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Genetic counseling program at UW-Madison helps meet nationwide demand

There are only 27 programs in the country, they only graduate on average a handful of students every year, and the graduates have a 100-percent job-placement rate six weeks after they receive their degrees. The program is genetic counseling and the University of Wisconsin-Madison is at the forefront of training genetic counselors to meet the growing demand for such specialists in the healthcare field.

“This is a very competitive program,” says Catherine “Casey” Reiser, director of the genetic counseling program at the UW-Madison. Reiser has a sound genetics background herself. She earned a bachelor’s in science in genetics from the UW-Madison’s College of Agricultural and Life Sciences in 1977, and a master”s in genetic counseling in 1980. “We only accept four or five students each year, and most of them have already had upper level genetics courses, biochemistry and calculus. They are trained as generalists who can step into entry-level positions, think critically and develop expertise quickly.”

Jay Flanagan is originally from Jasper, Minnesota and is a first-year graduate student pursuing a master’s in genetic counseling. He worked in a muscular dystrophy research lab at the University of Iowa and volunteered answering phones at a community crisis counseling hotline before applying to graduate school.

Although Flanagan”s undergraduate degrees are in chemistry and pre-med, he knew medical school was not for him. “Medicine is becoming more and more time managed and your time with patients is limited,” he says. “I went into genetic counseling because I wanted the interaction with the patients.”

Lindsay Zetzsche is a second-year student in the program. From Naperville, Ill., she graduated from Brandeis University in 2000 with a bachelor”s degree in neuroscience. “I found out about genetic counseling as a career path through my human genetics teacher at Brandeis, who was a genetic counselor at the Dana Farber Cancer Institute.” She wanted to stay in the Midwest. After meeting with Reiser, Zetzsche says, “I knew the program at UW was the one for me.”

The background of both students is typical of those who are accepted into the program. “The three things we look for are: course work, grades, and some level of exposure to genetic counseling and advocacy work,” says Reiser.

“We have amazing professional resources to give our students: access to top-notch physicians, the diversity of clinics they rotate through and the one-on-one attention they receive, and the Waisman Center itself,” Reiser says. The genetic counseling program at UW-Madison was one of first in the United States and has an excellent reputation. Students were admitted into the fledgling program in 1976. The first class graduated in 1978.

There are two genetics departments at UW-Madison-the genetics department in the College of Agricultural and Life Sciences and Medical Genetics in the medical school. They function as a single department with a chairperson who reports to deans in CALS and the medical school.

This cross-college arrangement is found nowhere else in the country, according to Michael Culbertson, the chairperson of the Laboratory of Genetics, who oversees both departments. “The great advantage,” Culbertson says, “is that plant geneticists and other researchers work side by side with human geneticists.” This proximity to other researchers and “free flow of information” that naturally result, he says, has led to numerous honors, including a Nobel Prize in medicine awarded to Joshua Lederberg in 1958 for his research on genetic recombination and genetic material in bacteria.

Once the students begin the genetic counseling program, they plunge right into classes, clinical rotations, teaching and counseling. During the first year, students rotate through the biochemistry clinic, bone dysplasia clinic, and the cystic fibrosis and neuromuscular clinics during the intake and lab rotations. In the second year, they rotate through the oncology clinic, general genetics clinic, and sickle cell and neurofibromatosis clinics. These rotations are done in a variety of hospitals in the state: at prenatal centers at Meriter and St. Mary”s hospitals in Madison, Children”s Hospital of Wisconsin in Milwaukee, St. Vincent Hospital in Green Bay, and Theda Clark Memorial Hospital in Neenah.

One of the strengths of the genetic counseling program at the UW-Madison is the opportunity for students to counsel families and individuals within the first few months. There is a genetic counselor in the room with them and they are observed by other students through a one-way mirror.

Flanagan”s first rotation was biochemistry. “I explained inheritance patterns and disorders to couples who had just had a child with a genetic disorder,” he says. “I worked with approximately 10 to 15 families during the 10-week rotation.”

When asked how the parents received his help, Flanagan perks up. “They accepted me as if I was a knowledgeable professional even though it was only my first semester in graduate school. I found them to be very receptive. By the time they get to the clinic, they are starting to deal with the condition and know what they have to do. You”re in a place of authority and they need the information you can give them.”

Flanagan is somewhat of a rarity in his chosen field–most men tend to avoid the so-called “helping professions.” He attributes his facility in talking to people and getting them to share feelings and concerns to growing up in a family with four sisters and a father who is a children”s pastor.”Outgoing and laid-back” is how Flanagan describes his father. The same adjectives could be used to describe his personality.

“I wanted a job with the opportunity to develop relationships, and genetic counseling provides that. Genetic counselors have more time to answer questions and talk about more personal issues than most doctors do. Most of our sessions were a half-hour, but considerably more time is spent with patients in other specialties, like oncology.”

After he graduates, Flanagan would like to live in what he calls “small-town USA,” a town with less than 10,000 people, where he could serve as a genetic counselor and also in an outreach/education capacity. “The public is still not very educated about genetics and the variety of disorders that can occur,” Flanagan says. “I would like to go out and help educate people, especially in the school setting.”

Zetzsche”s experiences are similar. “My first year I counseled a total of 16 cases, this year it”s close to 50. The counseling sessions build the skills you have.” By the time they graduate, most students in the program have served as counselors for more than 70 cases and have observed another 50 counseling sessions performed by their peers. In addition, during the two-year program, Zetzsche has been a teaching assistant for several undergraduate courses, including heredity and general genetics in CALS.

Those experiences have helped shape her career plans. “Ideally, I would like to work as a genetic counselor in a university hospital setting, performing research on the side and teaching.” But she isn”t ruling anything out.

With former students now working in Chicago, Salt Lake City and Seattle, Reiser affirms Zetzsche”s flexibility. “Every graduate of our program who has actively sought employment has had a job within one and one-half months of graduation. The future is bright, but the key is they have to be willing to move.”