Transcript: Episode Seven - World of Genetic Counselling

00:00:00:00 - 00:00:14:11

Speaker 1 - Courtney

Welcome to the Medical Genetics and Genomics podcast from the University of Glasgow.

 

00:00:14:13 - 00:00:34:18

Speaker 1 - Courtney

I'm Courtney. University of Glasgow alumni. I'm delighted to be hosting this podcast today with Dr Leah Marks and David Walker also fellow University of Glasgow alumni. Despite their wide range of knowledge and skills, today we're going to be delving into Leah and David's experiences and roles with genetic counselling, teaching and training.

 

00:00:34:20 - 00:00:36:19

Speaker 1 - Courtney

Hi Leah, welcome back.

 

00:00:36:21 - 00:00:37:16

Speaker 2 - Dr. Leah Marks

 

00:00:37:18 - 00:00:51:16

Speaker 1 – Courtney

Many of you may have met Leah in the previous episode. In addition to her role as a senior lecturer at the University of Glasgow, Leah is also the Deputy Program Director of the Medical Genetics and Genomics MSc program. David, hi. Welcome to the podcast.

 

00:00:51:18 - 00:00:53:02

Speaker 3 - David Walker

Hi. Thanks for having me.

 

00:00:53:04 - 00:01:13:05

Speaker 1 – Courtney

After graduating from the University of Glasgow, David completed the Genomic Counselling Scientist Training Program and works as a Principal Genetic Counsellor. David also now has a role as a training officer for Genomic Counselling Scientist Training Program. Thank you both very much for joining us today. I'm hoping to start by hearing the story of how you got to where you are today in your career.

 

00:01:13:07 - 00:01:15:11

Speaker 1 – Courtney

Can you tell us a wee bit about this?

 

00:01:15:13 - 00:01:37:10

Speaker 3 – David Walker

Yeah. Thank you. So, as you said, I started off studying at University of Glasgow. So, I did my undergraduate in genetics, and then, I also did the master's in Medical Genetics at the time. And I knew by that point that I wanted to be a genetic counsellor. So, it was also studying a part time counselling skills course that was run by the centre for Lifelong Learning at University of Glasgow.

 

00:01:37:14 - 00:01:55:05

Speaker 3 – David Walker

So, they did a counselling skills course, and I was doing that part time in the evenings at the same time as doing the MSc. I was working in pharmacy at the time as well, so I was trying to get some of that, you know, direct experience working with patients in a slightly more medical setting as well. And then after graduating, applied for loads and loads of jobs.

 

00:01:55:05 - 00:02:18:07

Speaker 3 – David Walker

Couldn't get a job anywhere, certainly not in Scotland. And I managed to finally convince someone in Sheffield to let me get a job in the lab. So, I worked as a genetic technologist in the NHS for just under two years, all the while applying to things like the STP and to the Genetic Counselling master’s at the time, and eventually got into genetic counselling through the first year that they did the STP.

 

00:02:18:09 - 00:02:42:10

Speaker 2 - Dr. Leah Marks

My route in is slightly different. I've spoken a wee bit about that in a previous podcast, but just to recap. So, I went to university to study psychology, and I changed to do a medical biochemistry degree because I preferred biological side of things. After that, I went to study for my PhD in developmental medicine, and that was at what was called Yorkhill Children's Hospital in Glasgow at that time.

 

00:02:42:12 - 00:03:07:13

Speaker 2 - Dr. Leah Marks

And in that department was based the Medical Genetics MSc. And I just got involved in teaching by chance. They were looking for somebody to help out with a bit of medical school student teaching, and I did that, and I find that really, really enjoyed it. And that gradually led to me doing more and more teaching. And then eventually I applied for a lecturer position while I was working as a postdoc researcher in the department.

 

00:03:07:15 - 00:03:28:16

Speaker 1 – Courtney

Brilliant. Thank you. That's really interesting to hear how you've become involved in teaching training and genetic counselling. It sounds, though Leah you might be coming from, academia setting and perhaps Davida a more clinical setting. I'm wondering how your teaching and training roles might be similar, and how they might be different due to this.

 

00:03:28:18 - 00:04:02:20

Speaker 3 – David Walker

Yeah. So, when I finally got into the STP and finished my training, I moved to Birmingham and gradually just got more involved in looking after some of the other trainees that are coming through the program. So regularly, having people sitting in in my clinics and asking for a bit of input into any specialties I've been developing. So, I got really interested in helping other trainees come through the program, and eventually started to take on more and more responsibility for that. And in the last sort of 18 months, managed to get a job as a training officer within the department as well.

 

00:04:02:22 - 00:04:14:08

Speaker 3 – David Walker

So, I am officially in charge of training the people who are in post in our department, making sure that they are on track to finish their portfolios and finish their training at the end of the three years of the STP.

 

00:04:14:10 - 00:04:45:19

Speaker 2 - Dr. Leah Marks

I suspect that with my teaching role in comparison to David's, mine is probably almost all associated with university programs. So, MSc’s, BSc’s, Bachelor of Nursing, Dentistry degrees. So, the programs are very set out and very structured and have been running many of these for quite some time. I am involved in teaching with NHS staff, but I think that might be a wee bit different to how David's role, where it's based and how it’s based.

