What Is a Genetic Counsellor? Skills, Salary, and Getting Started

Genetic counsellors are experts in medical genetics who support families and individuals who want to undertake genetic testing to assess the risks of developing certain inherited disorders, given their family history. Genetic counselling is a growing field, and innovative technologies continue to give genetic counsellors new ways to analyze genetic data and help people.

What is a genetic counsellor?

A genetic counsellor is a health care professional that advises people on genetic conditions that might affect them or their family through an assessment of family history. These conditions may include chromosomal disorders such as Down syndrome and Fragile X syndrome, multifactorial disorders like cancer or diabetes, or monogenic disorders like cystic fibrosis or sickle cell disease. 

Genetic counsellors work closely with patients following assessment to educate them on types of hereditary conditions, discuss whether they need genetic testing, and discuss the various options available, including any ethical considerations. People enter genetic counselling for many reasons, including when they are pregnant or thinking of starting a family and want to know the risks to their unborn child or when managing their health or that of a family member.

What does a genetic counsellor do?

Genetic counsellors work with people concerned with genetic predispositions at all stages of life. This may include prenatal screening to determine whether a baby is likely to be born with a hereditary disease or condition, working with adults to assess whether they are likely to develop genetic diseases following the onset of specific symptoms, or new information about their family history. 

They also provide counselling and support following testing, helping people adapt to the implications of results on their physical, mental, and familial well-being. 

Typically, as a genetic counsellor, you will do the following:

• Interview patients to understand their medical and family history.

• Assess whether patients are at risk from genetic disorders using information from their family history.

• Discuss testing options with patients, including risks, social and ethical considerations, and benefits.

• Support patients and their families with counselling and education following results and before testing.

• Refer patients to necessary medical professionals.

• Perform prenatal genetic screening and pregnancy counselling.

• Support couples through premarital genetic screening and help families care for affected children.

• Provide counselling in cases of exposure to teratogenic drugs.

Generally, genetic counsellors work in hospitals or clinics, but they can also work in laboratories, clinical settings, and private practices. 

Genetic counsellor salary

According to the Government of Canada Job Bank [1], the average base pay for a genetic counsellor in Canada is $55.00 per hour. Genetic counselor wages generally range from $21.82 to $66.00 per hour. 

Job outlook and related roles

The Government of Canada Job Bank projects a positive job outlook for genetic counsellors in Canada from 2022 to 2024. Nearly all provinces and territories have “good” and “very good” ratings for job prospects, and employment growth has led to several new positions [2].  

Career progression is positive, with plenty of options for specializing in a particular area, such as oncology and prenatal. There are also some niche specializations, such as psychiatric genetic counsellors and chromosomal disorders counsellors, and the opportunity to move into more senior positions with management responsibility.

Genetic counselling specializations

Genetic counsellors can work with the general population or specialize in a single area related to a type of condition or group of conditions. As a genetic counsellor, you can also specialize in a particular group of people, such as children. 

Cardiology 

Genetic counsellors specializing in cardiology work with people to establish a genetic risk for cardiovascular diseases, such as sudden death syndrome, hypercholesterolemia, and cardiomyopathy. 

You would collect information on family history, make recommendations for screening when necessary, and support patients through genetic testing, diagnosis, and options available.

Neurology

A specialization in neurology means a genetic counsellor is qualified to establish a genetic link for neurological diseases, such as Alzheimer's, dementia, and epilepsy. 

You would work with patients to decide whether they want to undergo testing and its implications, supporting them through the process and helping them understand the results.

Oncology 

Oncology specialists look for inherited risks of all types of cancer. You would support patients to understand the risks of having children and passing on hereditary cancer genes and the risk to those seeking help after discovering they may have a hereditary cancer gene. You would have the opportunity to offer cancer screening and discuss treatment options and risk reduction strategies.

Pediatrics

Genetic counsellors specializing in pediatrics work with families of children diagnosed or at risk of an inherited condition. You would work hands-on to advise families of their options and offer emotional support.

Preconception

Preconception genetic counsellors work with couples looking to conceive to assess genetic predispositions and support a low-risk pregnancy with lifestyle and health advice and guidance. 

Prenatal

Genetic counsellors specializing in prenatal offer screening to expectant parents to determine the risks of their baby having genetic disorders. This can be a standard part of pregnancy care for high-risk patients—generally those over 35 years old.

Steps to becoming a genetic counsellor

Genetic counsellors are highly qualified and undergo extensive education and training to do their jobs effectively. This education takes at least six years to complete.

1. Complete a bachelor’s degree

The first step to becoming a genetic counsellor is to earn a bachelor’s degree, ideally in a relevant subject, such as biology, biochemistry, biomedical sciences, or social sciences. However, the subject isn’t always a prerequisite for the next step as long as you have a degree. This step typically takes four years.

2. Earn a master’s degree in genetic counselling

After earning a bachelor’s degree, the next step is enrolling in a master’s in genetic counselling degree program. Programs must be accredited by the Accreditation Council for Genetic Counselling (ACGC). Your master's degree program usually takes two years to complete. 

The course covers areas such as molecular genetics, research methods, counselling, human development, and ethics. It also includes clinical experience on rotation to cover various areas in the field. You may also need to complete a research project or thesis.

3. Pass the board certification test from the CAGC or ABGC 

Genetic counsellors can choose to gain certification by passing a certification exam accredited by the Canadian Association of Genetic Counsellors (CAGC) or the American Board of Genetic Counselling (ABGC). If you do, you must undergo ongoing professional development activities to keep your certification current.

Currently, the genetic counselling profession in Canada is unregulated, as territorial or provincial legislation does not govern practitioners. Although it is not yet required, the CAGC's national certification credential is an important regulation for the profession in Canada. 

4. Develop knowledge and skills

As a genetic counsellor, you will be knowledgeable in your field, studying genetics, biology, general science, and ethics. You'll also have technical skills, including research methods and lab skills.

Additionally, genetic counsellors must be able to demonstrate people skills, including:

• Interpersonal skills: To simplify complex medical information for patients and caregivers to understand

• Compassion: When dealing with people who have found out worrying or upsetting information about their health or of someone to whom they are close 

• Critical thinking: To work out how best to present information to patients and how best to analyze risks

• Decision-making: This is essential when considering how best to share knowledge with patients and their families. 

Next steps

If a career as a genetic counsellor sounds interesting to you, but you're not sure if it's the right career path for you, consider taking an introductory course, such as An Introduction to Genetics and Evolution, offered by Duke University. If you're ready to start on this career path but haven’t yet earned your bachelor’s degree, that’s the best place to start. 

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