and MAD, GC and feel that I need more information. I very much want to see more opportunities for advancement and continuing education for GCs. However, the conversation I’ve heard thus far has focused on the Clinical Doctorate, and while this may be a great option as an optional, advanced degree, I would like to see (and would be happy to be involved in) an exploration of not only a Clinical Doctorate, but also other possibilities for for advancement through expanding the availability of PhD programs, certificate programs, or fellowships. With the size of our profession and small number of existing programs, I am not certain what array of options are feasible to be supported, maybe all of them and maybe one or two. I would just like to see all the possibilities explored so that our profession call make a fully informed decision about advancement opportunities. I realize that everyone has different goals and challenges, so a consensus may be difficult, but a hearty discussion of all the options and more voting opportunities for everyone’s voice to be heard seem like a great place to start.

  5. Ian

    Nicely written article. Many genetic counselors seem to find excuses as to why a doctorate should not be offered, but the field is ready to be pushed forward. To hinder such progress does us all a disservice. The medical/research community will not slow down, and we need to keep up lest we get left behind. Genetics is an area of study where two years of study just doesn’t seem adequate, and this disconnect is only going to become more obvious as the worlds of genome sequencing and epigenetics open up. Since genetics is a field where progress is guaranteed, it’s surprising to see so many against it.

  6. Carin

    I think this is a fantastic article and whole-heartedly agree with Heather and Dawn. With only 5 year experience, I am already becoming aware of the glass ceiling very near my head. I think the need for more opportunities for advancement as well as the need for more in depth education (nicely described by Ian above) are both key arguments in support of an advanced degree clinical doctorate.

  7. Catriona Hippman

    First of all, I want to say thanks for having the courage to open this up to public discussion and to express some of your frustrations. I can completely identify with the desire for further education and career advancement, however, from my perspective a Clinical Doctorate is not the answer. Not for an entry-level degree, and not for an advanced degree. I am hugely interested in serving on the task force to explore advanced degree options. I don’t know what has been articulated yet for goals for the task force, but priorities I see are 1) to explore the needs and motivations of genetic counselors interested in advanced training, and 2) to explore what such training could look like. It is curious to me that those who signed the petition are so set on a clinical doctorate when it seems to me that a lot of these questions haven’t been answered and that a lot of assumptions are being made. I think before we reach a solution, we should fully understand the problem.

    Potential problems and solutions:
    GCs want greater autonomy / increased status in the health care team – it seems to me the best response to this need would be to increase efforts in terms of licensure and public awareness campaigns – we can all join together to promote the value of genetic counseling!

    GCs want greater responsibility – perhaps look to management positions that are already available – could consider an MBA?

    GCs want more involvement in research – consider a PhD or simply increasing involvement in research and building your CV, increasing publications. Please note: it is not necessary to change fields to do a PhD in Genetic Counseling, just because this particular degree doesn’t yet exist. You can do genetic counseling research in a variety of departments.

    Reasons that I feel that a Clinical Doctorate as an advanced degree is a bad idea:

    My assumptions include that the purpose of a clinical doctorate is to focus on increased clinical training, and no further research training (based in part on my knowledge of the difference between a PhD and PsyD in Psychology). This increase in clinical training would also require increased capacity in terms of clinical supervision.

    From these assumptions, I believe that:

    1. the system barely meets clinical training needs for the Master’s degrees currently offered; I don’t believe there is capacity for increased clinical supervision.
    2. Having no additional research training wouldn’t necessarily give you any of the advantages that you posited with respect to ability to obtain faculty appointments (this is an institution-specific decision and there are many institutions (most? A question for the task force…) that currently enable genetic counselors to hold faculty appointments (another question for the task force is why GCs want faculty appointments), ability to apply for grant funding (already possible for most grant opportunities; maybe easier with a PhD, but I’m not at all convinced that a Clinical Doctorate would be an advantage), ability to serve as the PI on an IRB-approved protocol (again, this is already possible; easier with a PhD, not convinced it would be easier with a Clinical Doctorate),

    Most importantly, I believe that a Clinical Doctorate is unnecessary because I don’t feel that there is a need for increased scope of practice that would be addressed by a Clinical Doctorate.

