chutes and (career) ladders: developing a section of ... · research committee –sawona biswas,...

Chutes and (Career) Ladders: Developing a Section of Genetic Counseling at Your Institution

Donna M. McDonald-McGinn, MS, LCGC and Christine G. Spaeth, MS, LGC

Developing a Section of Genetic Counseling

Pittsburgh 2018

Society for the Study of Behavioral Phenotypes Melbourne, Australia – August 28, 2018

Donna M. McDonald-McGinn MS, LCGCClinical Professor of PediatricsPerelman School of Medicine of the University of PennsylvaniaChief, Section of Genetic CounselingDirector, 22q and You CenterAssociate Director, Clinical Genetics CenterChildren’s Hospital of Philadelphia, Philadelphia, PA, USA215.590.2920 [email protected]

mailto:[email protected]

Disclosure:

I have presented lectures on 22q11.2DS for Natera

Boat House Row - Philadelphia

Disclosure:

This presentation was prepared in collaboration with Margaret Harr, MS, LCGC


Disclosure:


I am representing the Section of Genetic Counseling at:

• Children’s Hospital of Philadelphia (CHOP)

• University of Pennsylvania – including the Hospital of the University of Pennsylvania (HUP)

What is the purpose of organizing a Section of Genetic Counseling?


1. Advocacy

2. Professional Development

3. Establishing an Academic Home

Historical Perspective


• Mid-1970s: 1 GC at CHOP

• Mid-1980s: 2 GCs at CHOP; 1 at HUP

• Early 1990’s: helped launch the GC training program at Beaver College (now Arcadia U)

• 2013: 26 GCs at CHOP and 14 at HUP

• GCs embedded in numerous departments across CHOP and HUP

• Taking on novel roles

• Involved in administrative decision making across the institution

• February 2014: PA Licensure became a requirement

• CHOP GCs initiated discussion surrounding genetic counselor billing

This broad breadth of interests and physical locales across campus emphasized the need for a centralized home


• Compliance with licensure

• Develop scope of practice

• Support professional development

• Provide CEU’s

• Encourage GC billing

• Provide educational opportunities

• Ensure a sense of belonging

Proposal Submitted on June 12, 2014 To Pediatrics, Pathology and Surgery Chairs


• Provided general background information

• Defined genetic counseling as a profession

• Delineated training and GC skills

• Described the current role of GCs at CHOP

• Counseling patients and…..

• Writing letters, vetting referrals, prepping cases, providing patient follow-up, organizing specialty clinics, attending family meetings, assisting with inpatient consults, reviewing lab results, coordinating complex appointments, writing lab reports; coordinating research and sample collection, maintaining patient databases; writing papers, chapters, and grants; presenting at local, national and international meetings; supervising students, educating/supervising physicians, basic scientists, medical students, genetic counseling students, undergraduates, patients and families; supporting insurance pre-authorization, communicating with payers; creating patient friendly literature, interfacing with family support organizations, planning conferences; managing teams, etc, etc, etc…..

Proposal included Section Goals


• Peer-to-peer mentorship on professional issues

• Developing areas of expertise, creating opportunities for advancement, encouraging appropriate

compensation via partnerships with Human Resources (HR) and market analyses

• Sharing resources

• Letter templates, patient resources, lay publications

• Peer-to-peer education

• Advances in the field of genetics, advances at CHOP and HUP

• Supporting academic growth

• Paper, abstract, chapter, and grant writing, IRB proposals, public speaking, teaching, mentorship

• Organizing student and shadowing supervision

• Formalizing GCA positions

• Providing opportunities for CEUs

• Partnering more closely with local and distant training programs

• Interfacing with local, regional, national, and international GC governing bodies

First steps would require:


• Establishing billing parameters for GCs

• Standardizing documentation for GCs

• Defining access to EPIC and scope of practice for GCs

• Developing a more comprehensive GC career ladder

• Addressing GC recruitment and retention

Proposal Approved by Department Chiefs at CHOP


• Inaugural Section Meeting held on November 11, 2014!

