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