    Additional disadvantages to a Clinical Doctorate:

    While you say that we have a two-tiered system right now, with some GCs having PhDs, I disagree. For GCs with PhDs that apply for clinical positions, my understanding is that they do not receive any benefits or advantages as a result of their PhD, and are evaluated on their clinical training and experience. With a Clinical Doctorate, my assumption is that these individuals would be competing for clinical positions (given that the purpose of the clinical doctorate is enhanced clinical training) and so would be evaluated differently by employers for that degree, and GCs with a Master’s would be disadvantaged in this system.

    I don’t buy the argument that a Clinical Doctorate is necessary to address new developments in a rapidly progressing field – this is the purpose of continuing education and recertification. GCs will always have to update themselves to keep abreast of the latest developments in the field – it’s the nature of the job, and a very attractive aspect for many.

    Having said all that, my mind is not completely closed to the possibility that you could convince me otherwise with evidence to back up your opinions. To reiterate, what I see as being most important is to understand the needs and motivations for advanced training and then developing solutions based on those needs. So what are your needs that are not being met that have resulted in your desire for a Clinical Doctorate? It really sounds to me like what you want is a PhD in Genetic Counseling.

    • CCGC

      “It really sounds to me like what you want is a PhD in Genetic Counseling.” My thoughts exactly. All of these arguments are to do with research opportunities. There is no evidence that a CD would get you anything that a PhD would not.

    • Getting fed up, MS, CGC

      Is anyone else struck by the disingenuous irony of someone who has been promoted to the rank of full professor within ~15 years of completing her MS complaining about bouncing off of glass ceilings? Many of our doctoral colleagues toil into their 50’s before even being eligible for this rank. Or by the rapid back-peddling from the entry-level CD issue by someone who, less than a year ago, was cranking out PR about the imminent launch of an entry-level CD program that had not yet been approved by either the Ohio regents or our profession’s accrediting body (umm… maybe because it doesn’t accredit CD programs…or do former board presidents expect some special treatment/influence?). Here we go again, with efforts now redirected toward an advanced-practice CD model, though one wonders if the author has taken the time to understand at more than a superficial level the associated issues. I personally hope that the GCADTF gives this ill-conceived change.org petition the attention it deserves – zero. This is not how we do things in OUR profession, and of that I am very proud. Of course the GCADTF can’t and shouldn’t try to solve all the complexities of entry-level and advanced –practice training simultaneously on the artificially accelerated timeline that was put in motion in the first place by this sort of manipulation. Catriona and others get it — reference their excellent posts.

      To move forward with anything productive, the very bad idea of an entry-level CD needs to be put to rest once and for all. If that happens, GCADTF has done its due diligence, unlike some others. If not, then whatever resources that could possibly go to developing advanced training opportunities will be squandered on trying to figure out how to create diploma mill programs whose coffers will be the only ones to truly profit from sending us all of us scrambling back to school just to get a piece of parchment saying that the owners of said coffers think that we are now up to the level of the new DGC wuunder-grads.

      Yes, we need to use our collective brains, logic and creativity to figure out what career ladders should look like and what it takes to get there in a rigorous and credible manner that won’t make us the laughing stocks of the very colleagues and employers whose respect the proponents of these other ill-conceived initiatives apparently so badly crave. The profession, not these people (and their mother-in-laws and assorted Facebook friends) on this petition, and not an accreditation council of 7 people, needs to put on its thinking cap and figure out what any new degrees, certificates or other credentials actually mean and qualify us to do. Any ill-conceived program whose curriculum looks like it was scribbled out on a cocktail napkin and tweeted out into cyberspace as an online CD isn’t going to benefit the individual who writes a big check for it. More importantly, it does nothing to elevate the practice or profession of genetic counseling.

