200 Hurdles to Freedom

When commenting on this post, please keep your specific thoughts about the exam private and do not share publically. I have been advised by the ABGC that sharing information about the exam may be punishable by law and result in the revocation of one’s certification or right to sit for future exams.

There are a few hundred genetic counselors out there, including myself, who are on their last lap before the 200 ABGC approved questions that will determine if they are certifiably qualified to practice genetic counseling.

Apparently, none of us feel being a “master” is enough.

With this summer heat and pretest anxiety, many of us might be feeling like this guy did for 8 years – Am I really prepared for this? Do I know what I am doing? What will my legacy be in regards to this long endeavor?

I think this is  a good time to remind ourselves of the utility and value of this exam. (And, of its intrinsic meaninglessness in the grand scheme of life.)

For those of you who do not know, this is the first year the ABGC is offering their own certifying exam. All genetic counselors currently certified in the last 10 years or so passed the ABMG general genetics exam and the genetic counseling subspecialty exam. Since the ABMG offers their exam every 2 years and the exam was not specifically designed for professional/clinical issues dealt with by genetic counselors, many counselors had difficulty obtaining the coveted “CGC”.

From what I understand, this has hindered legislation granting licenses to genetic counselors in many states as all proposed bills have suggested licenses be granted to those who are certified (See here for the NSGC discussion of certification versus licensure).

Licensure is a complex topic that should be further addressed here, but this is meant to be motivational (and I have to study!!!) – So here is a list of random exam-related items to consider:

1.  If you received your masters in genetic counseling, MANY people believe you are qualified to be a genetic counselor. You might be the only person who is currently doubting this. And, you are too crazed with exam fever to be a reliable source on the matter.

2.  This new exam (yes, I do feel like a knockout mouse) is based on the survey that was given to assess daily activities and skills of practicing genetic counselors and 868 genetic counselors responded. That is a large “n” ladies and gents – the items on the exam will likely (finally!) be fully reflective of what we are taught in graduate school and how we practice.

3.  Which brings me to the next thing nagging me. Can we really rely on the anecdotal information about the ABMG exam we have received from colleagues and former teachers? Is hearing, “oh, the test is often cyto heavy” or “I couldn’t believe how many ART questions they asked that year!” really very instructive?

    – As comfort, normative seeking creatures, we want to know we are “doing the right thing” as we force ourselves to study areas of genetics we know less about. We ask others and ourselves, “Should I focus on Thompson and Thompson? The UPitt review course? Memorize Smith’s? But, we ARE in uncharted ABGC territory – we do not know how to best prepare. But, BE CONFIDENT, they are going to ask questions about genetics. And you are likely to have read the answer at some point in your studying, regardless of your favorite source book.

    4.  Remember, the exam is supposedly designed to be FAIR – there are an allocated number of questions for different areas (check out the exam bulletin)

    1. Case prep and History
    2. Risk assessment and diagnosis
    3. Testing
    4. Psychosocial assessment and support
    5. Ethical, legal, research, resources.

    If you were an exam writer, you would imagine there are certain things you want to be sure every GC knows (carrier screening issues, testing minors, survivor guilt…) in each of these areas. You know this stuff!

    5.  When you finish the exam, you can do the following guilt free:

    1. Nothing
    2. Eat cookies, cheese, candy…(because you now have time to exercise)
    3. Take a vacation
    4. Get a pedicure
    5. Jump on your bed (I encourage you to do this before the exam too)
    6. Read ANY book you want
    7. Go out very, very late
    8. Play Pretty, Pretty Princess with your kids (or other people’s if it is not creepy)

    6.  When you find out you PASSED –

    1. You can give yourself as many gold stars as you want
    2. You will receive increased respect from colleagues and patients (and yourself)
    3. Maybe you will get a raise and/or promotion
    4. You will have increased job mobility
    5. Maybe you will open up a private GC practice
    6. You might have the option to be licensed
    7. You can throw out your graduate school notes!

