Wednesday, October 31, 2012

Yay! Bucket list - CHECK!


Hi, this excerpt is published in the Perspectives in Genetic Counseling column featuring Global Genetics.  Since not everyone have access to this publication, I thought I'd share what I wrote.  

As a reference, here's the website where you can get the published copy:
http://bulletin.arcadia.edu/wp-content/uploads/2012/04/Spring2012Perspectives.pdf


Global Genetics

A Dream Fulfilled: The Philippines’ Master of Science in Genetic Counseling Program

By Mercy Laurino, MS, CGC, LGC 


I vividly remember when Dr. Carmencita Padilla, a medical geneticist from the Philippines, asked me to collaborate with her in creating the first Master of Science in Genetic Counseling training program in the country. We initially met in San Diego at the American Society of Human Genetics meeting in 2007. Over a cup of coffee, Dr. Padilla told me that the Philippines urgently needed a training program in genetic counseling, given the increasing application of genetic and genomic technologies. She told me about the expansion of the country’s National Newborn Screening Program, the Philippines Birth Defects Study Surveillance Study Group, and the proposed implementation of the Telegenetics Program.

Honestly, I was initially apprehensive to accept the offer, because I couldn’t foresee being able to take on such great responsibility so early in my career. In 2007, I had only been a genetic counselor for about four years, and I did not have any experience implementing training programs. However, just as W.H. Murray’s passage in The Scottish Himalayan Expedition says

   Until one is committed
    there is hesitancy, the chance to draw back,
    always ineffectiveness.
    Concerning all acts of initiative(and creation),
    there is one elementary truth,
    the ignorance of which kills countless ideas
    and splendid plans:
    that the moment one definitely commits oneself, 

    then Providence moves too.

As a Filipino immigrant, I feel I was offered the chance to make a remarkable contribution to my home country. I was invited to collaborate with the Philippines’ highly motivated medical genetics team to promote health in the Filipino population. The care of the Philippines’ 92 million people, in terms of clinical and research genetics, was in the hands of only seven medical geneticists. It was evident that more support from health care providers with specialized training in genetics and genetic counseling was needed. I realized that I could really make an extraordinary difference – I didn’t have to wait.


Then the moment came when I fully committed myself – the time I did say “yes.” I shifted my conversation with supporters from “I don’t know if I can do this,” to “how I am going to make this happen?” I gave my word to Dr. Padilla in 2008 that I would take part in this partnership, and I gave myself one year to prepare. I ended my work at the University of Washington’s Genetic Medicine Clinic in May 2009, and went to the Philippines to start curriculum development in a formal way.


Given the current needs of the country, we committed to developing a curriculum not only to train Filipino students in didactics pertinent to genetic counseling, but also to train them how to best integrate this field into the existing public health care infrastructure. My work began by reviewing several existing genetic counseling curricula from various programs around the world.


Early on, we realized that one of our challenges was finding faculty members who had the expertise to teach specific courses. We ultimately ended up requesting a U.S.-based expert in genetic epidemiology to teach some of our modules via web-based communication. In the end, the curriculum became a compilation of both genetic counseling and public health didactic courses, as well as clinical training rotations.


In January 2011, the Board of Regents at the University of the Philippines (UP), Manila formally approved the curriculum of the M.S. in Genetic Counseling Program. It was certainly a historic moment to welcome and teach the Philippines’ first cohort of genetic counseling students six months later. The students came from diverse backgrounds: nursing, cell and molecular biology, medical technology, social science, and medicine. Some of the students had previously worked at the country’s Institute of Human Genetics Department as newborn screening program managers and nurse coordinators. As part of their training, the medical fellows are also now required to obtain their genetic counseling degrees a major accomplishment.

I am proud to share that one of these pioneering students, Mr. Peter James Abad, has an accepted publication in the Journal of Genetic Counseling to reflect how the issue of cultural awareness in genetic counseling impacted him. He states, “In the Philippines, culture plays a powerful role in shaping the people’s understanding of what is normal and deviations from normal, the latter often attributed to supernatural and mystical retributions. Acknowledging the already existing folk understanding and perceptions about the cause of their illness is important prior to explaining its probable genetic etiology.”1


Furthermore, the UP Manila and Stanford University’s M.S. in Human Genetics and Genetic Counseling departments have established a “sister program” partnership. The intention is to promote cross-cultural awareness and clinical exchange through bi- monthly video-conferencing. We had our first collaboration in November 2011, which proved successful. Stanford made the connection to UP Manila’s secure network, while I was on Skype, since I had been back in Seattle since September. I crossed my fingers the whole time for technology to cooperate, and thank goodness it did! The UP Manila and Stanford genetic counseling students met virtually, and a second-year-student from Stanford presented the first patient case for international discussion.


If left to my own timeline, the fulfillment of this dream would have not happened until 35 years from now as my retirement work. Indeed, it was the ongoing gracious support and valuable guidance from my family, friends, and esteemed medical genetics and genetic counseling colleagues that fueled my commitment and determination. I am especially grateful to receive insightful words of wisdom from my own program director, Carol Walton, MS, CGC, in the midst of this work.


And no matter how much I pinched myself (and had teary eyes) during my recent flight back to Seattle from Manila, this dream not just a dream anymore had manifested into reality.


Reference

1. Abad PJ. Explanatory models of illness may facilitate cultural competence in genetic counseling. J Genet Couns. 2012 Jan 28. [Epublication ahead of print.] 

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