UC Irvine

Previous studies assessing the genetic counseling graduate program (GCGP) application experience have been limited and largely focused on admitted applicants; half of applicants are not admitted annually, but there is a significant gap in the understanding of their experiences. This study aimed to evaluate the factors affecting GCGP selection, barriers in the application process and factors affecting the overall application experience for 2021-2024 GCGP applicants. The factors and barriers affecting various GCGP applicant subgroups were also compared. Of the 377 participants who completed the online survey, 30% were matched, 41% were unmatched, and 28% were first-time applicants in 2024. The top factor influencing GCGP selection across all participants was the cost of tuition (74%), while the cost of individual program applications was a frequently selected barrier in the application process (68%) and a factor influencing the overall application experience (49%).GCGP selection by unmatched applicants was notably influenced by the cost of living in a program’s area when compared to matched applicants (p=0.020). Unmatched applicants also more frequently indicated that obtaining advocacy (p<0.001), volunteer (p=0.002), or research (p=0.007) experience were barriers in the application process, when compared to matched applicants. Matched applicants more frequently reported that exam-related costs were barriers in the application process, when compared to unmatched applicants (p=0.002). One notable theme in this study was diversity. Diversity within the patient, faculty and student populations were each more frequently cited by non-White applicants as factors influencing GCGP selection when compared to White applicants (p<0.001 for all three comparisons). Diversity within the genetic counseling field was also cited more frequently as a barrier by non-White (p<0.001) and LGBTQ2IA+ (p=0.007) applicants when compared to White and non-LGBTQ2IA+ applicants, respectively. In addition, diversity within programs was more frequently selected as a barrier by these two subgroups, when compared to White (p<0.001) and non-LGBTQ2IA+ applicants (p=0.031), respectively. A lack of diversity within programs and the field of genetic counseling was cited more frequently by non-White applicants as affecting their overall application experience when compared to White applicants (p<0.001 for both comparisons). Working to address these factors and barriers, particularly for underrepresented groups in medicine, could advance diversity within the genetic counseling field, guide recruitment strategies, and enhance the match/application process and experience.