    7.  If you find out FAILED (less likely to happen)

    1. You are still a MASTER and likely still have your job
    2. You can take the test again in 2010 (that is novel!)
    3. You will NOT be a guinea pig on the next exam and will be better informed
    4. You can apply for a new career – that is exciting too!

    If anyone wants to post random disease factoids here or thoughts about the exam, please do.

    However, keep it ethical. Do NOT share any information about the actual exam as it is in everyone’s interest to keep his/her exam experience private until the testing period closes.

    GOOD LUCK!!!!!!!!


    Filed under Jessica Giordano

    19 responses to “200 Hurdles to Freedom

    1. Tiffany

      Thanks, Jessica! I needed that…

    2. laura

      Thanks for the words of encouragement!!

    3. Sarah

      As I did take the day off to study for my exam…I mean “force myself to study areas of genetics I know less about”, I appreciated reading this!

    4. E K

      Thank you so much for writing this. It is easy to forget that there are other people in your shoes in this ordeal, and this made me feel so much better! Good luck on the exam!

    5. Mara Van Etten

      Thank you for this note! It was more helpful than you know!!!!!!!

    6. Rachel

      Thanks for the post. It is a nice reminder that I am not the only one whose stress level is sky-high right now.

      Good luck to all those who are writing the exam in the next month (and to all those who are also writing the Canadian exam in November)!

    7. Love this Jess! Very much needed. I also think one can make an argument for a PRE-exam day pedicure. You can always review notes while getting your toes painted, no? I wouldn’t say the same for a manicure, but pedicure definitely.

      Good luck everyone!

    8. Janelle

      That was really good Jess!
      And so right about listening to what others say who took the ABMG exam this year… does make you wonder as “guinea pigs” if we will be questioned the same way as they were?
      As for post-exam I’ve always loved the board game “Trouble” (with that popping bubble thingie in the middle of the board)… I might have to play w/the young at heart though… don’t know any kids to play with :/

    9. J

      As someone who has taken the exam once before and did not pass the GC part (but passed the general genetics exam), it has been very difficult studying for this comprehension version without feeling like a guinea pig.

      I thought when the ABGC changed the exam, it would also provide a course book, but I was mistaken and bummed about this lack of attention. The UPitt and ABMG review courses are great, but they do not provide a comprehensive review for the GCs. Much is missing from those reviews for GCs; we need our own course, vignettes and pre-post tests that reflect our work.

      Unfortunately, the test has little value right now, I am sorry to say, for many GCs out there. While it is a huge accomplishment and it will feel AMAZING to pass it (just you wait!), there is no moving up the ladder for us, no reward, no salary increase or new job position; just a three letter initial to follow your name. I’m not trying to be unappreciative of the opportunity to be certified, but the ABGC should realize that certification should come with some kind of reward—-and not just self satisfaction.

      Some of us will get Licensure after certification, but what does licensure really do? So far, not much, but please correct me if I am wrong. The State of Massachusettes just got licensure this year, and the LGCs are no different than the CGCs or GCs. None of my colleagues got pay increases, new job offers or special accomodations because they are now LGCs…so what gives?
      Why all these months of studying, agonizing over being a guinea pig and sacrificing yet another summer?

      Will it all be worth it? I hope so, because 2 out of the 3 past summers has been all about studying, and that’s not satisfying at all.

      Good luck to all the GCs out there– I wish you all the very best and I hope that in the future we have better review courses and review books to satisfy the exam criteria. Stay positive and read the questions carefully! You can do it!

    10. Lola Cook

      The great news is not that much happens if you pass or fail! So relax!! And do all the items under #5 anyway!

    11. H

      First, I want to say thanks for this–it made it smile.

      Second, I want to say good luck to all of you are gearing up to take the exam. Remember, you have to be smart to get into and get through GC school, and your prep for all of that will carry you through this too.

      Third, I want to say relax. I know how crazy and stressed it feels to try to study for this exam. I felt like a mad woman trying to balance work, my family, studying, eating, sleeping, and being social. It was all very overwhelming until 3 weeks ago today.

