Genomic Counselling – 2025 review results

Current priority areas

• 10 Year Health Plan for England: fit for the future
• Science in healthcare: Delivering the NHS Long Term Plan – The Chief Scientific Officer’s strategy

Stakeholder feedback

Feedback collecting through the Curriculum Library survey collected between January 2024 and November 2025. All stakeholder feedback is presented verbatim.

Programme

• There needs to be some way of ensuring that STP trainees can manage a band 7 caseload when they have completed the course. We have found that year after year the STP graduates are struggling to manage a band 7 caseload when they start work as Registered Genetic Counsellors. The course does not seem to prepare them for independent and clinically safe (but rapid) decision-making. Guidance on clinical numbers is needed – they should need to see a certain number of patients per month towards the end of the course. Too much time is spent on the dissertation in their final year, which impacts on their clinical experience. They also don’t seem to have a solid grounding in genetics knowledge. There are gaps in their knowledge, despite the huge number of competencies that they complete. Perhaps there is too much focus on completing competencies and not enough focus on a thorough understanding of genomic principles.
• ….In addition, in relation to the curriculum, there needs to be leniency for how not every service will be as specialised as others to ensure those in smaller services for example, still feel able to meet competencies. Additionally, some competencies still relate to whole genome sequencing which is not always seen/led by trainees, so ensuring this again is not a barrier for the portfolio.
• I feel the timing of the MSc dissertation deadline disrupts the flow of training for the genomic counselling trainees. Just when you want to be ramping up their confidence by immersing them in clinical work in their 3rd year, they are completely distracted by the dissertation deadline. They are allowed to take a very large number of weeks off to work on their dissertation which could amount to months in a row. This really breaks their flow. In addition of course they have to ensure their complex 3rd year TAs are all completed, as well as prep for their final year assessment. If we can move the dissertation deadline to second year I really feel this will open up the opportunity for these trainees to complete the programme appropriately trained and ready to take on a band 7 caseload. They enter the STP at MSc level and there should be no reason they don’t immediately start on the dissertation to hand in in second year. I fundamentally do not feel the current set-up of the curriculum produces genomic counsellors who are able to practice at band 7 level safely straight after they graduate.
• There are too many TAs – I mean that genuinely. There are so many TAs that take up so much time and attention which could be better spent working on clinical exposure and lived experience. Equally it limits the trainees in their ability to say ‘yes’ to ad hoc training and learning experiences – they are so overwhelmed by the TAs they are required to do that we find they often will not do “more” than they “need” to do. An example is something like once they’ve updated one leaflet, they won’t do another as they’ve already completed the relevant TA!

S-GC-R1 Introduction to the Principles and Practice of Genetic and Genomic Counselling

Module aim

• It is very important for all genomic healthcare scientists to have a patient centred approach and to be aware that there is a patient at the centre of the genomic testing process but I believe it is an excessive use of resources to require bioinformaticians to complete an entire module in genomic counselling – a month shadowing counsellors and clinical geneticists, a few weeks writing up, a month trying to find something useful to do while the other trainee in the department is shadowing, a week of academic teaching in person and remotely and several days revision for exams – an investment of around 3 months’ time and the costs associated with that. Bioinformaticians that I have met who trained on the previous curriculum and spent around a week shadowing genomic scientists seem to have a patient centred approach without this large investment of time, as do the Cancer Genomics trainees, who do not have to complete this module. Bioinformatics trainees must acquire so much technical information and skills over their training but most of this is crammed into the second and third phase. It would be better to have another technical module in the first phase and add a counselling training activity to the cancer genomics and genomics modules so that bioinformatics trainees spend some time with genomic counsellors but don’t invest a quarter of their first phase in it.

DOPS

• Module S-GC-R1 Introduction to the Principles and Practice of Genetic and Genomic Counselling – when undertaken by STPs who are not in the Genomic Counselling workstream (Andrology, Embryology, Bioinformatics, Genomics). In Clinical Genetic Services we are facing increased demands to host the rotation (for example, 10 trainees to host when we only have 1 GC STP) and it has become unmanageable.  Whilst the Genomic Training Academy will address some challenges,  the DOPS are often not skills they will utilise in their future practice, A DOPS/OCE that covers how what they have learnt about genetic/genomic counselling relates to their speciality would be a way that that could incorporate their learning from their training activities and reflect on how they will apply this learn to their own speciality.

S-GC-R2 Introduction to Genomics in Mainstream Healthcare and Social Care

• no feedback received

S-GC-S1 Counselling and Communication Skills for Genetic Counsellors

• no feedback received

S-GC-S2 Applied Genetics and Genomics in Clinical Care

• no feedback received

S-GC-S3 Advanced Counselling and Ethical Practice for Genetic Counsellors

• no feedback received

S-GC-S4 Applied Genomics and Bioinformatics in Advanced Clinical Care

• no feedback received

Changes made

Module level changes

Programme level changes

• no changes made
  

Periodic review

This specialty curriculum requires significant change beyond the scope of an annual review.

Response – no

Rationale

Please provide an overview of the rationale for why the proposed changes are needed or why changes were not needed, with reference to stakeholder feedback.

Response

Most changes are refining and clarifying the current Training Activity content to better reflect the task or skill and are therefore considered minor changes. In doing so we have also embedded some additional consideration for elements of Equality, Diversity & Inclusion in the scope of the TA, asking trainees to demonstrate their learning and skill in supporting patients with different needs.

We have a pair of Major changes which involves the removal of current TA and replacing it with a new TA created in the same module. Current TA4 in S-GC-3 (theoretically completed in Year 3; preparing individuals for genetic testing outcomes) overlaps significantly with TA5 in S-GC-2 (completed in Year 2; preparing individuals for testing outcomes and implications). The only distinction is the time points at which the TAs are implied to be completed, hinting at the level of complexity of the cases, but there are ample opportunities to demonstrate more complex genetic counselling across the curriculum, as this is the very core of our role.

In its place we have introduced a new TA asking trainees to consider specific needs for marginalised groups (e.g. ethnicity, sexuality, gender diversity, disability etc). We will make this clear in the new reflective guidance document planned to accompany this curriculum review.

I confirm I have reviewed the Reflective Practice Guidance for ETAs and DTAs and have made any changes necessary.

Specialty Lead Editor signature: David Walker and Matilda Bradford
Date: 30 December 2025

Change control - completed by the school

Programme structure

Completed by: Chris Fisher
Date: 7 January 2026

Health and Care Professions Council (HCPC) mapping

• No changes to learning outcomes. HCPC mapping maintained.

Completed by: Chris Fisher
Date: 7 January 2026

Major change control

School Lay Representative Collaborative Review

• Lay feedback

Stakeholder survey

• Survey period: TBC
• Unique page views: TBC
• Survey responses: TBC