imagine a health record system designed specifically for genomics. Because let's be honest, electronic health records are not built for genetics. Now you can stop imagining and start using because you know, tips is just this. Fino tips is the world's first complete genomic health record system. Now you can try it for free. Just go to fino tips dot com slash sign up again. This is a free service you can use by visiting fino tips dot com slash As many of you may have heard the podcast award nominations have just opened as of july 1st. So I need you listeners to go to podcast awards dot com. Do a quick registration and then select DNA Today in the science and medicine category. This is going to help us get nominated. We've been nominated three other years. We're going for 1/4 nomination and hopefully win. If we can get your rallying support. So please podcast awards dot com. And if you share this on social media and tag us, I will give you a shout out on the show. That's right. I will publicly thank you for nominating us in the podcast awards. So definitely put this on social media, tag us and I'll give you a shoutout in the next show.

Thank you. How is it that we find ourselves surrounded by such complexity. Hello, you're listening to DNA Today Age next podcast and radio show. I'm your host here Dean on this show. We explore genetics impact on our health through conversations with leaders in genetics. These are genetic counselors. Like today's episode researchers, doctors, patient advocates and more. In this episode, we are asking your listeners submitted questions about the jet counseling board exam. These questions were asked through twitter instagram and facebook group. To answer these questions is the president of the american board of counseling known as A B. G. C. Adam. Buchanan. Aside from his role at A B G. C. Adam is an associate professor, genetic counselor and director of the guys in our genomic medicine institute. Previously, he was a research associate at Duke Cancer Institute. His clinical expertise includes intimate knowledge of recommended risk management for hereditary cancer syndromes. He is also co leading guy Zingers, my co genomic screening program for medically actionable genomic results and is helping to develop a health services research portfolio on patient participation, family and system outcomes of this program.

Thank you adam for joining the show. We're going to be talking about the board exam which is on a lot of people's minds as the class of 2020 recently graduated and some of them are gearing up for boards next month. So thank you so much for coming on the show and sharing your insight about the board exam. Thanks for having me. I'm looking forward to talking to start from the top. How can genetic counselors sign up for the exam. What is the time frame? So the sign of information is through the A. B. G. C. Website which is a B G C dot net. There's a link on there to get to our exam partner which is called P. S. I. So PSC is the uh psychometric group that helps prepare the exam and uh if you follow that length then it's pretty self explanatory and how to get signed up. That has to be done by July 17 for the August exam cycle. And so for those taking it in february, do you know the deadline for that or does that differ per year? Uh It's in january, I don't know the exact date Probably a couple of weeks before if it's matching with the other timeframe and for those that aren't familiar, the exam is four hours with 200 questions.

Which is quite a lot to get through. Um 30 of those being experimental and not counting towards the score but maybe a future question. Are there different sections to the exam or all of the questions mixed together throughout thinking of how G. R. S. And S. A. T. S are set up and how this might differ? The exam is based on what's called a detailed content outline which is derived from practice analysis that occurs every few years and that content outline has five sections. So questions for each individual exam taker are scrambled up within those five sections for how many answer options there are. Is it like a. B. C. D. Or their five answer options. How does the exam look is it all the same? It is each one is four options. A. B. C. D. And there is not a multi select option. So there's not an all of the above or uh A. N. C. Or being the sort of response option. Oh that's good to know because at Sarah Lawrence some of our questions that were kind of bored style would have some of those above all and that makes the question a little bit trickier.

Um So that's good for people to be aware of the things that's changed over time. It used to be that there are five options that used to be that some of those multi select options are possible. But the guidance that we got from our partners at sea was that those can be problematic from a really understanding what the candidate is capable of doing. It becomes more about test taking strategy than your actual content knowledge. It's good to see that you're adjusting as time goes on to see what's working best for the jet council community. And at the end of the day we're looking to see if the test taker is ready to be fully functional Jet counselor on their own and have enough knowledge. Um So and part of that is I can only speak for myself but I think there are other people with me that I am not good at Math. I think that's one of the reasons I went for genetics and that other more math centered areas of Biology and science. I'm learning that there isn't a calculator provided on the exam, you can correct me if I'm wrong there. Um what can people expect to be given when going into the exam, other materials?