 

00:04:45:21 - 00:04:51:03

Speaker 1 - Courtney

And David is it okay to ask what your role as a training officer involves in a little bit more detail.

 

00:04:51:05 - 00:05:17:16

Speaker 3 – David Walker

Yeah. So, I still have my regular clinical caseload, so I still see patients as normal. But on top of that, I will help trainees plan how they're going to meet all of their competencies, or what they’re now called training activities in the program, to demonstrate their understanding and their learning throughout the three years that they are with us. I will supervise them directly in clinic and help them start to manage their own caseload.

 

00:05:17:18 - 00:05:34:07

Speaker 3 – David Walker

I give them a bit of support when they go off to university and do an academic component as part of the training as well. We help them with their final assessments at the end of the STP as well, and just generally give people day to day support to become good genetic counsellors at the end of it.

 

00:05:34:09 - 00:05:45:07

Speaker 1 – Courtney

Sounds that you're definitely with people every day. That sounds wonderful. And I suppose maybe just from a background of the STP, is it possible to give us a run through of what that involves as well?

 

00:05:45:09 - 00:06:07:15

Speaker 3 – David Walker

Yes. So, you’re probably aware that there's a couple of different routes into genetic counselling. I'll let Leah say a bit more about the traditional MSc routes. The STP for genomic counselling started in 2016, so I was one of the first people to go through the training program. And what the STP does is try to integrate your work-based learning with your academic learning.

 

00:06:07:17 - 00:06:41:23

Speaker 3 – David Walker

So, you are employed full time for three years on a fixed term contract in the NHS. So, when you've gone through the process and you get your offer at the end, you are employed for the full three years that you're there, you're being paid. And if you're aware of NHS pay scales, you're paid at NHS Band 6. So relatively generous for a training scheme. And you're in the department, you're working with genetic counsellors, you're attending meetings, you're attending clinics, you're taking part in clinics and eventually developing your own caseload and contributing to the department by the end of the program.

 

00:06:42:00 - 00:07:02:14

Speaker 3 – David Walker

But at the same time as that, you're also studying part time. So, every so often you go off to the University of Manchester. No matter where you are in the country, that's the university that does the teaching for the STP. And they will support you with the academic component of your learning. So, across your three years, you're also studying part time, an MSc in Clinical Science.

 

00:07:02:16 - 00:07:31:20

Speaker 3 – David Walker

So, at the end of the program, you complete your portfolio that demonstrates you've met all of your competencies or training activities in the training program. You've also got your MSc in Clinical Science. And then once you pass your final assessment, what then happens is the National School of Health Care Science, who runs the program in England, will give you a certificate that allows you to formally register, and you would register with the HCPC, the Health and Care Professions Council, and you register as a clinical scientist.

 

00:07:31:22 - 00:07:43:12

Speaker 1 – Courtney

And Leah, you mentioned about being involved in the structured courses through the different university degrees. How does that tie in with the training through the scientist training program, do you think?

 

00:07:43:14 - 00:08:08:00

Speaker 2 - Dr. Leah Marks

I think that the main aspects have involved in training genetic counselors is through the MSc program in Genetics and Genomics counselling that's been running at Glasgow for several years, and for students who undertake that program, they go through a slightly different route to the STP. So, they undertake a two-year program, first year of which is mostly taught, and then finishing their first year.

 

00:08:08:00 - 00:08:36:04

Speaker 2 - Dr. Leah Marks

They complete some community placements in schools and working with charities or with care homes. And then they go on in their second year to spend basically the whole of their second academic year working in genetic counselling departments in hospitals. And then that gets them to the stage where they are eligible to apply for training posts in the NHS that they can then hopefully after, another two or more years, complete their registration.

 

00:08:36:06 - 00:08:58:18

Speaker 1 – Courtney

As you both said, there's a few different routes into genetic counselling as a career available across the UK. And it's great to hear the similarities between the training programs and the end goal of them both being the same and how they may differ in their structure. What is your personal experience been like with the MSc programs and the STP program so far?

 

00:08:58:20 - 00:09:19:06

Speaker 2 - Dr. Leah Marks

I think for myself, the MSc in Genetic Counselling program is quite different from any other program I've taught on. Most of the programs that I've taught on at the university have been really big. The medical program, for example, has over 300 students, the Genetics and Genomics masters, the other one I teach on tends to have around 40 students a year.

 

00:09:19:06 - 00:09:53:24

Speaker 2 - Dr. Leah Marks

So, the genetic counselling one is a much smaller program, tended to have about 8 students per year. And the other difference in it is that we work much more closely with NHS colleagues for this program, and perhaps on a day-to-day basis in some of the other programs would be the case. The NHS staff are integral in developing and in delivering the MSc program, but I think having a small number of students like this means that you get to really follow their progress quite closely over the 2 years, and you come very invested in their progress and how they're getting on.

 

00:09:54:00 - 00:10:12:24

Speaker 2 - Dr. Leah Marks

And I think the collaboration with the NHS, for me anyway made it a really interesting - a particularly interesting program. As I said, the first program I've worked on that has been so closely involved in the clinical side of things, which to me, coming as a pure biologist, I found fascinating, and I've really enjoyed.

