Lean In: A Reflection on Telemedicine

In early Spring 2020, I was sitting in Lauren Lichten’s office discussing my preferences for rotations throughout the rest of my training. Lauren is our assistant program director and coordinates all of our clinical rotations. When she asked me which specialty rotations I was interested in I listed a few areas of interest such as pediatric oncology and IVF, but didn’t have enough to fill out all five specialty slots we are allotted throughout our training. Lauren asked if I might be interested in rotating with JScreen, an Atlanta-based nonprofit geared towards promoting carrier screening in the Jewish population, to get some experience utilizing telemedicine. My immediate response was that I was absolutely not interested in telemedicine.

Cut to roughly seven months and a global pandemic later. I spent my late spring and summer rotations entirely online. While it was one of the most challenging things I have ever done, I have grown in ways I never could have anticipated.

When COVID-19 hit the US in March of 2020, no one knew what to expect. No one was prepared for genetic counseling graduate school to suddenly be online; no one knew how rotations were going to work. All we knew was that we would figure it out somehow. My cohort had just finished our first round of rotations, and we had been excitedly awaiting meeting our supervisors in our new placements after spring break. Everything happening virtually was not ideal for anyone, but I was particularly anxious to see patients online considering my special distaste for phone and video calls.

Over the summer I had the privilege to be the first Emory student to rotate with Integrated Genetics (IG) Cancer genetic counselors, a clinic that is always telemedicine-based. I was able to work with supervisors in three different states and see diverse patients from all across the country. I also improved my psychosocial counseling skills by paying much closer attention to the patients’ nonverbal responses, because it is more difficult to read patients over video. It was a really fantastic experience working with genetic counselors that typically use telemedicine and getting their feedback on the differences, pros, and cons of the medium. After I rotated with IG, I rotated with JScreen. Like IG, JScreen always utilizes telemedicine. My supervisor, Melanie Hardy, gave me fantastic feedback and advice on how best to build rapport with patients over video and phone, and built my confidence with her positive reflections on my counseling. More surprising than the skills I built was that I truly enjoyed telemedicine. I’m a homebody, and as much as I enjoy in-person clinic, the ability to work in the peace of my own home was a nice change of pace. As of Fall 2020, I am back in person for clinic at the Emory Perinatal Center. It was an abrupt transition to working online, and an equally abrupt transition coming back in person. Working over telemedicine during my training has made me a much better and more resilient genetic counselor, and now I get to build my skills in person again (with appropriate precautions).

All this to say: sometimes your training pushes you so far out of your comfort zone you don’t know what to do. Lean into the discomfort and trust the process – you never know what you might discover about yourself or the ways you will grow. While right now I still believe I want to start my career in an in-person clinic, my experiences with telemedicine have given me a confidence in my skills I never would have gained if I hadn’t been forced into virtual rotations by COVID-19. Maybe one day I will decide to work from home, and the unique circumstances of my training will have given me a unique set of experiences and skills I would not have otherwise had!

Kia Hutchins

Class of 2021

Online Interviews for Genetic Counseling Training Programs

In light of the rules and regulations implemented as a result of COVID-19 at Emory University for the coming week at least interviews have shifted online.

Hey! My name is Srika and I am a first-year student from India! I had to give all my interviews online last year during the process, even though I did not get to see the campuses and visit the program at all the schools I interviewed at - it all worked out! You are not at any disadvantage if you're interviewing online. In this post I just wanted to highlight some tips for interviewing online and about the interview and program in general.

Internet Connection and Zoom:

When I was interviewing I made sure that I had a stable internet connection and had my phone hotspot on as backup in case my WiFi failed me. The program will mail you a Zoom link for the interview, I would recommend clicking on the link they provide you to see if it works and Zoom may require you to install additional plug-ins (if you don't already have them). Zoom allows you to check your microphone sound and checks that you are able to hear before you join the meeting room. I tried to make sure that I would not have any interruptions during the interview as well and kept a glass of water by my side before I sat down for the interview. I also opened the link 15 minutes before the actual time of the interview - so that in case there was any issues with the link I could contact the program in time.

