Life is A Winding Road
By Nikki Fleming, Class of 2012
Many of us go through life believing there is a plan and a timeline for which things will happen for us. We will finish school, find an amazing job, continue to have passion and stability in that job, maybe find a spouse, have kids, buy a house, and die fulfilled and happy. I was no exception. I was already married when I applied to UNC-Greensboro’s genetic counseling program and in my first year at the program, we bought land in Boulder with a plan for me to finish grad school, find a remote job, and build a house. Then, we’d pay off the land and the house and buy an RV and travel the world with it while working. Everyone – including those at UNCG thought this plan was just a tad ambitious (and maybe a bit crazy too). But we were focused and we got all of the plan accomplished until the building process. Because then…we got divorced.
I’m telling you all of this because we as genetic counselors tend to be type A and plan for everything we possibly can. We often have high hopes and dreams for the future and we’re ready and willing to push forth and make them happen. None of these are bad qualities at all. However, I’ve found one of the most important qualities to have as a genetic counselor (and as a human) is being adaptable to the things thrown at us – whether that be a patient who was supposed to be a typical AMA case who ends up having a complicated family history of a chromosomal inversion, a young adult who you have to tell is affected with Fragile X and begins asking you whether she should have a hysterectomy, a career focus that you love but leaves you drained at the end of a 40-hour work week, or a divorce. Fortunately, genetic counseling is this amazing field that provides opportunities in so many different aspects of the medical field that there is something for everyone – and at every twist and turn of life; you just have to stay open to it. ???? And thus has been my life so far.
My first introduction to genetic counseling as a field, in fact, was by chance. I met an oncologist on a plane going to visit my then-fiancé. He was drawing a pedigree next to me and I asked him if that was something he was doing for his job; I had just taken my genetics final that day to apply to veterinary school. We talked for the length of the plane ride and he gave me his business card. When I got to the next gate, I looked at the card and realized his office was literally right across the street from where I lived. I emailed him expressing interest in a job. He said he might have something soon and a month later I followed up with a short email saying “All I want for Christmas is a job at your office. Merry Christmas!” The next day, I was hired – in a created position made just for me. The next week, I met the genetic counselor who came in monthly for his hereditary cancer patients and that is when I knew I was going to be changing careers – again.
My path after grad school did not go the way I “expected” either. Even though I became interested in genetic counseling in clinic, the jobs that were available for genetic counselors in my area after I finished school were only in industry. I wasn’t opposed to a different direction, but expected to go back into patient interaction at some point in the future. I also realized that often my job happiness was not as dependent on the tasks I was doing as much as the people I was working with. I began my post-grad school career at two major labs interacting with doctors and nurses about tests they ordered I appreciated the work here in that I used counseling skills from the clinical realm in order to impart knowledge and education to healthcare professionals, just at a different level than with patients, and I also spent time researching and summarizing large amounts of data for layperson and professional use. This is something that really drew me to genetic counseling initially as well – the combination of science and counseling. I found myself enjoying all of this more than I expected and liked the combination of structure and variety to my days. I especially liked working remotely, as I could often schedule my days the ways that worked best for my efficiency and health. Since my coworkers and I interacted all day long, I didn’t feel I was removed from the job socially either.
After a number of changes in my life – mostly personal – I looked into other possibilities that incorporated these aspects of my previous jobs with patient interaction too. I became a genetic counselor contractor, meaning I became a free agent to companies who need genetic counseling skills for any and all specialties and fields. It was a big leap for me in terms of taking a risk, but I’ve reaped so many rewards in terms of time flexibility, work/life balance, variety and diversity. In the last year as a contracting genetic counselor, I’ve counseled pediatric, prenatal, pharmacogenetics, and cancer patients by phone as well as made sales cold calls for genetic counseling services, written genetic testing report descriptions, determined whether patients qualified for testing and insurance reimbursement, trained for variant classification, and researched updates in the field. The last year and a half has been a welcome change from going into work and doing the same tasks every day – even if I enjoy doing those tasks. I also have so many different types of people to ask for advice if I’m struggling with a case or project and I gain so many applicable skills from such diverse work. Of course, there are challenges too. Work hours come and go, paychecks aren’t consistent, and I have not one but multiple supervisors with different expectations and roles. I definitely didn’t choose the path to consistency and that might not align with most genetic counselors’ lifestyles or personalities, but I can also structure my time and life in the way that feels natural to me day to day. I have the ability, time, and energy, for instance, to go to a yoga class in the middle of the day, explore more hobbies, spend time with friends whose schedules are not the typical 9-5, volunteer, and get more time outdoors. All of this makes me a happier person – but that’s just me.
I may not, of course, be a contractor for the rest of my life. I hold that as an option too. That’s not to say I’m letting life control me, only to admit that I will likely value different things at different times in my life – and you may too. If I have any advice for you as you choose where you go in your career as a genetic counselor, it wouldn’t be to become a contractor or to work in industry versus in clinic. It would be to consider what you want in your life, what fits with your passions and joys, and not to assume the only path open to you is the already beaten one. Create your own; it’s worth the effort.