 

00:10:13:01 - 00:10:39:07

Speaker 3 – David Walker

I suppose I've potentially got a long answer here, because I've really had two roles involved in the STP. One as a trainee and one as a training officer. So, forgive me if this waffles on a little bit. But I suppose as a trainee it was really interesting because we were the first group to go through the STP in Genomic Counselling at the time, and there'd been routes to training, to genetic counselling through the masters courses in Manchester and Cardiff beforehand at the time.

 

00:10:39:09 - 00:10:55:00

Speaker 3 – David Walker

But this was the first time we'd had a blended program like we did with the STP. And there was a bit of scepticism around it, around whether it was the right way to be doing it, whether it was a long enough program and whether the MSc was giving us the same level of background knowledge that we should have coming into it.

 

00:10:55:00 - 00:11:09:06

Speaker 3 – David Walker

So, there was a bit of scepticism and a bit of finding our way through the dark, really, because we didn't have anyone in the years above to ask, the people running the program hadn't run the STP in this way before. So, it was quite an interesting experience to go through that as one of the first people to do it.

 

00:11:09:06 - 00:11:41:18

Speaker 3 – David Walker

But I think that it's pretty well established and we're all pretty used to doing this. And we know where the difficult areas are, and where the less challenging parts are and how to share some of our successes as well. And then I suppose that then takes me on to being a training officer now, where actually I feel like I'm able to bring something quite interesting and unique to that role because I did the training program, so I can see all of the times when trainees might be struggling and be able to draw on what happened in my program to help them through those sorts of things and sort of relate to what's going on a bit more.

 

00:11:41:20 - 00:11:54:21

Speaker 3 - David Walker

And bring that to how we're running the program in our department as well. So, for me, I think having almost two hats on when I'm thinking about the STP has been pretty helpful to hopefully make things a little bit better for our trainees.

 

00:11:54:23 - 00:12:20:20

Speaker 1 – Courtney

That's really interesting to hear from both of you there on the different perspectives. And Leah, as you say, that's really interesting to think of the unique differences that you've experienced in comparison to the other programs that you've been involved with. And similarly, David hearing your “both hats” as you put it with being on the training program, and having been involved in delivering the training program. As you say, I'm sure that brings many benefits to your trainees, but also for yourself developing the program.

 

00:12:20:20 - 00:12:37:12

Speaker 1 - Courtney

Thinking about all of the components of programs, have either of you ever been involved in either establishing a training program or developing these? And if so, are you able to tell us a bit more about this?

 

00:12:37:14 - 00:13:02:01

Speaker 2 - Dr. Leah Marks

I have been involved in developing the MSc Genetics and Genomic Counselling in Glasgow. Several years ago, now, I came into it partway through the development stage. Some other people had already had the idea and sort of begun the spadework, if you like, for it. It's a long process. We had to work and collaborate, principally myself and a colleague, Maria Jackson, from the Genetics department.

 

00:13:02:01 - 00:13:21:02

Speaker 2 - Dr. Leah Marks

We had to collaborate, first of all, with the university itself. There's a lot of things you need to do when you're establishing a new program, a lot of paperwork. And because it was such a sort of joined up program with different departments, we worked quite closely with colleagues from the Psychology department at the university as well, who were going to deliver some of the teaching course.

 

00:13:21:02 - 00:13:51:11

Speaker 2 - Dr. Leah Marks

There was the NHS component and NHS staff who were really important in the design and the delivery in particular of the placement side of things within the program. And yeah, it took a while, took a long while to get all of the paperwork in place and submitted and approved both by the university, but also, crucially, by the GCRB, so that the genetic counselling program was actually accredited by the body that governs genetic counselling in the UK.

 

00:13:51:11 - 00:14:02:11

Speaker 2 - Dr. Leah Marks

And otherwise, there would be no point in setting one up because people who did the program couldn't have practiced as genetic counsellors. So that was a key thing and a key partner that we worked with as well.

 

00:14:02:13 - 00:14:23:05

Speaker 1 – Courtney

It sounds like a lot work, as you say, on developing and building the foundations for any educational program and a lot of hard work, dedication and effort’s been put in on the sides of both the university and the NHS to bring it all together. It's often the background work that we don't always know the extent of when we see the finished product.

 

00:14:23:06 - 00:14:26:09

Speaker 1 - Courtney

What about yourself, David?

 

00:14:26:11 - 00:14:51:02

Speaker 3 – David Walker

So, I can't take any credit for starting the STP in genomic counselling. That was well beyond my wheelhouse at the time. But since finishing the STP, I have been involved with reviewing the curriculum and refining things a bit more. So, the STP is run by the National School of Healthcare Science, which is now merged with Health Education England, and that's the body that essentially is responsible for delivering all of the STPs.

 

00:14:51:07 - 00:15:14:12

Speaker 3 – David Walker

So, you're probably aware that there's other specialties other than Genomic Counselling, including things like Genomics, but ranging up to things like Respiratory Science, Cardiac Science, Sleep Science I think as well. So, there's lots of different specialties that they manage and so there are people that they have involved in making sure that the course is being developed and is still meeting the requirements of the profession.

 

00:15:14:14 - 00:15:35:12

Speaker 3 – David Walker

So, I did manage to get involved at a really early stage just after finishing, actually, because they were reviewing the curriculum. So, they were reviewing all of the competencies and things that we’re meant to do as part of the training program to demonstrate our learning. And so, I was able to get into that through my boss, who was part of that committee and asked for some representation for recent trainees.

