An Interview with Genetic Counselor Jennifer Facher

Megan Sullivan

Providing information and support to families at risk for birth defects, genetic disorders, or inherited conditions, Jennifer Facher’s job is two-fold. She uses her scientific knowledge to help patients grasp complex medical concepts involving their genetic predispositions and provides emotional support as they make important health decisions. As a pediatric genetic counselor (GC) in the University Hospitals of Cleveland, Center for Human Genetics, Facher asserts that to this day, the most satisfying part of her job is when patients thank her for being there for them and playing a part in their ability to have healthy children.

What inspired you to become a GC?

In eleventh grade, I had a wonderful, down-to-earth biology teacher who invited a GC to speak with our class. The GC gave a fascinating presentation about genetic disorders and her role working with families affected by the disorders. Afterward I sat for hours in the library reading books on the subject. From then on I knew I wanted to become a GC someday.

What does a GC do?

There are various work settings for different types of GCs (e.g., prenatal, cancer, and pediatric). Pediatric GCs typically work with physicians to evaluate children suspected to have a genetic syndrome due to birth defects, developmental difference, or physical differences not characteristic of the family. The counselor explains the suspicions, syndromes, and testing procedures to the family. After a diagnosis has been made, GCs discuss recurrence risks and what the diagnosis means for the affected individuals.

Please describe a typical day at work.

On a clinic day, I am usually scheduled to see about six or seven patients. I begin by allowing a family to explain what they hope to gain from our visit and what they have discussed with their doctors. From this meeting, I learn the extent to which the family understands their child’s disease. I then take complete medical, developmental, and family histories, and explain that the geneticist will conduct a physical examination of the child and discuss any genetic testing they feel is warranted. I present the histories to the geneticist, facilitate the testing process, report results, and arrange follow-ups.

What educational background and skills are needed to be a GC?

I tailored my college experience—with a bachelor’s degree in biology—to meet the requirements for a master’s program in genetic counseling, which I went on to receive from the University of Pittsburgh. Undergraduate degrees in nursing, psychology, and chemistry can also lead to careers in this field. Most GCs take a certification exam given by the American Board of Genetic Counselors to become “board certified genetic counselors.” GCs need to be able to work well in a team environment (e.g., with physicians, nurses, and basic scientists) and in emotionally charged situations (e.g., with families contemplating continuing pregnancies affected with genetic disorders). The GC approach is traditionally nondirective, meaning that while we provide families with accurate information about the disease, recurrence risks, and support options, we leave all medical decisions up to the family.

What advice would you give to an interested high school student?

GCs not only discuss the science of genetics but provide psychosocial support as well. GCs must know how to talk to people in a composed, friendly, and conversational manner to develop a good rapport with families and reduce their anxieties. Students should not only explore the science of genetics, but also whether they are comfortable simply working with people going through difficult times. For example, volunteering at nursing homes, women’s shelters, and hospitals are good opportunities to practice and develop conversational and listening skills. The National Society of Genetic Counselors website at www.nsgc.org provides information about this field. (Look for Karen Goodnough’s feature concerning genetic counseling in next month’s issue.)

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