The evolving role of genetic counselors in South Africa: A decade of growth

Genetic counseling has evolved from focusing solely on congenital anomaly prevention to incorporating psychological counseling. Traditionally, its goal has been to enhance patient care by providing clinical information and facilitating psychological adjustment. However, with the rise of genomics and complex testing technologies, genetic counselors now engage in education, research, clinical practice, and laboratory roles. A previous study from 2013 described the role of genetic counselors in South Africa. This current study provides an updated perspective on these findings and how these roles have diversified. Registered independent genetic counselors were invited via email to complete an electronic survey adapted from the previous study conducted in 2013. The survey collected data on information pertaining to (1) demographics, (2) genetic counseling experience and employment, and (3) work/clinical practice. Data were analyzed using descriptive statistics. Of 44 contacted genetic counselors, 29 responded. Most were female (97%), under 40 years old (60%), and had practiced for less than 10 years (59%). Although many genetic counselors took on multiple responsibilitiessuch as clinical, administrative, research, and teaching-the proportion primarily working in clinical roles declined from 75% (12/16) in 2013 to 45% (10/22) in 2023. Notably, genetic counselors involved in teaching and training had significantly fewer years in practice (p = 0.0396; CI 95%), suggesting a loss of expertise in academic centers. A new trend observed since 2013 is laboratory-based responsibilities, with 68% of participants reporting duties in this area. The role of genetic counselors in South Africa has expanded substantially over the past decade, with a shift away from predominantly clinical roles. These findings highlight the need for adaptation of training programs and strategic workforce planning to retain expertise in academic centers and ensure the continued growth of the profession.