Genetic counselor

Jessica Rispoli Joines is a certified genetic counselor at the University of Maryland Medical Center and associate director of the Master’s in Genetic Counseling Program at the University of Maryland School of Medicine. She has been working as a clinical genetic counselor since 2000.

What does your job entail?

My main area of specialty is cancer genetics; however, over the years I have worked in a variety of clinics, including pediatric genetics and Huntington’s disease. In my current role, I meet with individuals and families who are concerned that their family history of cancer (often breast, ovarian, or colon) may be due to a predisposing cancer gene that is being passed on in the family. I meet with the patient and/or family to discuss their family history of cancer in much detail, and based upon the clues I see, we discuss the likelihood that there is a mutation in a cancer gene that may be putting family members at risk. We discuss the pros and cons to genetic testing and options for management if there is an estimated increased risk for cancer. If a patient undergoes genetic testing, I assist them with that process and counsel them accordingly when the results become available. One of the most important aspects of my job is making sure a patient understands the correct interpretation of their genetic test results and helping the patient develop a plan for management in light of their results and family history.

Also, in my current position, I serve as the assistant program director to the Master’s in Genetic Counseling Program at the University of Maryland [School of Medicine]. We currently have 13 students in our two-year program. I oversee their clinical rotation placements, serve on various program committees and teach.

What kind of schooling or training did you go through?

In undergrad, I majored in biology and minored in education. To become a genetic counselor, one must complete a genetic counseling graduate program that is accredited by the Accreditation Council for Genetic Counseling. I obtained my master’s in genetic counseling at the University of Maryland, Baltimore. During this training, genetic counseling students work in a variety of clinical settings, including prenatal genetics, pediatric genetics and cancer genetics. The training also includes rigorous course work in genetics and counseling skills.

What inspired you to this career?

Genetic counseling is a perfect fit for anyone who loves genetics but wants to work with people, rather than in a lab setting.

What do you like best about your job?

I love working in a field that is changing at such a rapid pace. It is fulfilling to work as part of the health care team and speak with patients about testing that hopefully will make a positive impact on their lives. I think it is fascinating that we have the technology to provide people with information surrounding their risk for various types of cancer. Although it can be daunting, it can be equally empowering. In my current job, I also love having the opportunity to teach and train our graduate students. I have also enjoyed over the course of my career the option to work in a variety of clinics.

What are the challenges?

It can be difficult giving bad news to patients in the event that they test positive for a mutation in a cancer susceptibility gene. Those can be tough phone calls to make. It also is challenging to work in a field where there is a lot of ambiguity with respect to certain test results. Sometimes genetic testing can lead to more questions than answers — which can be difficult for the families and genetic counselors. However, all of the current limitations and nuances of genetic testing are the reasons why genetic counseling is such a crucial aspect of genetic testing and why I feel so fulfilled by the work that I do.




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