Breaking the Plan
By Andrea L. Durst, MS, DrPH, LCGC, Class of 2005
Like many genetic counselors, I always had a plan. While my career has in part been the result of this careful planning, I have gotten to the place I am today by learning to be flexible in moving from “Plan A” to “Plan at this point I have lost count”, following my evolving passions, and adjusting to life’s unexpected turns.
I entered into the genetic counseling program at UNCG in 2003 knowing that I eventually wanted to specialize in cancer. While I was open to other experiences during my training, a cancer counseling position was still at the top of my list when I began looking for positions during my second year. I was offered and accepted a position to be the first genetic counselor at a hospital in Louisville, KY. Excited about the opportunity to start a new cancer genetic counseling clinic, I packed up the rental car (a garbage truck had pretty much sliced one side of my car in half during the graduation ceremony!) and headed for Louisville. That first year, I worked hard to expand my fledgling clinic in both reach and staff size. Starting a genetic counseling service from the ground up was no easy task, and I didn’t always know the best way to proceed with this effort. However, I had wonderful resources including several of my classmates who had also taken jobs starting new clinics—we held regular conference calls to compare strategies, ask questions, and offer support as we embarked on these journeys as new graduates.
As my clinic grew in staff size, I successfully advocated for a promotion to Manager of Genetic Counseling Services. We began discussing the possibility of expanding genetic counseling at the hospital to other areas. This gave me a needed push to seriously think about the kind of skills that I would need to successfully expand and manage the clinic that I had started. This led to my decision to return to school for my DrPH (Doctor of Public Health) in Health Management and Policy. I quickly found that I loved being back in school and found the classes that I was taking in public health to be so relevant to programs that we were implementing in the clinic. During my doctorate program work, I tried to involve genetics as often as I could. But as my interest in public health genetics was flourishing, the plans to expand my genetic counseling clinic became less realistic. My career was no longer following the well-laid plan that I had developed, and I was faced with a decision—do I move for a new job or stay and finish my degree?
Ultimately, I decided to complete the last two years of my degree full time, even though I wasn’t quite sure how I would use it once I graduated. While not Plan A (or B or C), this decision resulted in so many opportunities to further my expertise in public health genetics that I could not have predicted when I made the extremely difficult decision to leave my genetic counseling position. I was suddenly able to plan a practicum experience in Michigan with their Genomics and Genetic Disorders Section, which would lead to my participation on projects with the Region 4 Midwest Genetics Collaborative, The Genetic Alliance, and the CDC. It was during this practicum in Michigan that my mentor mentioned she had seen a position for Assistant Genetic Counseling Program Director at Pitt, and thought that I would be a great fit given their strong connection to public health. I agreed, and even though I thought it was a long shot, I applied.
I have now been the Assistant Genetic Counseling Program Director at Pitt for just over two years, and I am thrilled with “Plan at this point I have lost track”. I love working with, teaching, and mentoring students as they complete their genetic counseling training. Witnessing and being a small part of their success is beyond rewarding. I have also been able to advance my work in public health genetics by serving as Co-Director of the MPH Program in Public Health Genetics (one of two in the US), steering committee chair for NYMAC Regional Genetics Network, and co-chair of the NSGC Public Health SIG.
While my career path has not always been a clear or easy one, I have certainly learned a lot along the way. In my first position, I realized the importance of maintaining a good work/life balance. Though it is still sometimes difficult to make time for myself, I know that I will do my best work if I take time to recharge and to cultivate new and existing interests and relationships. This is why I now try to stress the importance of self-care to my students. Sometimes, moving forward in my career and in life in general was about making a decision at a fork in the road, and other times it was about picking up the pieces of shattered plans. One of the best pieces of advice I was given to manage both of these situations was to stop worrying about making the absolute “right” decision and rather think about whether I was making a “good” decision (because, for example, neither finding a new job nor finishing my degree full time were “wrong” decisions). I didn’t always know what those choices would lead to, but I trusted in my capacity to figure it out along the way, and was also fortunate to have a lot of support from the people in my life—my family, friends, colleagues, and mentors—who supported me, cheered me on, and pushed me forward exactly when I needed it.
I am excited for what the future of my career as a genetic counselor holds, but I no longer feel I have to plan for every minute of it!