So you're right that there's not a calculator provided or available, uh you can have a scratch paper that you use to work on problems. It's not designed to be intensive calculations on the exam. So it's not like you're having to fill that piece of scratch paper with calculations for a particular question, it's more focused on concepts than making sure people can do math correctly. So easier math to work with, as long as you know how to set up your busy and then you should be able to play with the numbers and it's not going to be uh really testing on the math, but more the procedure of what you're doing um for the question, which is probably good for people to hear that are a little bit nervous about that part of the exam. Um we have a bunch of listener questions that were submitted um looking to get insight on the boards exam from you. The first one is from jen and brooks who ask what book resources do you recommend to study for boards, what is the best strategy because there are, there's so much content to cover.

So it can be kind of overwhelming when starting out or even during studying to say, am I really covering everything I need to, The detailed content outline is broad and uh starting with that and seeing what's on the on the content outline is a great place to begin? Uh It tells you the major areas that are going to be asked about and when I mentioned that The exam is more focused on concepts and details that often applies to how each individual question is phrased. So it's seeking not to understand whether you can make a distinction between the 2019 versus 2020 n. c. c. and guidelines for hereditary breast ovarian cancer. But rather whether you understand some of the larger issues like what are the risk management options in hereditary cancer syndromes. So uh it flows pretty well from the training that everybody has had a pretty good coordination there. So I would suggest starting with a detailed content outline which is available on abc dot net and working off of that and we'll link to that in the show notes as well if people aren't familiar with that because that is helpful to sit down and be like okay how am I going to make the study plan and going off of that is going to be a good way to start?

Um speaking about N. C C N guidelines and you know, not having to know specifically between the guidelines. Is there any other content that is specifically not on the exam. So I'm thinking of other things that maybe I've memorized for grad school like carrier frequencies or other um specific more details. Uh Is there anything else that occurs to you that you're like, oh don't bother studying this because it's more about concepts, not any particular topic, but in general what the certification exam committee has done in concert with the item writers is to work to move away from. Uh huh. Those questions that get out very specific details like carrier frequency and seek to really address those larger concepts because we can we can look up those details in our practice. Uh It's the concepts that we want to make sure everybody has under their belts. So each item on the exam falls into one of three cognitive levels, the lowest of which being recall followed by application of an analysis.

So as you might imagine, the third of those is the more involved one that asks you to really apply that particular concept. So there's a mixture of those scattered throughout the exam, within those cognitive levels. And uh when it's recall, its uh it's kind of a clearer concept rather than a particular detail that you need to recall. And when looking at those three types of questions, would you say that there are more of those higher level thinking that last category you mentioned on the exam as opposed to the more straightforward recall questions? Or is it an even like third for each? It's scattered among them. It differs by this section of the detailed content outline. you can actually see that on the content outlining as well to see how many fall into each of those cognitive levels. Per section sounds like it's worth printing out and putting on your whiteboard or something. So that, that's always centered when you're studying as being a really good guide. Um, we have another question that kind of goes back to dates for the exam.

So it's offered right now in august in february is the two months that it's offered. Over the course of the year, Lauren asked what's the best date to take them fall or spring? Which springs it's february. So it's not quite spring, but I understand what she means by that right? Uh, late winter we're hoping it's spring is going to Montgomery. So it really depends on what someone's circumstances, both with work in which state they're working in. Uh, in terms of how people perform on the exam, there are not any significant differences between august and february. We've looked at that for several years now, since we've been offering the exam twice a year and haven't seen those differences. So what it comes down to is what somebody's employer needs, what their state needs for license. Sure. If it's a statement. Life insurer and those sorts of circumstances and with the states that have licensure, where you need to pass the board exam in order to practice. Some states give you, you know, in Connecticut, they give genetic counselors a year. So if you graduated in May, you have a year having a temporary license before you have to pass the boards to practice in Connecticut and I'm sure it's similar in other states.