 

00:15:35:14 - 00:15:55:14

Speaker 3 – David Walker

So, I was involved in that and then have subsequently been involved in reviewing that on an ongoing basis. And now in my training officer role as well, the National School are regularly asking for feedback and having regular meetings with every specialty, not just Genomic Counselling. And we recently went through a phase where we reviewed how we conducted all of our assessments.

 

00:15:55:16 - 00:16:19:15

Speaker 3 – David Walker

So, within the program, you have to do certain assessments as part of your portfolio. And I was able to contribute to how we've written up a new set of standards for how those assessments should be conducted. And that's for all specialties, not just Genomic Counselling as well. And I've also been involved in things like the interview processes and the shortlisting processes and designing the questions and final assessment questions and things like that, as well.

 

00:16:19:17 - 00:16:24:23

Speaker 3 - David Walker

So there's plenty of places to get involved if you are interested in doing that for the STP.

 

00:16:25:00 - 00:16:45:10

Speaker 1 – Courtney

Brilliant. Thank you for telling us all about that. And even the most well-planned journeys rarely go smoothly. So often these are experiences that we can learn a lot from. Is there anything that comes to mind when you're thinking about the highs and challenges of your journeys to where you are at the moment?

 

00:16:45:12 - 00:17:03:08

Speaker 3 – David Walker

Shall I start this one? I think I've got a few experiences, but probably the common thread for it is, if I'm giving advice to anyone listening to this, is just keep at it. So, it sounded like a smooth journey, I think, when I presented this earlier on, but actually I had a lot of rejections before I got to where I was first.

 

00:17:03:12 - 00:17:19:13

Speaker 3 – David Walker

So, I did the MSc in Glasgow because I didn't get into the University of Manchester that year when they were taking on trainees. So, I thought, right, I'll do a master's, and I'll get some more experience behind me. And I'm really glad I did because I got an awful lot from the MSc that Leah and the team ran at the time.

 

00:17:19:15 - 00:17:41:13

Speaker 3 – David Walker

And then that year I was in the master’s, I also applied to University of Cardiff and Manchester again. And I managed to get an interview for Cardiff, but I didn't get in. I didn't have enough experience, but they thought that I would get there eventually. And then the same thing happened the following year. All the while I was also applying for the STP in Genomics at the time because there wasn't an STP in Genomic Counselling.

 

00:17:41:15 - 00:17:58:11

Speaker 3 – David Walker

So, I thought, you know, I'll do something in genomics. I don't care if I'm in the lab doing various tests and analysis or if I'm in front of patients. I just want to do something in genetics. And so, I think it was the third or fourth round of applications, you know, third or fourth year in a row where I’d actually applied to things that I finally got into the STP.

 

00:17:58:13 - 00:18:27:15

Speaker 3 – David Walker

And so, you know, I always tell people that just dust yourself off and try again, really, you might be the best person on paper, but just for whatever reason, that hasn't come through in your application or hasn't been picked up in the people that have been interviewing you. It doesn't necessarily reflect anything back on you. It just means that it's a really competitive profession and set of training programs to try and get into, and there are some people that just managed to do slightly better on the day, even if they're not any more qualified than you, necessarily.

 

00:18:27:17 - 00:18:49:19

Speaker 3 – David Walker

So that's probably my biggest takeaway from all of this. And I still see that every year, because in this new role that I'm in now, I'm having lots of people then who try and get into the program and are emailing me or phoning and asking me: “What more can I do”? You can always try and get a bit more experience, but it is just a really competitive space and so keep trying because if it's meant for you, you'll get there eventually.

 

00:18:49:21 - 00:19:18:24

Speaker 2 - Dr. Leah Marks

I think looking at challenges and sort of highs and lows of the jobs I've had, I've obviously been in the one organization for a long time. But I think the challenge of that is possibly that you can become very settled and not take on challenges and new projects, and I think that has been something for me, that has been important is to continually look to develop the role I’m in and to take on new opportunities.

 

00:19:18:24 - 00:19:48:01

Speaker 2 - Dr. Leah Marks

I think I spoke about that previous podcast about the MOOCs. You know, to jump at opportunities that are presented to you, and it's the same with the Genetic Counselling program that we developed, we could have sat back and not developed that because we already had a very successful program in Genetics and Genomics. So, I think for me, my job role so far has been really enhanced by taking on, taking chances really on new projects and new ideas.

 

00:19:48:01 - 00:20:10:03

Speaker 2 - Dr. Leah Marks

And if, similar to David says, you to fail if you don't succeed at them first time, that's not necessarily a bad thing. It means that you might need to go back and rethink things, redevelop things, or go down a different pathway but taking these opportunities when they present themselves is what stops a job becoming very samey and a bit routine and a bit mundane and a bit dull.

 

00:20:10:03 - 00:20:11:11

Speaker 2 - Dr. Leah Marks

I think that's really important I think that's really important in a career

 

00:20:11:11 - 00:20:21:12

Speaker 1 – Courtney

Sounds like that’s something that really motivates you Leah as well and gives you a lot of satisfaction to really take things forward and grab opportunities with both hands.

