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It is easier, statistically speaking, to get into the NFL from a Division 1 football team than it is to get into a genetic counseling program in the United States and Canada.
At the moment, there are 6,517 certified genetic counselors in the United States, according to 2023 data from the National Society of Genetic Counselors. That is an increase of 100 percent over the past 10 years, and the field is expected to grow by another 100 percent in the next decade. Meanwhile, there are 58 accredited training programs in the United States and Canada, enrolling 826 students in 2022, or an average nine slots per program, according to the ACGC 2022 Annual Report, with roughly 16 people competing for each slot. By contrast, there were 1,696 active NFL players in 2023 and 16,671 students who played football in Division 1, or about 10 D-1 players competing for each NFL job.
“We take eight students each year, and in the last few classes about six students are now re-applicants, with the other two straight out of undergrad,” said Lynn Holt, director of the UAB Master’s in Genetic Counseling program in the School of Health Professions. Holt joined UAB as a member of the Department of Genetics in 1996 as the first genetic counselor at UAB and in the state of Alabama. She joined the School of Health Professions in 2007 and launched the school’s graduate program in genetic counseling in 2010.
High demand, high pay, high satisfaction
Demand is strong, and so is the pay. The average salary for a full-time genetic counselor is more than $100,000, according to the NSGC; but it can push past $250,000, depending on the counselor’s specialty area, training and experience. Job satisfaction is high too, with 84 percent of respondents saying they are satisfied with their current jobs and 86 percent saying they are satisfied with the profession, according to the same NSGC 2023 report.
“What is so special about genetic counseling is that it is just what it says, part genetics and part counseling,” said Georgia Haggard Dismukes, one of the newest graduates from UAB’s master’s program and one of the university’s newest employees. She began work in UAB cancer clinics in June 2024. “Some of the most rewarding things to me are to meet people where they are and participate in facilitated decision-making,” Dismukes said. “We are meeting people in really difficult times of their lives, whether it is cancer or a prenatal session where they are worried about their child. Being the person who can help them balance their goals and wants and desires is a real privilege.”
Dana Goodloe, a 2013 graduate of UAB’s master’s program, manages UAB’s 18 genetic counselors. “We serve the campus as a whole and in 33 distinct clinical settings at UAB and off-site, including the maternal-fetal medicine clinic at St. Vincent’s, Grandview and UAB Hoover,” Goodloe said. “We do things in a unique way at UAB; here, our counselors do not work for one specific clinic. We have the opportunity to be flexible and move around. In my time at UAB, I’ve done a little bit of everything. That sets me up in a good place to lead a team.”
As an undergraduate, Goodloe was interested in medicine, where she had a strong family background. “I knew I didn’t want to be a doctor or a nurse, but I wasn’t sure of my other options,” she said. “I spent a lot of time in college shadowing. A friend with a child with cleft lip met with a genetic counselor and said, ‘This is perfect for you.’” Goodloe had never heard of genetic counseling, but she arranged to meet with Holt and “did lots of shadowing” that quickly convinced her that her friend was right. “It is really complex science and really people-focused,” Goodloe said. “You get to spend time getting to know patients and really meet them where they are.”
“An explosion of tests and even treatments”
For years, genetic counselors could offer patients education, care and an understanding ear. Today there has been an explosion of tests and even treatments becoming available, and “there are always new discoveries and gene associations,” Goodloe said. “The majority of diagnoses we see are a condition I haven’t heard of before or a gene I have never encountered before,” Goodloe said. A disease that affects one in 10,000 people might be considered common in the genetics community, she said: “We see patients who are one in a million. They may be the only one in Alabama or one of a handful in the United States.”
Photo by Andrea Mabry | UAB Marketing and Communications
Although UAB’s program and others nationwide have grown in recent years, “the biggest rate-limiting step is finding clinical sites,” Holt said. “Students must be supervised by a certified genetic counselor” for every one of the 140 sessions they complete as students, including detailed, individual feedback after each session. “And a third of professionals are in industry,” Holt noted. UAB has its own clinical sites in the Health System, of course; but matching demand means the program also has “clinical partners around the country,” Holt said, which also gives trainees an opportunity to see how different health care systems and care models work. “That is the way we have been able to grow our program to eight students,” she said.
Growth in laboratory, industry roles
As the field has grown and added new training and opportunities, UAB’s genetic counseling program has expanded as well. Several years ago, it added a faculty member with experience in the growing laboratory genetic counseling specialty. Next up was a certificate program in industry genetics and genomics, offering training on molecular genetics analysis.
Victoria Moy, a 2024 graduate of the master’s program, now is a laboratory genetic counselor at UAB. “I provide genetic counseling for providers,” Moy said. “Instead of talking to patients, I’m talking to physicians and giving them expertise on testing strategies for their patients, explaining complex genetic topics and making test recommendations.”