How quickly is this enacted if you pass the boards on a monday, can you start practicing that next Tuesday or does it take a little bit of time to actually process the paperwork? It depends on what the state needs for verification that you passed. So as soon as you finish the exam and assuming that you passed, you'll know that right then in the testing center, uh, in that record of your having passed the exam will be available um, quickly thereafter through a B G C. We don't send certificates out to everybody until the end of the exam cycle. So that would be the first week of september typically. So if that license, your body needs that certificate, um, it wouldn't be, you know, until sometime in september before you'd be able to send that they can verify through the abc verification system there if that's the way that it works Okay. So it's going to depend on the state as a lot um, has to do because some states, as we said, have licensure and others do not.

I think new york doesn't um, if people are kind of new york Connecticut based listening, the most popular question, um we have gotten is hands down if there is a percent passing rate, So for instance you need to get say 75% on the exam in order to pass. Does this exist or if it does. Is that public information or is this really more in the back end of scoring? So there is some complicated nitty gritty about what it takes to pass that We probably don't have time to get into here. But the gist of it is that there's not a score. So it's not like an 80% and everybody who scores above that passes but rather what's called a passing point. So of those 170 questions uh how many do you have to get correct to pass? And that changes every time that practice analysis in the detailed content outline is done. It has to be reset through uh a process led by the psychometric group that we work with. So there is a point that occurs within each exam but it can vary from exam to exam.

So not a direct number to give for people to say if they're taking the practice test for instance to say okay I've gotten this score, I know I would pass on the exam. Is there a way that when you are taking the practice exam which is offered through um you guys at a B G. C. To know okay, if this was my real exam I would have passed. Unfortunately. No that practice exam is not tied to any m of the current way that the exam is administered. So All right, it's not going to give you a clue into passing or not passing? At least not in a very detailed way. I think the greater utility of that exam is just getting a sense of questions and topics and what it's like to sit down and work through an exam like that. It can be a really good way to study just so that you're familiar with how the questions are phrased and the different types of questions there are, as you mentioned before that there's three different types and I think for a lot of us that took GREs to get into grad school um taking a lot of practice test is a good way to prepare us for that.

So kind of similar continuing of that kind of study skill. Haley asked is there a best way to approach the questions? Is there when you look at a question, a certain thought process that you have To go through and hopefully zero in on that best answer. A lot of the skills from taking those other standardized tests apply here as well. So really stopping and reading the item and the response options carefully read each response option before you think you've got the right one picked out and just be careful and thoughtful about the process. The other thing that I think is helpful is to really zero in on the way it's phrased. So often there phrase to ask what's the next best thing, what's the best option or the best approach? So you want to see how that that's phrased and it's typically called out either with capitalization or molding what it is that the item is looking for. So those test taking skills that people develop over time on their way to and through grad school should apply here as well and for people that are looking to take the press exam that is available through your website, I believe when they go to do that, is it like a pdf that they receive of an exam with like an answer key at the back or does it actually take you through like what the platform software is going to look like on exam day.

It's a little bit different from the way the exam software looks on exam day. So it's more of a representation of items and uh what the response options are but it looks doesn't look exactly like to display that they'll see in the testing centers question about the scoring of the exams. Sophia asked well scoring this round of exams factor into these unprecedented times in light of the added stress of the pandemic with classes being online towards the end of the semester and rotations being cut short specifically for the class of 2020 which I would imagine is the majority of people taking the exam in august in february but obviously other genetic counselors as well. Um I'm sure that A. B. G. C. Has had conversations about how to handle this. Is there any differences with this round of testing? I'm certainly sympathetic to people are entering the profession now. It's an extremely challenging time and it is uh similar to a lot of what are other healthcare colleagues are going through, for example with interns just having started yesterday with their first day and their new jobs as physicians.

So uh we are recognizing that people are entering the profession at a challenging time. The scoring is not going to change because of the way that it's designed and having gone through the process of setting that passing point and I think that's appropriate in spite of the challenging times given that we need to make sure we're maintaining the protection for the public that the exam provides and regular for the profession. I think that's well sad and and there are some positive sides that some people have had more of a chance to study with. Uh you know, specifically it's Sarah Lawrence, we had classes and um or not end but begin to be online towards the end of March and didn't have in person rotation. So a lot of people had extra time to study, so there's definitely a balance there where you maybe didn't get as much time in in person classes and rotation but had more time on your own to study. So you know, I'm sure things are shifting, but definitely a hard time for people to um sometimes be studying and be prioritizing this.