      Three weeks ago today, I was diagnosed with cancer. The stress I thought I had preparing for this exam is nothing compared to what I have gone through after my diagnosis. I tell you this not to be dramatic, but to remind you that although it’s not fun to study and prepare, it’s a hell of a lot better than getting cancer! 🙂 Just remember to put things in perspective.

      So relax, take a deep breath. You will get through this. You will probably even pass. And if you don’t, in the grand scheme of things, it doesn’t really matter all that much.

      I’ve formally withdrawn from the exam. I’ve got bigger fish to fry. But I’ll tell you what, I can’t wait to beat this cancer so that I can experience all that exam stress again and become a CGC.

      • S

        Wishing you a complete and speedy recovery. God bless. 🙂
        Books you may enjoy:
        Judy Chiappone: Sacred Choices – The Gentle Art of Disarming a Disease and Reclaiming Your Joy!
        Patricia Foote: Managing Your Medical Journey

    12. A

      What an interesting thread. Regarding the comment:

      “Since the ABMG offers their exam every 2 years and the exam was not specifically designed for professional/clinical issues dealt with by genetic counselors, many counselors had difficulty obtaining the coveted “CGC”.”

      As a person who took the old ABMG/ABGC-two part exam, it had always been my understanding that ABMG mainly wrote the general exam and ABGC wrote the GC specialty exam. Who was in charge of administering the exam, scoring and all the paperwork was less clear since it seemed as if ABMG and ABGC shared the staff -except for the actual board.

      Also, the word had always been that it was the ABGC, not the ABMG (general) exam that was harder to pass. In other words, many counselors had difficulty obtaining the coveted “CGC” not because of ABMG’s general exam but because ABGC’s own exam.

      I found the ABMG exam much easier than the ABGC specialty one, but thankfully I passed both. I don’t have the official version of the rationale behind changing the certification exam strategy but I hope its for the best. Which leads to my next reaction regarding the comment:

      “Unfortunately, the test has little value right now, I am sorry to say, for many GCs out there. While it is a huge accomplishment and it will feel AMAZING to pass it (just you wait!), there is no moving up the ladder for us, no reward, no salary increase or new job position; just a three letter initial to follow your name. I’m not trying to be unappreciative of the opportunity to be certified, but the ABGC should realize that certification should come with some kind of reward—-and not just self satisfaction.”

      While I can’t agree more with the fact that GCs’ ceiling is low and there is little or no ladder to climb (still wonder why most of us are young?), it is not ABGC’s job to realize that certification should come with some kind of reward. It is OUR job to better market ourselves, stop selling ourselves short and value the expertise that we can bring into any medical team.

    13. C

      I work in a state with licensure and have been told by my employer that I must pass the boards, otherwise I have to either move to a state without licensure, or take a pay-cut and not be called a ‘genetic counselor’ until a sit for the boards again. So for some of you there are no implications for passing or failing the boards…for others of us, it’s a different story

    14. RD

      Interesting thread to read with all the comments…while I have not been told in so many words, my employer has indirectly stated that my Annual Review and thus a potential salary raise depends on me passing the boards….I don’t pass I don’t get a salary raise…so there you have it!

      Just one more motivating factor me to get done with this exam (hopefully once and for all!)

    15. B

      I agree whole-heartedly with A’s comment above (“What an interesting thread…”).

      I have to say I was a little taken aback by this blog post. The implication seems to be that we (Master’s level Genetic Counselors) shouldn’t have to take an exam to prove that we are qualified. That the degree should be enough. This is very strange to me as I am hard-pressed to think of a clinical profession that does NOT require a similar exam – Nurse, Physician, Physical Therapist, MFT, Social Worker…And not to mention the non-clinical professions – Lawyer, Stock Broker…I could go on and on.

      Yes, the exam is extremely stressful. But we are far from alone in having to go through this process. Implying that the exam is useless and/or unfair just further devalues our profession and hinders the effort towards professional growth/raises/promotions/ladder climbing.

      I agree even wholer-heartedly with H’s comment and would hope that everyone can keep the process in perspective…good luck all.

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