Molly Mizenko was just 9 when she began to understand what genes are and how profoundly a genetic anomaly can affect a person’s life.

Her younger brother Justin, just 18 months her junior, was delayed in speech and other developmental milestones and had been experiencing seizures. He was diagnosed with autism, but her parents knew there was something more. At age 7, he underwent genetic testing which revealed the answer: fragile X syndrome. It’s the most common cause of inherited intellectual and developmental disability, named because the X chromosome looks broken or “fragile” under a microscope.

A genetic counselor helped Mizenko’s family understand what the diagnosis meant. The counselor also pointed them to resources, helped connect them to other affected families and explained family members’ risks of passing the gene defect to future generations.

“There was the education piece and resources referral piece, but equally or more important was how they supported us emotionally, which was different than our experience with other providers,” Mizenko recalled. “We all had different reactions to my brother being diagnosed, but the genetic counselor met us each where we were at that time and helped us navigate the diagnosis in a way that was helpful for each of us as individuals.”

It flowed naturally that Mizenko chose to study genetics with a minor in psychology at North Carolina State University. She was determined to help families like hers by becoming a genetic counselor. After graduation and a gap year working as a genetic counseling assistant in the Epilepsy NeuroGenetics Initiative at Children’s Hospital of Philadelphia, Mizenko was admitted to the highly competitive Indiana University School of Medicine Master of Science in Genetic Counseling program and will graduate in May.

“This is something I have wanted to do and have been preparing to do for so long,” she said. “I’m finally going to be able to help families through an uncertain result or a new diagnosis of a genetic condition and be able to explain what this complex information means in a way they can understand, help them make informed decisions and help them integrate a diagnosis into their lives.”

Since its inception in 1991, IU’s genetic counseling program, run by the Department of Medical and Molecular Genetics, has graduated nearly 200 students, including more than 35 who currently work at IU School of Medicine, IU Health or other hospital systems in the Indianapolis area. Other graduates work in clinics across Indiana and nationwide, while a few work for private industry in nonclinical roles, said program director Paula Delk, MS. 

Over the past two decades, 100% of IU’s trainees have passed the certification exam; most have jobs lined up well before graduation. Genetic counselors are filling an increasingly important role within the care team through a career that combines high patient interaction with rapidly evolving scientific discovery.

“We’re living in an exciting time where our understanding of genetics is continually growing at a rapid pace,” Mizenko said. “Genetic counselors help providers in ordering the appropriate tests and interpreting the results to make sure not just patients but also providers know what these results mean and the implications they have for their care.

“Genetic counselors can provide tailored emotional support and empathy while helping patients navigate both the medical and psychosocial aspects of a diagnosis.”

Rising demand for genetic counselors

Several factors have converged to fuel the demand for well-trained genetic counselors. Federal funding for genetics research skyrocketed in the early 2000s, driven by the Human Genome Project. Its completion in 2003 expanded scientific understanding of inherited diseases and unleashed the power of genomics to advance precision medicine for cancer and other diseases.

“There are new gene therapies that are coming out, which is super exciting, and new genetic testing methodologies that primary care physicians might not understand,” Delk explained. “They might order testing and then not know how to interpret the results or need somebody who has more expertise to talk with their patients and counsel them about their results.”

Sometimes individuals seek out genetic counselors after having DNA testing done through a private company, like 23andMe, to help them process the results and understand their individual risks of passing along an inherited disorder.

The U.S. Bureau of Labor Statistics projects genetic counseling jobs will grow by 9% over the next decade, far outpacing most professions. The current average salary is about $100,000, including industry laboratory positions.

As the field has grown, so has the need to for specialization. While many graduates go into general genetics counseling for children and adults, IU’s program also introduces them to cancer genetics, cardiovascular genetics, metabolic genetics and neurogenetics. Seminars explore social, legal and public health aspects of genetics.

Recent graduate Cassidy Butler, MS, is now a certified genetic counselor working in pediatric neurology at Riley Children’s Health.

“The program was quite challenging and demanded a lot of its students, but I do think that it provided me with an excellent ‘genetic counseling tool kit’ to carry with me as I started my career,” she said. “The sheer volume of clinical cases alone helped prepare me for many different challenges that you face as a genetic counselor.”

What’s it like to be a genetic counselor?

Butler and 2025 program graduate Jade McIntyre, MS, now a general genetics and pediatric genetic counselor at IU Health, discuss what makes genetic counseling a rewarding career.

Question: How did you become interested in genetic counseling?

Jade McIntyre: Genetic counseling encompasses all my passions: genetic counselors are lifelong learners who analyze intricate genetic information, communicate it with clarity and compassion, address the practical and emotional implications of testing and diagnoses, and work to include patients and families in the decision-making process. As a recent graduate, I am excited to enter a field at the forefront of precision medicine and to work collaboratively with other medical providers to improve patient care.

Q: How did you make yourself a competitive candidate for the Genetic Counseling program at IU School of Medicine?

Cassidy Butler: I involved myself in research and genetic counseling-related work and shadowing opportunities in undergrad. I think that my role as a research assistant and completing my own capstone research project focused on genetics helped prepare me, as research is a major component of IU’s program. I also volunteered and then worked part-time as a genetic counseling assistant at IU. During this opportunity, I was able to shadow many genetic counseling cases across various specialties.

Q: What was the highlight of your time in the Genetic Counseling program?

McIntyre: During our Psychological Aspects of Genetic Counseling course, we had the opportunity to meet with five families in which a loved one had been diagnosed with a genetic condition. Their stories offered insight into how families perceive genetic services, how they cope with receiving a diagnosis, and what aspects of their healthcare experiences were most meaningful to them. This experience deepened my understanding of the unique role genetic counselors play in patient care and highlighted the many ways we can positively impact families throughout their diagnostic journey.

Q: What is the most rewarding part of your job?

Butler: The most rewarding part of my job is when I can tell that I have made a difference in a family's life. This happens in a lot of different ways, whether this is something as major as identifying a diagnosis that can greatly improve their child’s care or something smaller — but so huge to families — like being one of the first providers to listen to patients’ and parents’ frustrations and validate their feelings.

Q: What does your typical workday look like?

McIntyre: My core responsibilities include selecting appropriate genetic tests based on a patient’s clinical indication, assessing family history, obtaining informed consent, interpreting test results, and educating patients about genetic conditions — all while offering empathy and emotional support. If a patient chooses to pursue genetic testing, I coordinate the entire process and follow up by calling them with results, answering their questions and guiding them through the next steps.

Q: What advice would you give someone considering a career in genetic counseling?

Butler: I think outside of working hard academically and pursuing opportunities like genetic counseling assistant work, shadowing, crisis volunteering, etc., it is incredibly important to have a strong sense of empathy. This is something that you can constantly work to develop. Try expanding your worldview and seeking diversity in your day-to-day. Learning to see the world from another person’s perspective is invaluable to know how to best support patients and families who are going through an experience you likely will never have. Genetic counseling is about more than just educating families about their genetic diagnosis. It is also about helping them process the emotions that come with it.

Q: How do you feel you are making an impact on Indiana families as you work within the healthcare team for patients with genetic disorders?

McIntyre: The role of a genetic counselor complements the expertise of medical providers by enabling more targeted and individualized medical recommendations. Providers rely on the genetic counselor’s assessment, including interpretation of genetic test results and detailed family histories, to guide clinical decision-making and deliver personalized, effective care.

Note for prospective students: The Department of Medical and Molecular Genetics offers an annual Genetic Counseling 101 conference each August and can help undergraduate students find shadowing opportunities. Explore the field and find admissions information on the Master of Science in Genetic Counseling program website.