• Welcomed GCs at HUP as full members of the Section

Organizational Structure – Committee Driven


Executive Committee*

Education Committee

Professional Issues Committee

Outreach and Awareness Committee

Research Committee

*Executive Committee composed of: • Section Chief• Committee Leads• Departmental Liaison's • HUP Liaison

Executive Committee


• Meets at least quarterly to discuss: • New hires

• Recruitment and retention

• Career ladder

• Compliance

• Providing CEUs

• Training Programs

• National GC Awareness Day

• Social Functions

• Communication

• New Initiatives

Section Chief


• Welcomes new hires via letter and offers to orient in person when onsite

• Oversees provision of liability insurance certificate towards obtaining licensure

• Leads the EC in organizing meetings and functions

• Interfaces with HR, Compliance, Talent Acquisition (TA), and Business Administrators regarding recruitment and retention including ongoing compensation analyses and adjustments to the career ladder

• Oversees the Section Admin in supporting broad communication

• Interfaces with institutional administration regarding long-term vision

• Communicates with training programs towards supporting mutual missions

Committee Leads and Departmental Liaison's


• Serve as a sounding board for the Section Chief and GCs on issues surrounding professional development, career advancement, and conflict management

• Lead and fulfill Committee and Sub-Committee goals

• Identify areas of growth

• Develop new initiatives

• Encourage broad participation

• Engage with state, national, and international colleagues and the general public

Initial Career Ladder Established at CHOP in 2014


• 4 Tiers – each tier corresponded to salary grade in CHOP pay structure

• Genetic Counselor 1: Entry level

• Genetic Counselor 2: Licensure + 1 year experience

• Genetic Counselor Specialist: >3-6 years experience + additional expertise to support a specific position

• Divisional PI: Director, Associate Director, Assistant Director, Manager, Lead GC…

• Provided genetic counselors with support in advancement negotiations

• Assisted in hiring discussions with HR

• Created standardization across CHOP

• Promoted regular ongoing discussions

Section of Genetic Counseling – Overarching Umbrella

Education Committee

Professional Issues

Committee


Research Committee

Section Chief

Executive Committee

Administrative Coordinator

Education Committee – Stacy Woyciechowski, MS, LCGC


• Promotes Acquisition of Continuing Education Units

• Educational meetings, addressing professional issues, organizing the Philadelphia Genetics Meeting, and PAGC when at Penn

• Working with NSGC and ABGC to acquire category 1 CEUs for weekly Genetics Grand Rounds

• Up to 4 category 1 CEUs/year

• Interfacing with GC Training Programs

• Providing admission tours and interviews, executing affiliation agreements, organizing clinical rotations, supporting thesis matching, onboarding students and observers

• Fingerprinting

• Background checks

Education Committee


• Provides central contact for all GC shadowing/observer requests • Provides explanation to potential observers and gauges interest/timing

• Matches with GCs and creates itinerary

• Undergraduate Education Day• In collaboration with Outreach and Awareness Committee

• Liaison to HR for clearance• 150 observers placed to date

• Creates uniformity in process and policy• Developed policies regarding appropriate behavior/dress/preparedness

• “Tips for the CHOP Observer”

• Policy regarding onboarding/hosting minors

• Challenges: • Communication, workload, scheduling

Education Committee


• Provides central contact for all GC shadowing/observer requests • Provides explanation to potential observers and gauges interest/timing

• Matches with GCs and creates itinerary

• Undergraduate Education Day• In collaboration with Outreach and Awareness Committee

• Liaison to HR for clearance• 150 observers placed to date

• Creates uniformity in process and policy• Developed policies regarding appropriate behavior/dress/preparedness

• “Tips for the CHOP Observer”

• Policy regarding onboarding/hosting minors

• Challenges: • Communication, workload, scheduling

Outreach and Awareness Committee – Holly Dubbs, MS, LCGC


• Increase visibility of GCs across the institution and region

• Philadelphia Science Festival

• Genetic Counseling Awareness Week

• Awareness tables in 2 locations

• Informational brochure and videos

• Giveaways, games of chance

• Poster Session



• Promotes activities within the Section to foster interdepartmental counselor relationships

• Media Sub-Committee - Section wide announcements, Quarterly Newsletter, Facebook page

• Brown bag lunch discussions, Social events, Mentorship/Contact Program

• Recognizing fellow GCs for personal and professional accomplishments

• GC Job FairSurabhi Mulchandani, MSc MS CGC

promoted to Director of

Operations in the Division of

Laboratory MedicineA Day in the life of a Genetic

Counselor – Emma Bedoukian, MS,

LCGC

Margaret and Steve welcome twins!

Research Committee – Sawona Biswas, MS, LCGC


• Creating tip sheets for preparing IRBs, consent forms, and grants

• Providing support for abstract, platform, poster, and paper prep

• Thesis development (along with the Education Committee)

• Journal Club

• Creating a “research vault” of Section member publications/theses

Katie Grand, MS, LCGC

Professional Issues Committee – Margaret Harr, MS, LCGC


• Instrumental in facilitating GC billing

• Working with the insurance pre-authorization group on best practices for requesting/tracking pre-auths

• Providing updates on the electronic health record

• Developing a central smart phrase repository

• Working with EPIC development on updates specific to GC needs

• Supporting access to GC Services

• Supporting professional development

• Developing research opportunities across the Section

• “Harnessing the Power of the CHOP-Penn Genetic Counselors and Section of Genetic Counseling”

Where are we 4 years later?


