The genetic counseling profession is evolving in many ways, forcing new graduates to grapple with different career paths and educators to ponder if their programs appropriately advertise and teach what the workforce demands. While there may not be a perfect solution, transparency and open dialogue is always the first step.

Yalda’s Story, Recent Graduate

The Promise 

I wanted to be a genetic counselor (GC) for many reasons, but after pursuing a BSc and being disillusioned by the job market, one of those reasons was job security. As a child of immigrants, my career approach emphasized pragmatism. I recall telling my parents, “I know it’s expensive, but I would basically be guaranteed a job after graduation”, a belief reinforced by a field widely described as experiencing and projecting “significant growth.” 

The Reality

Between the two years from when I applied to GC programs and started my second year, the job placement rates at my program had shifted from approximately 80% within three months of graduation to 80% within six months. I witnessed my peers in the class ahead of me graduate into one of the worst job markets for GCs in over a decade, and I could only hope things would get better in a year. Six months of unemployment is not insignificant, given 83% of GCs graduate with some debt and 42% graduate with >$75k of debt (Greer et al. 2025). This is even more true for an international student who relies on private loans, where interest rates tend to be greater and payment is due from day one. In addition to the financial burden, there’s a toll on mental health that comes with prolonged unemployment: stigma, insecurity, shame and isolation, both self-imposed and otherwise.

These experiences raise questions about the ethical ambiguity of encouraging students to take on substantial financial and personal risk while promoting a profession that may not be able to support its graduates. This isn’t unique to our field, but it made me wonder: could this workforce shift have been predicted? 

Workforce data is limited, but what exists tells a concerning story of basic supply and demand economics. According to the 2017 Dobson DaVanzo report, the conservative estimate for predicting the demand of CGCs by 2021 was 3,371. The supply for 2021 was projected to be 4,875. However, the actual number of CGCs that year was at least 5,629, a 40% increase over demand. Interestingly, the report authors called for careful monitoring over the next several years, yet no further studies were ever published.

Meanwhile, the number of programs has been steadily increasing in the last decade, from 36 to 64. A challenging job market may not feel new to some, just another wave that will pass. However, with the current rate of graduates entering the job market each year and no foreseeable improvement in job openings, this level of discordance seems unprecedented.

Increasingly, we are seeing GC roles rebranded for advanced practice providers, genetic counseling assistants absorb expanded scopes, and contract positions that don’t create new jobs. The simultaneous pressure of a self-cannibalizing profession and a growing pool of new graduates feels like it is quietly suffocating those of us in between. 

The Loss

Another common response to this challenging landscape is to emphasize the versatility of our skill set for non-traditional roles. This is necessary and valid. However, this narrative can also be dismissive of GCs who desired a traditional career and should not be our default. As GCs, we often counsel patients who are grieving the loss of an imagined future. Perhaps this is the same.

Furthermore, if GCs are being pushed towards non-clinical roles, is this a reflection of our utility in the workforce? If the genetic counselor title is both misleading to students and stunting professionals, perhaps we must seriously consider adapting our professional identity or risk extinction. 

After graduation, these are the conversations I kept returning to with peers and educators, including with my program director, Katie Gallagher.

Katie’s Story, Educator

The Promise

As a clinical genetic counselor, my sense of responsibility is rooted in the patient in front of me. As a program director, that weight feels multiplied. I am simultaneously accountable to students who arrive with ambition and trust, to a profession I believe in, to the colleagues and staff who depend on this program for their livelihoods, and to an institution that requires a certain financial viability to survive. These commitments do not always align.

I strive to provide an education that prepares students to enter a dynamic field, ready to think critically, to advocate for their patients and to adapt as healthcare shifts beneath them. I work to dismantle barriers that have historically kept deserving people out of the field. Until recently, I also wanted to help grow our workforce to meet the needs of the patients and communities we serve. Now, I am no longer certain that growth is an appropriate goal. 

The Reality

We are training students for a market with limited job availability; unfortunately, even more so for international graduates and marginalized groups. We lack much formal data to confirm what many of us are observing, but the anecdotal evidence is accumulating. For every story shared like Yalda’s, there are likely many more that never surface. This is not a reflection of individual failure, but rather a systemic one.

The Loss

If we do nothing, the market will eventually decide for us. This may stall or shrink our profession, limit access and diversity, and make GC no longer seem like a reasonable career path for some. Every stakeholder in this system is navigating real constraints, but the difficult questions are what we owe the people sitting in our classroom now, and what we owe them when they leave it.

Shared Message on Accountability 

The disconnect between the current supply and demand of the genetic counseling workforce is not a rumor or a rough patch; it is a structural challenge of which the most vulnerable are bearing the brunt of the weight.

So, who is accountable? If the problem is systemic, responsibility might be too. 

Since there is no regulatory oversight to balance supply and demand, maybe we need to start by holding each other accountable. Educators need to be more honest with prospective students, provide more training that evolves with the market, and sustain support beyond graduation. GCs in the workforce need to train, uphold, and expand GC positions. Prospective students need to ask hard questions, and new graduates need to bring awareness to their experiences. Last but not least, the professional organizations at large need to better monitor and report on workforce realities, listen to their newest members, and build a more sustainable path forward that strengthens both the current workforce and is worthy of the people entering it. 

References

Accreditation Council for Genetic Counseling. (2024). 2024 ACGC annual accreditation report. https://www.gceducation.org/2024-acgc-annual-accreditation-report/

Greer, H. L., Petty, E. M., Lasarev, M. R., & Kuhl, A. (2025). Impacts of student debt on the professional and personal lives of genetic counselors: A 10-year perspective. Journal of Genetic Counseling, 34, e70013. https://doi.org/10.1002/jgc4.70013

Hoskovec, J. M., Bennett, R. L., Carey, M. E., DaVanzo, J. E., Dougherty, M., Hahn, S. E., LeRoy, B. S., O'Neal, S., Richardson, J. G., & Wicklund, C. A. (2018). Projecting the supply and demand for certified genetic counselors: A workforce study. Journal of Genetic Counseling, 27(1), 16–20. https://doi.org/10.1007/s10897-017-0158-8

National Society of Genetic Counselors. (n.d.). Code of ethics. https://www.nsgc.org/About/Code-of-Ethics-Conflict-of-Interest/Code-of-Ethics

National Society of Genetic Counselors. (n.d.). Past professional status surveys. https://www.nsgc.org/Research-and-Publications/Professional-Status-Survey/Past-Professional-Status-Surveys

Sarah Lawrence College. (n.d.). Genetic counseling program overview. https://www.sarahlawrence.edu/genetic-counseling/program-overview.html#acc-103-job-placement-rates-for-graduates

Virgolino, A., Costa, J., Santos, O., Pereira, M. E., Antunes, R., Ambrósio, S., Heitor, M. J., & Vaz Carneiro, A. (2022). Lost in transition: A systematic review of the association between unemployment and mental health. Journal of Mental Health, 31(3), 432–444. https://doi.org/10.1080/09638237.2021.2022615

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