 

00:20:21:14 - 00:20:23:03

Speaker 2 - Dr. Leah Marks

Yeah, definitely.

 

00:20:23:05 - 00:20:33:24

Speaker 1 - Courtney

So, thinking about your full experiences and your careers to date, are there any tips that you would give to others considering starting out in a career in genetic counselling?

 

00:20:34:01 - 00:20:37:17

Speaker 2 - Dr. Leah Marks

I think Dave, this is one for you, first of all.

 

00:20:37:19 - 00:21:10:04

Speaker 3 – David Walker

Ok, I’ll go ahead then. It's probably all the stuff that you would already know already, but the key thing that sets you apart when trying to apply to either the STP or the MSc’s around the country now as well, is making sure that you've got good evidence of care experience and different programs have different quantification of that, but some kind of evidence that you have worked in some kind of caring role. And that doesn't mean you have to have worked in a care home full time for a couple of years to do that, you can demonstrate caring experience in other roles.

 

00:21:10:04 - 00:21:35:09

Speaker 3 – David Walker

So, for example, when I did my pharmacy work, I really leaned in to helping patients sort of understand the differences in medicines that were available to them and how to manage their prescriptions a bit better, and generally how to make their lives a bit better. And I really leaned into sort of the consultations that I was doing at the time of helping people to stop smoking and weight loss and things and trying to demonstrate my listening and empathy skills there, really.

 

00:21:35:11 - 00:21:52:15

Speaker 3 – David Walker

And you can do that in lots of different roles the more directly relevant the better. But it doesn't mean that you have to have been at a bed side in the hospital to demonstrate that you can do that in lots of other roles. You can do that in your volunteering on the Samaritans phone line, or any sort of charity work that you do as well.

 

00:21:52:17 - 00:22:15:10

Speaker 3 – David Walker

You can even draw on personal experience. And it probably doesn't make a huge amount of difference to go off and do lots and lots of extra study just to get ahead in application. If you're getting rejections and struggling to get into genetic counselling, the thing that's going to set you apart is getting the experience of doing something to help other people and managing to bring that into your applications.

 

00:22:15:12 - 00:22:34:03

Speaker 3 – David Walker

So, I think that's probably the biggest thing from an application point of view, it's probably quite difficult for most people to get any opportunities to shadow genetic counsellors. And the reason for that is that most of us work in the NHS. And in order to shadow anyone in the NHS, you need to have an honorary contract with that hospital or that trust.

 

00:22:34:05 - 00:22:54:13

Speaker 3 – David Walker

There are other roles now that are starting to pop up across the country, which aren't quite officially stepping stones, but a lot of people are able to use them as a stepping stone role. So, you might have heard of Genomic Associates or Genomic Practitioners in the country now. And these are more junior roles at NHS band four or band five usually.

 

00:22:54:15 - 00:23:16:23

Speaker 3 – David Walker

And they sort of have an assistant role really. So, we are using them in Birmingham, for example, to help us perhaps gather some family or medical histories ahead of appointments where that previously would have been a full genetic counsellor appointment, so that we could then go on and see one of the consultants. Or now, maybe giving some of that work to our genomic associate colleagues, consenting for whole genome sequencing.

 

00:23:17:00 - 00:23:47:11

Speaker 3 – David Walker

It's the same conversations you have each time. So, actually, a lot of our Genomic Practitioners now will obtain consent to do whole genome sequencing for our patients. And actually, they don't see a Genetic Counsellor ahead of that time. And so those are really good roles. If you see them to apply for and get some real understanding of what actually goes on in genetics departments and getting some direct patient contact as well. In order to stand out in those roles, you probably still want to have a lot of good people skills and good caring skills so that we pick you from the crowd.

 

00:23:47:13 - 00:24:08:03

Speaker 3 – David Walker

So, you still need to stand out in those roles and get all that experience. But that might be the sort of job that you could look for to try and get your foot in the door. And they've only been popping up in the last year, 18 months or so. So, you might not have heard of those before. So, between those roles trying to get the care experience and what I said before about dusting yourself off if you're not successful, I think that's the main advice I'd give really.

 

00:24:08:03 - 00:24:44:05

Speaker 2 - Dr. Leah Marks

I think that some advice I would also give for interviews is to be able to demonstrate the ability to reflect on what you've done. Sometimes you can see somebody who has a lot of experience and maybe more than someone else, but doesn't really seem to be able to pick out from that experience how they developed as a person, and to look back on the experience and to think about what they did, how it affected them, how their previous life experience maybe affected how they acted in the situation, and, crucially, what they can learn from those experiences and how they can take that forward.

 

00:24:44:05 - 00:25:07:23

Speaker 2 - Dr. Leah Marks

And how do we take the learning from that and implement it in a different situation the next time something happens. So, I think being able to show that, and it's useful to have a look at models of reflection, just to give yourself a little sort of prompt and a way into thinking in that kind of way. It's quite different, especially if you're coming from a very sciency background, haven't really been great at encouraging a lot of reflection in science often.

 

00:25:07:23 - 00:25:23:09

Speaker 2 - Dr. Leah Marks

And then you're trying to move maybe into a genetic counselling type role, type of career, reflection suddenly becomes very important. And you need to be able not just to look at something you've done and say, yeah, I did that well, you need to really be able to look and see what you can learn from an experience.

