Abstract
The genetic counseling (GC) community has long struggled with increasing racial and ethnic diversity within the profession, with the most recent Professional Status Survey (PSS) in 2021 indicating 90% White membership. While several studies have tried to pinpoint what barriers exist that make it difficult for applicants who are historically underrepresented in medicine (hURM) to enter the profession, none have examined the GC admissions process itself and how that may contribute. The aim of this study was to survey individuals who have participated in GC program admissions within the past five years to determine the current practices used in evaluating applicants and whether there are any areas that can be modified to make the process more equitable for hURM applicants. This mixed methods study used an online survey instrument that was distributed to four different professional GC organizations. Fifty-eight people who worked in GC admissions participated in our survey. Respondents were asked about the details of their admissions process in detail regarding (1) the initial review of applicants, (2) interviewing applicants, (3) ranking applicants, and (4) if, and how, the process differed with reapplicants. Most respondents (92.3%) considered their program to have a holistic admissions review process. However, 84.6% of respondents who were shown a list of deal-breakers that would prevent further evaluation of an applicant selected at least one option, which directly contradicts the nature of holistic review. Other factors identified in this study that may contribute to the lack of diversity in our profession include the absence of mandatory annual diversity and bias training before participating in admissions and the makeup of admissions committees. Participants were also asked about what their program has done in light of the justice, equity, diversity, and inclusion (JEDI) conversations the GC community has had in the past few years. Most respondents agreed that admissions committees have power in shaping the makeup of the GC profession (90.9%) and are that their program is actively trying to find ways to modify their admissions process to make it more equitable. Reported strategies include offering financial assistance, removing the GRE requirement, and continuing to offer virtual interviews in the future. Our findings demonstrate that while most GC programs have some holistic components built into their admissions process, there are many areas in which it can be improved to develop a truly holistic review. We recommend collaboration between GC programs as they work towards creating a more equitable admissions process so as to create meaningful change in diversifying the field.