Moy says she felt well prepared for the demands of the job. “We come out of our training with a diverse skill set,” she said. “That is one of the interesting things about our profession. You have the opportunity to find where you fit best, especially here at UAB. What kinds of work hours do you want? Do you want to see patients? Do you want to write grants and do research? I can work in a lab for five years and then, if I decide to, work in prenatal counseling for a few years. It keeps you on your toes and keeps your mind going.”
Research makes an impact
Most students start out thinking that they will specialize in one of the best-known areas of genetic counseling, including prenatal, pediatric and cancer, Holt says. Interacting with Ashley Cannon, Ph.D., the research project coordinator for the master’s program, shows them other possibilities.
Cannon, a 2015 graduate of the master’s program, came to UAB after earning her Ph.D. in neuroscience and working at the Mayo Clinic. “I was studying neurodegenerative diseases in a genetics lab,” Cannon said. “There were no good biomarkers or clinically available genetic testing. I didn’t know what genetic counseling was. But I was introduced to it by families of patients we were studying. I was stuck looking at brains and mice all day, and I wanted to interact with people and provide the counseling that is so necessary for these adult-onset genetic diseases.”
Cannon’s plan was to get her genetic counseling degree and go back to the Mayo Clinic; but she met Bruce Korf, M.D., Ph.D., a renowned geneticist and specialist in neurofibromatosis, at UAB, “and he created a position for me in the NF Clinic here,” Cannon said. “I was doing my clinical genetic counseling, and I had my research focus working with a clinical trial.” Cannon worked with patients and families to document how they felt about treatments, the side effects and their other needs. “It was about better understanding the patient perspective,” Cannon said. Now the Food and Drug Administration is using her published papers to inform the development of future drugs.
Today Cannon works part time with the master’s program in helping students identify research questions and develop the thesis-style work they will do throughout the 22-month program. “My day job is with a company called InformedDNA,” a Florida-based company specializing in tele-health genetic counseling, “where I help establish clinical programs that are often associated with clinical trials,” she said. “This is a niche area, and my job would never have existed five years ago. As of five years ago, we finally have some drugs and hope with clinical trials.”
Another change is “there are a lot more industry jobs now,” Cannon said. “Now that there are these big testing labs, there is a growing need there for genetic counselors. There are so many areas that genetic counselors can be in. They can work for insurance companies, labs, telehealth companies and life sciences companies, as well as for hospitals. I think that really demonstrates the skills that we have learned in the genetic counseling program.”
UAB is “a driving force in the field”
About half of the genetic counselors employed by UAB are UAB alumni, Holt said: “It is definitely pretty fun to see students join UAB as graduates. They are our colleagues a lot longer than our students. The expectation in our program is that we will be professional colleagues, mentors. I think that makes them feel more comfortable to stay on.”
As the figures at the beginning of this story make clear, getting into a GC program is not easy — so much so that many ultimately successful applicants find other ways to boost their credentials and gain experience. The field has recently added a new type of position: genetic counseling assistants.
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“This is a really new role that has emerged in the past five years,” Holt said. “There is no training path for that. It is usually people who have graduated from undergrad and are getting some clinical exposure or in-depth understanding of the field. It is a reflection of the evolution of the profession and its evolving roles.”
Georgia Dismukes is one of several former genetic counseling assistants at UAB who went on to complete the master’s program in genetic counseling and now work at UAB. Dismukes began her undergraduate career at UAB thinking she wanted to earn a Ph.D. and work in a cancer lab, but early on she switched her major to the then-new Genetics and Genomic Sciences bachelor’s program. Then, “right in the middle of COVID, I realized research was not for me,” Dismukes said. After graduation, a genetic counseling assistant job came open and Dismukes was excited to be hired. “You get to see exactly what being a genetic counselor is like without actually being one,” she said. “If you get into that job and think, ‘This is not for me,’ then you probably don’t want to become a genetic counselor.”
During her year as a genetic counseling assistant, Dismukes traveled to UAB clinics with genetic counselors and handled test ordering and administrative tasks. “The assistant goes through and orders the testing that the counselors discussed with patients and makes sure the samples have been received,” Dismukes said.
“You can shadow a genetic counselor for a day or two and see only a tiny part of the things we do,” Holt said. “Being a genetic counseling assistant doesn’t guarantee that you will get patient exposures, but it definitely gives you an insight on what the responsibilities are.” As with many other aspects of its genetics programs, the way UAB uses genetic counseling assistants is both intentional and pace-setting, Holt says.
“Genetics is not a one-off,” she said. “It is something that UAB values and has invested in and supported all these years.”“UAB has really set itself up to be at the forefront of genetic counseling nationwide,” Goodloe added. “I have loved to be part of that evolution as we have become a driving force in the field in how we use genetic counselors and allowed them to practice at the top of their scope.”