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Alumna Shares Closer Look at the Field of Genetic Counseling

During her senior year, Mikaela Francisco ’18 attended a Biology Department seminar about up-and-coming fields in science. It was at that presentation when she discovered what she wanted to do with her career: genetics. Now, as a prenatal genetic counselor at the Children's Hospital of San Antonio and a clinical instructor for the Department of Obstetrics and Gynecology at Baylor College of Medicine, Francisco will be giving her own seminar to the Biology Department on Friday, October 22, at 1 p.m. in Moody Science 101 about her profession. Genetic counseling is a medical specialty where experts help patients and families understand genetic health history, inheritance risks, and to better understand their prognosis and diagnosis.

Francisco always had an interest in science, but she also wanted to pursue a career that helped people. Growing up in the rural community of Moses Lake, Wash, she only knew about doctors and nurses in that regard. While she initially came to TLU as a pre-med, she decided—after much self-reflection—that wasn’t the path for her. During the first semester of her senior year, with her own senior seminar quickly approaching, she found herself still unsure of what career she would go into. And then she attended a Biology Seminar about Genetic Fields where she was instantly drawn to the possibilities.

“I knew genetic counseling was what I was supposed to be doing because it fit every single box and combined my love of science with my desire to help people,” she said. “I specifically chose to go into maternal fetal medicine because I feel it was the first actual clinical experience I got to see in genetic counseling. While you can do genetic counseling in all kinds of specialties like pediatrics or oncology, I felt like this area was where I could be the most useful and help the most patients.”

In addition to helping patients and their families understand genetic factors and risks, Francisco also counsels them about testing options. In prenatal counseling, she is often working with patients who know they have a family history of a certain condition or illness to see how she and the hospital can assist them.

“We also see patients during their pregnancy to discuss ultrasound abnormalities, teratogen exposures, abnormal prenatal test results, and recurrence risk of genetic disease," she said.

From her training, Francisco says genetic counseling began gaining more interest in the early 1950s when doctors and scientists started asking more questions about inherited health traits and risk factors. The field has grown and expanded tremendously since then and is still considered to be a newer area of academic study in the sciences.

“What we’ve learned in just the last 20 years—from new tests and how we screen for diseases—has so greatly benefitted our field,” she said. “Genetic technology has improved so much that there is more need for genetic counselors to help people navigate their results.”

Mikaela Francisco in the TLU Biology lab working on her summer research project.
Mikaela Francisco '18 working on her summer research project in the TLU Biology lab.

Francisco says those results are often difficult for families to process. She not only acts as a resource for them, but she and her colleagues at the Children’s Hospital of San Antonio are also big disability advocates.

“By the time I see people, I’m seeing them in the eye of their storm,” she said. “They’ve been told their results and I have an hour to sit down with them, provide resources, and answer questions. I see my work as giving them a rain jacket or an umbrella to get through their storm. I meet with two to four patients a day and we might order testing or write letters to insurance companies to explain why testing is warranted. I can see and upwards of 20 patients per week. Even though it can be hard at time, I love being able to have to the opportunity to help these families however I can.”

She hopes her upcoming presentation can inspire students the way she was when she first heard about genetic counseling.

“Maybe I can open that door for students to talk about this field as a career,” she said. “My professors—Dr. Grove, Dr. Lievens, and Dr. Gustafson- all worked very hard to make sure I was equipped to get where I needed to be for graduate school. Something you must consider when looking at colleges is if you’re going to a school where the faculty and staff are going to help you excel. That’s exactly what TLU provides.”

Having previously attended other schools, Francisco says TLU was the only undergraduate college she was encouraged to do research.

“I felt behind at first because I didn’t have two years of research under my belt, but the faculty were so encouraging and helpful,” she said. “They are great about answering questions and never make you feel like you don’t know enough. They care how you’re doing in their class and will personally help you if you’re struggling. They make you realize that you’re going to get where they’re at just over time. They helped me develop my confidence and a better understanding of my own knowledge that guided me where I am today.”