In 2022, I applied to genetic counseling programs (GCPs). I remember feeling excited and nervous about the next step in achieving my professional goals. Part of my process of creating a list of potential schools included scrolling through program websites to hopefully find a Black genetic counselor (GC) in leadership or on faculty. As a prospective Black genetic counseling student, seeing cultural representation was important as a potential predictor of my experience in the program. It also served as an indication of the support a program could offer beyond the classroom in my career as a GC.
After searching through numerous websites and finding almost no Black GCs, I decided to search for GCPs at Historically Black Colleges and Universities (HBCUs) in the hope of finding the representation I was looking for. Unfortunately, at that time there were no GCPs at HBCUs. However, I discovered that a program had once existed at Howard University but closed in 2014. I recall in that moment questioning why there are no GCPs at HBCUs, considering these schools could play a pivotal role in producing and supporting the development of more Black GCs. In fact, from 2011 to 2021, the nation’s four historically Black medical schools (Meharry Medical College, Howard University College of Medicine, Morehouse School of Medicine and Charles R. Drew University of Medicine and Science) graduated more Black physicians than the top 10 predominantly white medical schools combined. It stands to reason that the same could be replicated in the field of genetic counseling.
My graduate school search process, though disheartening, was unfortunately not surprising, given that only 2% of GCs self-identify as Black (NSGC PSS, 2024). Fast forward to my time as a second-year diversity scholar at Columbia University’s GCP, I decided to investigate the role of HBCUs in genetic counseling after learning about developing HBCU GCPs. Specifically, I was interested in understanding how the lack of Black GCs would impact these programs. Improving the representation of Black GCs is crucial in both clinical practice and within GCPs, but it is paramount at an HBCU GCP. If HBCU GCPs existed when I was applying and I noticed a lack of Black GCs apart of the programs, it would have raised many internal questions for me. To delve deeper into this topic, I conducted interviews with key individuals in the Black GC, HBCU GC and broader GC communities.
For background, HBCUs were established at a time when Black people were prohibited by law from pursuing postsecondary education. Although Black students can attend any institution today, a study found that 21st-century Black students are drawn to HBCUs because they desire to be in a predominantly Black environment where they can connect with the unique cultural and traditional practices of an HBCU. Additionally, they value the opportunity to be surrounded by more Black students and faculty. This is typically an environment previously unfamiliar to some aspiring Black college students, and one that contrasts sharply with what most Black genetic counseling students experience. This study and others show the importance of creating this desired environment at HBCU GCPs.
However, as expressed by all the individuals I interviewed, the lack of Black GCs makes cultivating this environment difficult. Additionally, I learned the challenge is further compounded by stringent hiring requirements. This scarcity makes it hard to find Black GCs who not only meet the Accreditation Council for Genetic Counseling (ACGC) requirements to lead or join the faculty at a GCP, but also who are willing to relocate to where the program is based. If GCPs at HBCUs do not build upon a foundation of Black GC leadership, or at least have a well-defined plan to do so when able, they may run the risk of creating problematic power dynamics as non-Black GCs are in positions to make decisions for HBCU GCPs and without the appropriate cultural context and lived experience.
Although Black GCs are needed at HBCU GCPs, a Black GC I interviewed candidly shared their reservations about pursuing a program leadership position and their conflicting feelings about recruiting more Black students to genetic counseling. They stated, “I know what people have to go through to diversify the profession,” highlighting the experience many Black GCs will likely face, including frequent and repeated microaggressions, being the only Black person in the room, and feeling responsible to represent a whole community of people. This emphasizes again the importance of having Black GCs who can connect and mentor the potential higher proportion of Black GCs students who may enroll at HBCU GCPs.
Two Black GCs I interviewed also expressed their optimism for Black GCs who get to work at HBCU GCPs. They mentioned the opportunity to be in a more diverse academic community that is intrinsically supportive of diversity work and can also provide the emotional care needed when engaging in this work. One admitted feeling alone in performing these tasks at times or being perceived as the assumed frontrunner of this work at their job in a less diverse environment. The concern of tokenism also arose in interviews as, although being a part of an HBCU GCP is desirable to support the next generation of Black GCs, there is an understanding that just because a GCP is at HBCU does not mean that there will be more Black GCs within the program due to reasons previously described. Considering this, becoming “the face” of a program can feel inevitable and very uncomfortable especially if someone is one of the few Black GCs in a program.
It is commendable that GCs are taking the responsibility of reintroducing HBCU GCPs especially considering the lack of Black GCs who meet hiring requirements and who want to be in those positions. They will assist in creating more Black GCs, which will result in more Black GCs being able to be a part of HBCU and non-HBCU GCPs in the future. However, we must be aware of the historic and respected space GCPs are re-entering and how the lack of diversity in genetic counseling directly conflicts with these esteemed institutions. All in all, HBCUs are schools that were built on the premise of inclusion, emphasizing that all are welcome to attend and work at these institutions, even if they are not Black. As a new Black GC, I am excited to watch HBCU GCPs successfully join the growing list of ACGC-accredited GCPs. This will hopefully allow aspiring Black genetic counselors to have a different application experience than I did.
References
Johnson, J. M. (2017). Choosing HBCUs: Why African Americans choose HBCUs in the twenty-first century. In Black colleges across the Diaspora: Global perspectives on race and stratification in postsecondary education (pp. 151-169). Emerald Publishing Limited.
National Society of Genetic Counselors 2024 Professional Status Survey
Rice, V. M. (2021). Diversity in medical schools: a much-needed new beginning. Jama, 325(1), 23-24.
Traevia Morris, MS, CGC (she/her) is a genetic counselor in Virginia, where she provides genetic counseling services within multiple clinics in cardiology. She is passionate about promoting the use of genetics in cardiology, health equity, increasing diversity in genetic counseling and fostering public health principles within the field.