      • Joy Larsen Haidle

        Dear All,

        As I write these comments, please understand that I do not yet know how I feel about the best route for our profession to pursue and I have certainly not invested as much time as many of you have on this issue. I appreciate all of the efforts on both sides of the issue to investigate the options and thoroughly vet the information to determine the best pathway in the short term and perhaps the long term. I agree that entry level CD is not an appealing option with significant ramifications to the profession. Personally, I must explore further the idea of an advance degree to become better informed on that option from the profession stand point and as an independent practicing GC.

        What is missing for me to become better informed is transparency. There must be some benefit to consider the CD or it would not have become an issue deserving so much consideration nor would other professions have considered this route. While I have attended every session, webinar, and electronic communication on the issue, I have not seen much of tangible benefits presented. So either there really isn’t any or the membership would benefit from additional discussion from those who support the CD route with point/counter point on the “why.” It is important for the membership to have access to the results of the survey prior to the vote if we want the membership to embrace the decision. As an active member who knows the inner mechanisms of NSGC and trusts the people involved, if I am feeling that communication has been sparse and leading me towards a desired outcome then it may be worth reviewing before the vote.

        Also, the wording of the current motion as presented to the membership in the eblasts and the survey needs to be evaluated again if the vote is to decide on only the entry level CD. “a. Maintain the current standard – master’s as the sole entry level degree/terminal degree or b. Move toward an entry level clinical doctorate with elimination of the entry level master’s degree.” To me, the words terminal degree in option “a” suggests that a vote cast in this direction keeps us at status quo with no further need to evaluate additional options. From the discussion here, I am grateful that the group is entertaining the option of an advance degree. Without an edit to the wording, I fear it will create a lot of confusion about the intended outcome and the impact of the decision.

        If I look at this discussion as a now prospective student (which frankly is exciting and frightening. Who knew I would potentially be back to school roughly the same time I would be sending my son to college! Eeek! Where did the time go!), I am looking for options that fit my current job (incentive to go back) and vision for something new. According to the 2012 PSS, almost 45% of the membership is working in clinical practice outside of an academic medical center. As a GC working at a private hospital, a PhD is not as appealing as I look over qualified and like a failed academic. The Clinical Doctorate *may* be a better fit for this group of GCs (as I said above, this is missing for me to make an educated decision). I completely support the option of a PhD in Genetic Counseling for the reasons outlined in this discussion thread. If I am going to write the grant, do the work, and be responsible for the data and budget, then I deserve the credit as a PI and choose the topic where I would like to spend my time to add value to my profession. Hence the long term vision that I might contemplate something new (no need to notify any employers over that whim!).

        I think people fear change and the unknown. There is a comfort in keeping with what I chose to do 20 years ago, but we are a dynamic group of people. I am glad that a group of dedicated people are asking the tough questions and evaluating the impact. If that didn’t happen, our profession would have ended a long time ago. It might be reasonable to contemplate a multi-tiered option for the advanced degree that includes the option of a CD and PhD to fit the needs of our diverse membership and the ever changing landscape of our work settings. That decision is much harder to make without carefully exploring the capacity, how the roll-out might take place, and over how many years. I am assuming that is where task force #2 comes into play.

        As someone who has spent a lot of time on federal efforts and B&R, I don’t suggest consideration of a multi-tiered advanced degree lightly as I see some repeat work coming and potential bottle neck…especially at a time when we must do everything possible to maximize the ability of the existing clinical GC workforce to increase patient capacity and receive additional recognition from the payers.

        Thanks for reading to the end. I appreciate the opportunity to share my opinion and am very interested in your thoughts.

