The composition and capacity of the clinical genetics workforce in high-income countries: a scoping review

Abstract

As genetics becomes increasingly integrated into all areas of health care and the use of complex genetic tests continues to grow, the clinical genetics workforce will likely face greatly increased demand for its services. To inform strategic planning by health-care systems to prepare to meet this future demand, we performed a scoping review of the genetics workforce in high-income countries, summarizing all available evidence on its composition and capacity published between 2010 and 2019. Five databases (MEDLINE, Embase, PAIS, CINAHL, and Web of Science) and gray literature sources were searched, resulting in 162 unique studies being included in the review. The evidence presented includes the composition and size of the workforce, the scope of practice for genetics and nongenetics specialists, the time required to perform genetics-related tasks, case loads of genetics providers, and opportunities to increase efficiency and capacity. Our results indicate that there is currently a shortage of genetics providers and that there is a lack of consensus about the appropriate boundaries between the scopes of practice for genetics and nongenetics providers. Moreover, the results point to strategies that may be used to increase productivity and efficiency, including alternative service delivery models, streamlining processes, and the automation of tasks.

Attitudes and Practices of Australian Nephrologists Toward Implementation of Clinical Genomics

“…In future, if nephrologists feel comfortable with using genomics in routine care, the RGC may involve a nephrologist with genetics expertise together with a genetic counselor, with review by a clinical geneticist being reserved for complex-cases. This model would provide a more feasible approach, particularly in the context of shortage of genomics professionals in Australia and internationally [28][29][30] .…”

The 2019 US medical genetics workforce: a focus on clinical genetics

“…15 Additionally, a recently published systematic review indicated the shortage of genetics providers and lack of boundaries between scopes of practice for genetics and nongenetics providers and possible solutions such as alternative service delivery models, streamlining processes, and task automation. 16 Finally, the US Government Accountability Office (GAO) published a report on 31 July 2020 that highlighted the recent modest increase in newly certified medical geneticists and the lack of clear data on demand for and the number of genetics professionals needed to provide genetic services. 17 This article presents the findings of a 2019 US survey of medical geneticists conducted by the American College of Medical Genetics and Genomics (ACMG) through the National Coordinating Center (NCC) for the Regional Genetics Networks.…”

Experiences from the epicenter: Professional impact of the COVID‐19 pandemic on genetic counselors in New York

“…Telegenetics is the use of technology such as computers, telephones, or mobile devices with audio and/or visual components to provide genetic services remotely (Gray, 2000; Mitchell & Demiris, 2005; National Institutes of Health, 1996). While these remote services were introduced to expand access to care to more rural areas (Gray, 2000), the increasing demand for genetics professionals nationally (Cooksey, Forte, Benkendorf, & Blitzer, 2005; Dragojlovic et al, 2020; Hoskovec et al, 2018) has led to a rise in the desire for telegenetics implementation in many areas (Hilgart, Hayward, Coles, & Iredale, 2012; Vrečar, Hristovski, & Peterlin, 2017). Despite this, the majority of genetic counselors were not using telegenetics in patient care prior to the COVID‐19 pandemic.…”