A little over six months ago, my husband and I left our home in Michigan and relocated to Dubai in the United Arab Emirates (UAE). It was a move we had been contemplating for several years, hoping to eventually settle down somewhere closer to our home country, Lebanon. I had been practicing in a cancer genetics clinic for over four years, and up until deciding to leave the country, had not really thought about switching specialties, or changing jobs. However, the field of genetic counseling in the Middle East and Arab world is still in its infancy with a primary need for genetic testing and counseling in the preconception/prenatal and pediatric spaces. I knew a move to that part of the world would likely entail a major transition. When I was offered a genetic counseling position at an IVF/PGT laboratory in Dubai, despite being anxious about the move, I took a leap of faith and accepted the position.

I was excited to be practicing in the Middle East and serving the Arab community, but I was acutely aware of the challenges that lay ahead. The concept of prenatal genetic testing was something vaguely familiar to me, but I was certainly not well-versed in its intricacies. Additionally, while I speak Arabic, providing genetic counseling in Arabic was not something I was particularly comfortable doing or had great confidence in offering. And last, but certainly not least, even though I am Arab and identify as part of the Arab community, serving a primarily Western community throughout my professional career made me realize that I did not really understand the cultural implications of genetic disease in the Arab world and the differing goals of genetic counseling among Arab patients.

Therefore, the transition, at least in my own view, was not particularly smooth. Providing even basic education in Arabic was a trying and painstaking task. So, I decided to master one skill at a time. I focused first on becoming familiar with medical and genetic terminology in Arabic, testing options, their benefits and limitations, and the general structure of the healthcare system in the UAE. As I began gaining more confidence in my counseling and knowledge, I was able to slowly start shifting the focus back to the patient. The Arab/Middle Eastern world is made up of more than 15 different countries, each with their own unique cultural backgrounds and unique needs in education and counseling.  I began to understand patients’ expectations and understanding of genetic testing and could use this new understanding to better connect with and counsel my patients.

It’s only been a few months, and there is certainly a long path ahead, but I’ve learned a few important lessons, about the practice of genetic counseling, but more so, about myself. Below is a list of some of the most important lessons I have learned:

• Genetic counseling skills are 100% transferable and it is vital that we recognize and capitalize on the versatility and strength of our training and leverage our unique skill set.
• Cultural competency is key to the provision of equitable genetic services to all populations we serve.
• Confidence in your capabilities is critical. Typically, things are much more overwhelming in our heads than in reality.  
• Challenge yourself and take on new roles – it’s the best way to grow.
• Be patient and kind to yourself – the path to success is often not a linear one.

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