 

00:25:23:11 - 00:25:51:06

Speaker 3 – David Walker

I would echo that actually for the STP side as well. And one of the big reasons that people tend to fall down in their applications or not be shortlisted or invited to interview is they might have all the experience under the sun, but they just haven't communicated that well according to the application and the person spec. When you look at those on paper, you might expect that the person with all the experience gets it, but actually it's the person who manages to reflect on those experiences and convince me that they've got the right skills.

 

00:25:51:08 - 00:25:56:11

Speaker 3 - David Walker

Those are the people, then, that do better at interview and get further on in the process as well.

 

00:25:56:13 - 00:26:10:22

Speaker 1 – Courtney

That I'm sure will be really helpful to many people. And thinking about those who are already in the genetic counselling field and are perhaps interested in taking on some of the teaching training roles that you're both involved with. Do you have any advice for them?

 

00:26:10:24 - 00:26:40:05

Speaker 2 - Dr. Leah Marks

I think that you should jump at opportunities. I know I've said this before, but you might not see something as a big teaching role or a big training role, if it's just maybe mentoring one person or taking on a small amount of face-to-face teaching or online teaching or something like that. But I think often, as was my experience, that the way into these things is just by offering to help out, if you like, and whether or not it even is an official part of your role in your job.

 

00:26:40:09 - 00:27:02:21

Speaker 2 - Dr. Leah Marks

If you just take on these opportunities, you'll soon find out if a) you enjoy it and b) you're good at it. And once you have established that, I think if it's something that is an area of strength for yourself, I think opportunities do present themselves to you. And I think you, often, you can fall into these types of roles because they're not something that everybody wants to do.

 

00:27:02:21 - 00:27:25:17

Speaker 2 - Dr. Leah Marks

And if you have an actual genuine interest in them, then you have skills in that area, then I think often the opportunities are open up for you if you just take the chances that are there. I think that's important to do. Don't wait for a full-time teaching position to come up and apply for it, because they'll not come up often. And you'll be competing with many others, but just take the little opportunities that present themselves along the way.

 

00:27:25:17 - 00:27:33:04

Speaker 2 - Dr. Leah Marks

And hopefully from there you can kind of then develop a portfolio of teaching that you will have when the bigger opportunities do come up.

 

00:27:33:06 - 00:27:57:19

Speaker 3 – David Walker

Similar sort of idea for Genetic Counsellors that are in post. Most of us will have some sort of teaching in education as part of your job plan anyway. So most genetic counselling departments will usually be attached or be involved with some sort of teaching at one of the universities. So, most of the genetic counselling units are in the big cities, where most of the big courses will do medical training or something else.

 

00:27:57:19 - 00:28:15:16

Speaker 3 – David Walker

And there's lots of MSc’s in genomic medicine and various titles popping up around the country. So, most people in post will have some sort of official opportunities to get involved in. Whether it's just delivering a lecture or the odd class tutor or something that will definitely be there, and there's almost an expectation that you do some of that anyway.

 

00:28:15:18 - 00:28:34:23

Speaker 3 - David Walker

And then for the growing number of trainees that we all have in our departments, there's always opportunities to get involved with them, whether it's just having trainees sitting in your clinics and you're taking on a little bit of responsibility for them at that one moment in time. As Leah says, if you find that, you enjoy that and are good at that sort of thing and that enriches you, then do that a bit more often.

 

00:28:34:23 - 00:28:51:15

Speaker 3 – David Walker

Maybe seek out the trainees coming into your clinics a bit more often. It does delay things a little bit. It does add a little bit of time onto all of your clinics, but if you've got an interest in training and supporting people, then inviting those people into your clinics and creating that space for them is only going to do will, do wonders for both of you, really.

 

00:28:51:18 - 00:29:09:22

Speaker 3 – David Walker

And also, as Leah says, just look for any opportunities at all in the department. Most official training officer roles tend to be at more senior bands then. So, you're looking at potentially becoming a Principal Genetic Counsellor. And depending on where you are in the country, there aren't that many roles. We're quite ethnic specialty as is, so there's not hundreds of those posts popping up anywhere.

 

00:29:09:24 - 00:29:24:14

Speaker 3 – David Walker

And similarly to what you said, I wouldn't just wait for one of those roles to pop up to decide to get involved in training. You probably want to be doing lots of bits to demonstrate that that's something you've been interested in and are good at before you apply for those jobs, because there won't be hundreds sitting around the corner really.

 

00:29:24:14 - 00:29:30:21

Speaker 3 – David Walker

Yes. Just keep doing stuff. Just keep getting involved. It the opportunities are there. Just make sure you're grabbing them.

 

00:29:30:23 - 00:29:53:17

Speaker 1 – Courtney

That appears to be a common theme, that there's plenty of opportunities out there and if that's something that people are keen on and interested in, then to really just go for it and get everything they can from it. Thinking on the next thing that we spoke about earlier, about establishing and developing training programs or educational programs, is there anything that you would say to people interested in this?

 

00:29:53:17 - 00:29:56:12

Speaker 1 - Courtney

Any guidance for that side of things?