About the interview:

I was nervous before the interview but the program leadership and faculty were very warm and welcoming, so don't stress! I had a bunch of questions prepared to ask about the program, rotations, the focus internship and Emory in general. . There are group and individual interviews along with a writing exercise, which are not there to test your knowledge on genetics in any way. The purpose of the interviews is to get to know you and your experiences so don't worry cause you're the expert on you. Even though it sounds cliché - just be yourself, you made it to the interviews for a reason :).

Here are a few student perspectives on interviews from the blog.

About the program:

The program consists of classes, clinic and the focus internship. The amount of time spent in clinic increases gradually each semester. To mention a few things we find very valuable: we start observations in the second half of the first semester and that we have an innumerable specialty clinics to choose from. The focus internship is also a unique, well-structured platform for us to conduct our capstone project work. You can read the FAQ's and the program website for more information on the program structure.

Hope everyone is safe and keeping well! Just be yourself and enjoy the interview process!

If you have any other questions regrading the program and interview, do not hesitate to reach out to me: srika.amin@emory.edu , or the program.

A Ship to Sail

My favorite book is “Little Women” by Louisa May Alcott (judge me if you want, but I love it). A quote from this book also stands to be one of my favorites. It says, “I am not afraid of storms, for I am learning how to sail my ship.” This quote has held true for every season of my life, and none truer than navigating life in grad school.

As you may have read in the previous blog posts, adjusting to grad life and learning how to be flexible around all of its frustratingly wonderful and wonderfully frustrating demands can be difficult (especially difficult if you’re stubborn and stuck in your ways like I am). When I started school, I knew that the schoolwork would be hard, and the material would be complex. I was prepared for that. What I was not prepared for was the amount of personal growth that grad school also required of me. In more ways than one, graduate school and the people that have become part of this season of my life have encouraged self-reflection and growth right alongside my classwork and clinical experiences.

Yes, the schoolwork has been difficult, time consuming, and so worthwhile. My clinic experiences have ranged from mildly interesting to profoundly impactful. My classmates have played many different roles in my life including study buddy, co-adventurer, ear-lender, counselor, and friend. My professors and supervisors have set high expectations for me and pushed me to be the best I can be. Through all of this, I have realized that grad school, especially genetic counseling school, is not just about academic learning and professional development. For me, as well as for my classmates, it has been about learning more about ourselves, defining just what kind of genetic counselor we all want to be, and discovering what impact we want to leave on patients, colleagues, and the field of genetics once we venture on to begin our careers.

I will gladly admit that for the two months after I committed to Emory and before school actually started, I would get overwhelmingly nervous just thinking about what the next two years would bring. This feeling was not because I did not want to go to school, but because I wanted it so badly and had for so long. I would get anxious thinking about it because I worked to get to this moment for 6 years and my dream was finally tangible. At this time, I thought that the limits of my dream were confined within the title of “genetic counselor” and it's cookie-cutter definition. What I have come to learn over the past 18 months is that my dream is so much more defined, and it has significantly broadened. I now recognize that I want to be a genetic counselor in a pediatric or prenatal setting. I want to use the skills I have acquired through my training to teach others about genetic counseling and foster an interest in genetics among other medical professionals. I also want to guide future genetic counselors to discover how they want their title as “genetic counselor” to be defined.

As I approach my last semester of grad school and dream new dreams for the future of my career, I take confidence in knowing that I am more prepared for my first job as a genetic counselor than I was for graduate school. I know that being a genetic counselor is a profession that encourages constant self-growth. It is one that allows you to progress your interests and dreams as rapidly as the field of genetics is progressing. I also recognize that this chapter in my life is one that will stay with me for the entirety of my career. Of course, the training that I received is what allows me to be a qualified genetic counselor. However, I believe the experiences and the revelations that I have encounted here will have a much greater impact on my career.

For anyone preparing for interviews, considering genetic counseling school, or even just wanting to learn more about it, I believe it is important to keep an open mind. It is necessary to realize that the title of “genetic counselor” holds much more than one definition. Each genetic counselor has the opportunity to mold that definition to encompass each one of his/her dreams and goals. Regardless of how your interest in genetic counseling began, what expectations you have for your future career, or even how scary the prospect of grad school (and post-grad life) may seem, make sure you enjoy the journey. You are in good company and after all, we are all just learning how to sail our ships.