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To: Multiple recipients of list HUM-MOLGEN <HUM-MOLGEN@NIC.SURFNET.NL>
Subject: ETHI: Genetic Couselors
From: Hans Goerl <GENETHICS@delphi.com>
Date: Wed, 26 Jul 1995 01:00:45 -0400

Here are 4 more responses concerning genetic counseling and counselors. It
seems the United States is creating qualified counselors at the rate of
fewer than 100 per year. Yet there doesn't seem to be much of a demand for
them. Are, or will there shortly be a lot of people in this country and
elsewhere undergoing predictive or prenatal genetic testing without
appropriate counseling?


From: "S.Robert Young" <N700053@UNIVSCVM.CSD.SCAROLINA.EDU>

In so far as there has been this ongoing discussion about Genetic Counselors
thought I would give some specific information:  The following is the list
of U .S. Training Programs that were recently given Interim Accreditation by
the Ame rican Board of Genetic Counseling (in parentheses following each
program I'll a dd the number of 1994-5 students accepted according to a
survey done by Becky B utler of U of Arkansas in Spring of 1994):  U of
Calif, Berkeley (8), Brandeis (?), U of Cincinnati (5), U of Colorado (8),
Howard U (?), Indiana U (?), U of Calif, Irvine (4), U of Michigan (4), U of
Minnesota (6), Northwestern U (?), S arah Lawrence College (25), U of South
Carolina (8), U of Texas, Houston (4), M ed Coll of Virginia (?), U of
Wisconsin (4), and U of Pittsburgh (12) -- The fo llowing programs were
granted "Recognized New Program Status: Beaver College an d Johns Hopkins
University/Natl Ctr for Human Genome Research.  ---- I would li ke to take
the opportunity to add two additional points:  There is no question that
many, many institutions and individuals would like to add on genetic couns
elors but the existing positions are not there.  I do not feel right in
trainin g genetic counselors and then having them take jobs outside their
field waiting  for a position to open up.  For the last two years our
graduates just managed to find jobs (they did not have any choice of
places).  Also, if we are to trai n any additional counselors we're going to
have to find outside funding.  I tri ed to get a very, very modest increase
in operating expense from my Dean this l ast week and was told that he
couldn't justify spending any more on a program t hat sends 5 out of 6 of
it's graduates to other states (and furthermore 5 of 6 students come from
out of state so I think he's right).  --- The need is there and it could
easily become overwhelming overnight but the student slots and cur rently
available job slots aren't there now.  We'd love to train them if these gaps
could be attended to.   Sincerely,  Bob Young,PhD Professor and Director,
Univ South Carolina MS Training Program.

From: A D Stewart <gen6ads@SUN.LEEDS.AC.UK>

Your answers to this query are not yet comprehensive ...

As a university scientist who has worked in a National Health Service
mol. gen. diagnostics laboratory, I have some knowledge of the UK system
where there is a national network of regional genetics services.  Scientists
do not do counselling without specific training and employment as such.
Theoretically, everyone has access to these services free of charge through
referral from another specialist or their primary care physician (GP).  This
is not to say that provision is adequate to meet demand now, let alone in
the future.  These generally operate to high professional standards.

There are also private set-ups promoting their tests, especially of
course for paternity testing but also for prenatal Down's, etc., and even
gender.  As far as I know there is little or no regulation of these in terms
of either the counselling provision or diagnostic precision.

I know that there is also a comprehensive system in Germany, where there
is great awareness of the ethical dimension.  The insurance based system
is highly regulated and insurers have to undertake to provide specified
genetic tests by paying for such work as is undertaken in the many Human
Genetic s departments in the Medical Schools (or by private organisations).
The money follows the patients, in other words; but there must be others who
are far better informed than I am about how this system works.


From: Rolf Sijmons <R.H.Sijmons@MED.RUG.NL>
Just a little note to correct the small mistake made in the info by Peter
Devile e, Leiden The Netherlands on the Dutch Clinical Geneticist training
program. It
takes 4 years in stead of the reported 2 years (and good results) to obtain
certified specialist degree Clinical Geneticist. The board is now
considering ma king that 5 years by the way. Training includes laboratory
training (DNA, cytoge netics, biochemistry of metabolic disease), but the
main part of those 4 years i s dedicated to clinical diagnostic aspects
(specific physical examination, syndr omal diagnosis, etc) and genetic

From: A D Stewart <gen6ads@SUN.LEEDS.AC.UK>

The Department of Medical Genetics at St Mary's Hospital, University of
Manchest er, runs an M.Sc in Genetic Counselling.  Entry is very

Best wishes,

Alistair Stewart


Department of Genetics
University of Leeds
Leeds LS2 9JT

FAX   (+44) 113 244 1175
PHONE (+44) 233 3108

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