 

00:29:56:14 - 00:30:29:06

Speaker 2 - Dr. Leah Marks

I think I would say start early. These things always take longer than expected to get going. So don't think now at that this time in the year, January, I think I'll start a training program in a master's program in September. It's going to take another year above that. There's so much regulatory stuff that you need to go through, and it's very important because if you don’t go through the regulatory side of things with the appropriate bodies or universities or training departments, whoever it is, your training won't be of as high quality. But it also, won't be accredited by the appropriate people.

 

00:30:29:06 - 00:30:47:19

Speaker 2 - Dr. Leah Marks

So I think that's really important. And have a think about the type of student or trainee you want on your program and what you're learning objectives and outcomes are. Start with what it is you want the  person coming to end up as after your program and work from there. But I think my main thing would be the time factor.

 

00:30:47:19 - 00:31:05:03

Speaker 2 - Dr. Leah Marks

Just realize that these things, and don't be discouraged when they take longer than you think they were going to initially. Everything that's worth doing does take a while and it’s just part of the process you have to go through and reflect and look back and amend things and modify things, and you'll end up with a better training program at the end of it.

 

00:31:05:03 - 00:31:07:11

Speaker 2 - Dr. Leah Marks

If you go through that process.

 

00:31:07:13 - 00:31:13:23

Speaker 1 - Courtney

And in general, is there anything else that you would like to share with our listeners?

 

00:31:14:00 - 00:31:36:05

Speaker 3 – David Walker

I suppose just around the STP, I could talk to you for hours about the ins and outs of the STP really, a couple of big things just to be aware of. If that's something you are applying to or you're not quite sure if it's something you want to think about yet, is that it is a great program in the sense that it's a three-year program where you'll get registration probably a bit quicker than if you went to the MSc route.

 

00:31:36:07 - 00:31:54:24

Speaker 3 – David Walker

But it is really hard, very hard to get into. You can't always guarantee where you're going to end up either. That's going to be true for any jobs you apply for at the end. But for the STP, the way that you get in is you rank the preference of where you want to go in the country and the people who score the best at interview get their top choices.

 

00:31:54:24 - 00:32:10:14

Speaker 3 – David Walker

And so, you might well get into the STP, but you may end up in a part of the country that wasn't necessarily top of your list. And all departments are accredited to deliver the training. And I'm sure you'll still have a great training experience. But one of the drawbacks of the STP is that you can't really plan for where you might end up.

 

00:32:10:14 - 00:32:31:15

Speaker 3 - David Walker

And so, if you've got roots somewhere in a particular part of the country, other commitments that mean you can't move very much, then actually you somewhat limit your chances of being successful then if you can only go to one place. If you live in Newcastle and you can only stay in Newcastle, then you're relying on being the person that's put Newcastle at the top of their priority list and also being the best person at interview then.

 

00:32:31:17 - 00:32:56:21

Speaker 3 – David Walker

So, it can be quite difficult to be where you want to be and it is a really intense training program. The first year you're barely in the department actually, because you're rotating in and out to other departments as part of your training. So, you'll rotate into the labs to learn how the scientists do things and how the bioinformatics team do things and will get you about into lots of other specialties, like the breast screening units and bowel units and things to just understand how it all clicks together really.

 

00:32:56:21 - 00:33:19:19

Speaker 3 – David Walker

All the while you're doing all of your clinics, you're doing your academic work, there's a research project that takes up the majority of your third year, if not some of your second year as well. There's a final assessment to prepare for, and towards the end of your training, you'll be taking on a bit more of an independent caseload where as well as still observing other people, you're starting to do things on your own without anyone necessarily holding your hand in that clinic.

 

00:33:19:21 - 00:33:42:07

Speaker 3 – David Walker

And so, it can be a really, really intense three years. So, it is funded, it is a bit quicker, but it is really, really tough. And just to be aware of that and mindful of that coming in and using that actually in your applications and recognizing how difficult it is, but also then demonstrating the softer skills that you have that will make you more resilient and make you more suitable to bind to the program.

 

00:33:42:09 - 00:33:45:01

Speaker 3 - David Walker

I think that will set you up in good stead for it.

 

00:33:45:03 - 00:34:05:16

Speaker 2 - Dr. Leah Marks

I think the only thing I would add to that is if you are, as I see, many students who are really, really set on working with patients in a genetics context. And if you're somebody who just does not get into the Genetic Counselling program, as David said, in some ways is a numbers game. There just so many highly qualified and suitable applicants.

 

00:34:05:16 - 00:34:30:06

Speaker 2 - Dr. Leah Marks

You might happen to just be one of the people who doesn't manage to get in. I think, to look around and consider other careers - David's mentioned the Genomics Associate, which is a great opportunity, but there are a lot of other areas that you can use your science training, your science degree and work with people. So, I think that's one of the big attractions of a genetic counselling career, is the fact that you're working with people, you're helping people.

 

00:34:30:10 - 00:34:54:05

Speaker 2 - Dr. Leah Marks

And I think many science graduates can see that as almost that's the only job I could have where I could work and help people. But even looking to other jobs at the NHS, look to jobs within charities, third sector, look to education jobs, a lot of education jobs. You might not be working with people's medical, health and medical conditions, but you are working with people in very similar ways.