        Best,

        Joy

  8. Dawn

    Thanks for these comments. We are thrilled that this blog continues the advanced clinical doctorate discussion. In the interest of keeping the momentum, we have a few more comments/responses. We also invite you to continue this discussion on the NSGC clinical doctorate discussion forum.
    1. Tuition: We agree with MAD, CGC, that the cost of any advanced degrees will be a critical consideration. Tuition must be reasonable and take into account earning potential. We’ve got your back on this one. Heck, Dawn’s still paying off her master’s degree and she graduated in 1999.
    2. Options: The cool thing about an advanced clinical doctorate degree would be that it would be optional. In or interested in a position that would benefit from an advanced skill? An advanced degree might be for you. If you don’t need, can’t afford, or are not interested in an advanced degree, you don’t have to do it. This is different from an entry level degree with coordinated transition program. Advanced = optional.
    3. Distance learning: From other disciplines and accrediting organizations (like PT and audiology), we have some interesting and useful examples on how to use past clinical experience and a previous degree as a springboard to a clinical doctorate. Some programs have some in person time once a month and the rest is accomplished through distance learning. Others are entirely on line while some offer traditional in person programs. The great news is that we are not so different from other disciplines that we can’t translate these types of programs into an effective GC clinical doctorate model. Here’s one sample example: http://www.rmuohp.edu/index.php?/prospective_students/degree_programs/transitional_doctor_of_physical_therapy_tdpt/
    4. Clinical Doctorate in Genetic Counseling vs. a PhD in Genetic counseling. Catriona and Anon CGC make some excellent points about the benefits of a PhD in Genetic Counseling, but we think there is a need for both degree options because of some important differences.
    A clinical doctorate is an advanced professional degree that reflects expertise in clinical care and patient centered clinical research. It is focused on clinical competencies required to practice, not focused on conducting basic research. Individuals with a CD tend to work in a clinical role in a variety of settings (hospitals, clinics, academic centers, private practices) where they provide patient care and may perform patient focused research. Most CD candidates do not prepare and defend a dissertation; instead they perform a clinical based research project. (Clark, et al., Stuenkel, et al.; )
    Individuals with a Doctor of Philosophy (PhD) focus intensively on a specific field or topic with the goal of teaching or conducting research. PhD candidates often prepare and defend a dissertation based on their original research in their field of choice. Most PhDs work in academic institutions and focus on teaching and basic research. They often have less clinical exposure and see fewer patients than their clinical colleagues.