Currently employ 68 GCs at HUP and CHOP


HUP (N=26)CHOP (N=42)

In 4 years:

• We’ve witnessed an overall 41% increase in GCs

• 46% increase at HUP

• 38% increase at CHOP

With 26 GCs in 6 Departments/Divisions at Penn


42 GCs in 5 Departments/Institutes at CHOP


Joseph Stokes Research Institute


Center for Autism Research (CAR)


Center for Fetal Diagnosis and Treatment


Division of Genomic Diagnostics (DGD)


Pediatrics


With Endocrinology and others now hiring…

Human Genetics


To meet this exponential demand we recognized that we must train more GCs

• Launched a GC training program at UPENN

• Celebrated with a Section luncheon and discussion on January 18th

• Currently accepting applicants for the inaugural class in 2019


Welcome

In Celebration of the

Master’s in Genetic Counseling Program

at the Perelman School of Medicine of

the University of Pennsylvania

Section is hosting a GC Job Fair


• Thursday, January 31st from 12:30 – 3:00 PM

• Currently have 10 open positions at CHOP (4 newly created)

• Clinical Genetics (3)

• Neurology (2)

• 22q

• DGD

• Endocrine

• RIMGC

• SDU

• Additional positions expected

Annual hiring period results in reassessment of career ladder and compensation to support recruitment and retention


• Compliance at CHOP is currently adjusting verbiage to address titles:

• Genetic Counseling Assistant title for non-GCs or those GCs wishing to work prior to graduation

• Graduate Genetic Counselor – prior to obtaining PA provisional license

• Provisionally Licensed Genetic Counselor – once provisional license is obtained

• Licensed Genetic Counselor I – once license is obtained

Title: GC Assistant

Graduate GC ProvisionalGC

Licensed GC I

Licensed GC II

Licensed GC Specialist

Clinical Genomic Scientist II

Licensed GC Manager/Licensed GC Senior Specialist

Certification None None None ABGC ABGC ABGC None ABGC

License NoneAwaiting

Provisional license

Provisional license

PA GC license

PA GC license PA GC license

None PA GC license

Minimum Education

College Grad

Master’s Degree in

GC/Genetics


GC/Genetics


GC/Genetics


GC/Genetics


GC/Genetics

MS or PhD in GC or Genetics


GC/Genetics

Minimum Experience

None None None None 3 years as independent

GC

>3 years as independent

GC +

appropriate role + skills

6 -8 years +

appropriate skills

6 years as independent GC

+ appropriate skills +

supervisory role

Position titles and career ladder matrix is fluid:

Compensation analysis is ongoing


• Recognizing Importance of GCs and general shortage

• Close partnership with administration - HR, Talent Acquisition, and Compensation Analysts

• Cognizant of national and local salary averages

• Monitoring baseline starting salaries for genetic counselors across CHOP

• Monitoring salaries for existing GCs to maintain parity

• Monitoring incentives such as signing bonuses and moving expenses

• Ongoing markets reviews

Constantly establishing new goals


• 2019 Section Goals:

• Increase publications across the Section

• Institute collaborative research across the Section

• Improve participation in Committees/Sub-Committees

• Improve participation in social functions

• Improve collaboration across the CHOP-Penn community

• Continue to train, recruit, and retain GCs

In summary, the benefits of formalizing a GC Section are many


• Engagement across the institution with HR, TA, compliance, and administration to support recruitment, retention, advancement

• Improving the sense of community in diverse settings

• Supporting communication and resource sharing

• Implementing uniformity and standardization

• Observers, students, GCAs, documentation, career ladder and salary review

• Advocating for change wherever needed

• HAVING FUN!

Barriers to organizing formally


• Time

• Funding

• Cross-talk between departments

• Rallying volunteers

• Potential expectations of uniformity in productivity and job descriptions

• Potential expectations of cross coverage

Initial steps are doable


• Identifying key stakeholders

• Advocating for your group

• Setting realistic expectations

• Time commitment

• Work load

• Collaborating with others

• Don’t be afraid to ask!

• Think big!

• Just do it!

Thank You for Your Kind Attention


chutes and (career) ladders: developing a section of ... · research committee –sawona biswas,...

Documents