 

00:34:54:07 - 00:35:15:22

Speaker 2 - Dr. Leah Marks

My job doesn't involve working ever with patients, but I spend my entire day working with people and all of their problems and their issues and the highs and the lows. So, I think seeing one career as being the only way to help people with a science degree, sometimes, I really have seen people who have got very blinkered as if don’t get into this career It's the end of the world.

 

00:35:15:22 - 00:35:36:02

Speaker 2 - Dr. Leah Marks

So, I think just look around and perhaps see that there are a whole breadth of opportunities that you can look into, and then the end perhaps would be useful in a genetic counselling career at a later point in life. But it's certainly not the only pathway there is. And to be open to other opportunities and other things can only be a useful thing.

 

 

 

00:35:36:04 - 00:35:51:15

Speaker 3 – David Walker

I'd add to that as well actually, when I was in the lab before I managed to get into the STP in the first place, I had my sights set on getting into the STP to be a clinical scientist in genomics. And I was also applying for the STP in genetic counselling, and at one point I was just ready to pack it all in.

 

00:35:51:15 - 00:36:08:14

Speaker 3 – David Walker

And say, well, if I'm not getting in this year, I'll give up. What will I do then? And actually, you know, in the labs as well, then you've got your genetic technologist posts and they can go relatively senior as well depending on the size of your lab, you might have quite a few people in relatively senior posts that would roughly be paid at the same as genetic counsellors as well.

 

00:36:08:16 - 00:36:31:23

Speaker 3 – David Walker

So, if you're looking to progress a career and still be involved in genetics in the NHS, then there's the technical route where you don't actually go through the STP. You just apply for those posts and become really good at them, and you can register by working through them. So, there's still a technical there are the genomic associates and practitioners post that we're looking at may not be so relevant for people who've already got degrees, but there is an apprenticeship route in development as well.

 

00:36:32:00 - 00:36:52:11

Speaker 3 – David Walker

Certainly, for England at least, I do not quite know what that's going to look like yet, but that's potentially another route to build up your skills from the bottom, really. So, look out for those in the next couple of years, I think. And just always stay interested in things. There's always courses, there's always MOOCs online there's always things you can attend that demonstrate that you're still interested in genetics.

 

00:36:52:16 - 00:37:09:23

Speaker 3 – David Walker

And it may be that actually, yeah, you take a sideways step and do some other things and come back with a bit more life experience. When I was applying to the STP in the beginning, I thought, why am I not getting in, I'm the bee's knees, this makes no sense? and then I looked back on my applications and the sorts of things that I was drawing on at the time and going actually, I was just out of university.

 

00:37:09:23 - 00:37:26:00

Speaker 3 – David Walker

I didn't know anything about the world. And it was after working in the NHS for a good few years, then I got a better understanding of what was going on and got out of just being at university and recognized that applying for jobs and things, you need to demonstrate your professional and people skills just as much as your academic achievements.

 

00:37:26:02 - 00:37:39:14

Speaker 1 - Courtney

Many valuable insights there. Thank you very much for sharing all of those. Lastly, just to end on a fun note, are there any fun facts or interesting facts about yourself that you'd like to share with everyone?

 

00:37:39:16 - 00:37:58:13

Speaker 2 - Dr. Leah Marks

Well, with that question my mind always goes blank, and I can never think of anything interesting. I think the most random thing about me probably, is that I was in Taggart, the murder mystery program from Scottish TV when I was in school. I was picked to be on an episode of Taggart, where I was part of a group of school pupils going round.

 

00:37:58:13 - 00:38:20:05

Speaker 2 - Dr. Leah Marks

Actually, with the murderer, “A Nest of vipers” it was called, and the murderer was a guy who was demonstrating the snakes to the school children at the zoo. And then he was taking the vipers out and putting them in people's beds to kill them, basically. So that's probably about the most random thing I've ever done. And at 12 years old, I think my career in acting stopped there and I became a scientist instead.

 

00:38:20:07 - 00:38:49:23

Speaker 3 – David Walker

I can't match Taggart, but that did lead me on a thread there actually. So, because I live in Birmingham and it was local at the time, I did apply to be part of the Commonwealth Games. I was going to say last year it was 2022, wasn't it? And so was in the opening ceremony, if you ever watched that. There's a big section where there's lots of people that tie dye robes and were carrying and flapping around some books and were meant to represent the rich history of writing in Birmingham, and the fact that Birmingham has public ownership of lots of the works that are in the library and so on.

 

00:38:49:23 - 00:38:56:17

Speaker 3 – David Walker

So, if you look very, very closely and squint from afar, you can kind of see me flapping around a giant, giant book above my head.

 

00:38:56:19 - 00:38:57:19

Speaker 2 - Dr. Leah Marks

Very cool.

 

00:38:57:21 - 00:39:25:03

Speaker 1 – Courtney

In the midst of celebrities. So, as we bring this podcast episode to close, I'd like to give a big thank you to Leah and David for sharing in their wealth of knowledge, experience, and expertise with us today. I've certainly thoroughly enjoyed learning from you both, and I hope our listeners have as well. You've both been wonderful guests, and it's been my pleasure to host you both on the Medical Genetics and Genomics podcast from the University of Glasgow.

 

00:39:25:05 - 00:39:26:04

Speaker 3 - David Walker

Thanks for having us.

 

00:39:26:08 - 00:39:44:16

Speaker 2 - Dr. Leah Marks

Thank you very much.