Abstract
There is a recognized need for increased gender and racial diversity in the genetic counseling profession. Recruitment and retention efforts aimed at diversification may be positively impacted by better understanding the demographics, dynamics and the effect of diversity within genetic counseling student cohorts. In addition, characteristics such as sexual orientation, religion, and disability status, which can further contribute to diversity, have not previously been studied on a large scale. In this quantitative study, current genetic counseling students and 2017 and 2018 graduates who were practicing genetic counselors were surveyed regarding personal and cohort demographics, the effect of these on dynamics within student groups and cultural competency during graduate training. Approximately one third (29.8%, n=106) of the 360 participants self-identified as underrepresented in genetic counseling (URGC) which was defined as an individual who was not a white, able-bodied, heterosexual female. URGC individuals were significantly more likely to disagree with positive statements about diversity and inclusion in their cohorts (p<0.001) and were more likely to report being the target of microaggressions than those not underrepresented in genetic counseling (NURGC) (p= <0.001) However, NURGC participants who had a URGC individual in their cohort (N+U) reported a statistically significant increase in the number of microaggressions they witnessed than their counterparts who did not have a URGC classmate (N-U) (p<0.001).While the majority of participants received cultural competency training, N+U individuals reported that they were significantly more likely to have received their cultural competency education from personal narratives from classmates (p<0.001), guest speakers (p= 0.038), and workshops designed by individuals who specialize in diversity, equity and inclusion (p= 0.018), than N-U individuals. The greatest proportion of genetic counselors reported that having classmates of a different ethnicity or religion had a positive impact on their current practice. This implies that having diversity in cohorts during graduate school may positively impact genetic counseling practice. Despite efforts to both diversify the workforce and create culturally competent genetic counselors, URGC individuals were more likely to have negative experiences during their training. Therefore, a crucial component of the genetic counseling profession’s diversification efforts should be training of students, faculty and clinical supervisors on issues regarding diversity, equity and inclusion.