    5. Faculty Status: Catriona Hippman is right – every academic institution is different in their approach to allowing individuals with Masters degrees to be faculty or serve as a principal investigator. And, of course, the policy changes from year to year. We LOVE seeing genetic counselors who are Professors, Associate Professors, or Assistant Professors at their academic institutions. It warms our hearts. Heather has been very lucky to work in an institution that is extremely supportive of genetic counselors. However, even in this great environment she spent 9 years as an unpaid auxiliary track faculty member due to her Master’s degree, until she and her colleagues convinced the P&T committee that they should be on the regular clinical track. We also know that there are institutions who do not even allow master’s level faculty to be non-tenure track faculty. Most fall somewhere in between. Having said this, we have a small story. When trying to figure out why Emory policies have changed towards having masters level faculty, Dawn learned that one of the main reasons that their institution frowns on MS level as faculty is that one small piece of university ranking is involved in counting the number of doctorate level faculty (category: academic staff with a doctoral degree). The more doctoral level faculty, the higher you score in that category. We all know how excited academic institutions get about that U.S. News and World Reports ranking! Is this the only reason, absolutely not, but it does cause some reluctance to add on masters level faculty of any discipline.
    6. A Little History: Although this doesn’t directly pertain to the discussion at hand, it appears some clarification is needed about the Ohio State University genetic counseling program. OSU happened to be in the process of starting a new genetic counseling training program in 2009 when the Clinical Doctorate was presented at the AEC. The session was very positive and persuasive so it appeared that some type of clinical doctorate option would be happening before too long. As a result, the OSU program leadership elected to submit an application for a Master’s Degree, entry-level Clinical Doctorate degree and transitional Clinical Doctorate for University approval so that they were ready for whatever direction the field decided to go. The new program approval process at OSU takes many years, so they only wanted to go through the process once. The application was an attempt to be proactive and efficient, not to push the profession one way or another. As it became clear from discussions nationally that the profession was moving away from the idea of an entry-level clinical doctorate and based on feedback from the other GC programs in the state of Ohio, OSU pulled the clinical doctorate proposals from final Board of Regents consideration, submitting only the Master’s degree proposal which was approved on October 22, 2012. Currently, OSU is finalizing their application to ACGC for accreditation of the master’s program. However, the leadership at OSU is still very interested in the clinical doctorate as an advanced degree option and would like to see it considered further in national discussions about advanced training options for GCs.
    7. The Informal Petition: As noted by “Getting Fed Up”, we agree that our petition was informal and not inclusive of all genetic counselors since it was passed around via e-mail, Facebook, and the Discussion forum. This also means that there are likely many more genetic counselors in favor of an advanced degree Clinical Doctorate that never saw the petition. Oh yes, and it’s totally true that Dawn’s very sweet, ex-science teacher, 65+ year old mother-in-law is in support of a clinical doctorate and signed the petition, BUT, as everyone signs their name to the petition we do know that the vast majority of individuals signing the list are genetic counselors. Of course, like Joy Larsen Haidle, we are very interested to see the results of the member survey from last month so that we can really assess member interest in an advanced degree Clinical Doctorate in a more meaningful way. Check out the latest DNA Exchange posting “When Masters Degrees Roamed the Earth” (http://thednaexchange.com) to see the results of another informal poll of genetic counselors on the clinical doctorate issue and some further discussion on the topic.
    Thanks again for all your thoughtful responses and interest.
    Heather Hampel and Dawn Laney

  9. Sheri Babb

    I posted a question on the Clinical Doctorate Discussion Forums on January 3, 2013 asking for the results to be posted from the GCADTF survey that closed January 7, 2013. No response has been provided yet. The notification sent to the membership requesting survey participation stated the Task Force will vote in January 2013. The outcome of the survey will represent a vote of the membership to be included with the votes of the Taskforce member organizations regarding the adoption of an entry level clinical doctorate as the sole degree option. I hoped the membership would be notified of the results of the survey prior to the Task Force taking a vote.
    I am confused by the push for an entry level Clinical Doctorate as opposed to offering a PhD for those seeking a doctorate degree to be more involved in research in the academic setting and/or pursue a faculty position. My understanding of the overall purpose of a healthcare profession transitioning to a clinical doctorate is to graduate individuals better prepared, with broader educational experience and more hands-on clinical experience. Is this the focus of the push for a clinical doctorate in genetic counseling? This does not seem to be a significant part of the argument toward this transition.
    I know genetic counselors with additional degrees including a PhD, an MBA, or MSW. The 2012 Professional Status Survey indicated other advanced degrees held by genetic counselors include MD and JD. The options for advanced degrees that complement our existing genetic counseling degrees are many and varied.
    The 2012 Professional Status survey shows that 22% of those responding have achieved faculty status. I suspect few of these have a doctorate degree.
    It seems that changes need to be made to expand the presence of genetic counselors by increasing the number of graduates coming out of genetic counseling programs. I think we can anticipate many new opportunities for genetic counselors but we must expand our presence to fill and/or create these new positions. I agree that changes need to happen in our profession to keep up with the pace of genetics being incorporated in all areas of medicine, but I am not convinced yet the best way to accomplish this is through an entry level clinical doctorate.

  10. Shabnam

    Hello everyone,
    I am very new to this topic. I have been thinking about Genetic counseling for couple of years, but have been wanting to tsee if a PHD program is offered. No luck finding such a program online. Would anyone know if any school has already started offering a PHD in GC?

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