Um But yeah, the field we can't exactly um you know, take a step back and reduce our expectations. Um Going along with that Sarah asked, do you expect the pandemic to have any effect on the results of upcoming exams? So you know, going along with class rotations Being online if you expect there to be a dip in the passing rate um which has fluctuated the past few years but it seemed to be between like 75 and 90%. We'll definitely keep an eye on it. It's hard to know what to expect. You're right that typically, especially for first time test takers, it's been about an 85% rate for those who have passed. So uh we will know in september what that rate was and we would necessarily be able to attribute a lower rate if it were to occur to pandemic or two social justice uh protests and concerns and or anything else that might be going on in the world now, but we'll definitely keep an eye on it.

And Christina asked how our test taking centers in a BGC protecting test takers when it does come to covid, if exams are exams centers are going to say 50% capacity or something along those lines. Test takers are required to wear masks, what might this look like in august and we can't really speak to february yet but maybe more for august so the test centers are requiring that everybody have a mask. And so that's really important for everybody to their they cannot take the exam with that being masked. So uh That's critical. The other thing is that they're operating at around 50% capacity. So it differs by kind of state to state. And there are several international test centers as well. So they're taking the guidance of their local health departments or national health departments and setting their capacity accordingly which is appropriate and for people to know ahead of time that they're going to be required to wear a mask and to double check with their specific testing center.

But I'd be surprised if they weren't having to wear a mask and to find one that's going to be comfortable because if you're taking exam for four hours and you want to be focused um Finding one that's really gonna work for you during that time. Um Another question kind of going along the lines of a lot of conversations that have been occurring more so in the jet Council community Audrey asked regarding accessibility of becoming A. G. C. And helping to expand diversity of the field. Are there any plans for reducing the price of the board exam which I believe is about 900. Um And if there's been conversation there. I mean obviously this is not something that happens overnight but if you could kind of share what A. B. G. C. Has been talking about in terms of um the price of the board examined and helping to expand diversity kind of within that we review the price about annually in the time that I've been on the board. So it is something that we have an eye on. Uh and I anticipate that we'll discuss that as part of our larger discussions around diversity inclusion in the field. Uh You may have seen that we've had a twitter listening event recently to hear more about people's thoughts about diversity inclusion in the field specifically with a role for A.

B. G. C. And uh that we're taking several steps to uh impact the diversity of our profession and work with our other partners and genetic counseling organizations to ensure that the profession better mirrors the patients that we serve definitely. And for those that may have missed that. It was I believe it was hashtag a Bgc listens so we can link to that in the show notes as well. So you can go back and read through the tweet chat that happened I think a couple weeks ago a couple months ago I'm losing track of time during covid speaking more to the phrasing of boards questions. Um has there been discussions about altering the phrasing of boards questions to be more inclusive towards our community, our patient population as well as the genetic counselors in our community. It's an important question and it's something that we are actively working on. We've long worked in the item writing process to remove descriptors that that seemed extraneous or prone to bias.

Uh but now we are looking to get internal and external uh guidance on reviewing the item bank. In other words the group of questions that we have available for each exam and uh reviewing it for that implicit bias and uh making corrections if we find it definitely. It's very important to see that. And a lot of the conversations we've had here on the show you can look more to twitter is great. Hashtag G. C. Chat. A lot of these conversations been happening especially in the past couple of months. Um so you can kind of continue educating yourselves listeners by going there and we're going to link to a lot of things that we mentioned today during the show. In the show notes. Thank you adam for coming on the show and really exploring all this. I think it's going to be helpful for people studying for boards to be able to really get a better sense of what they're expecting on test day and what mindset to be in and what to study. Any final tips for our test takers out there. I will mention one thing that I think you'll see coming out soon.

I don't want to get ahead of an announcement from A. B. G. C. But we have been exploring remote prospering for the exam again because we're really focused on safety with this administration and we want to explore all options for making sure that everybody can take it in a comfortable environment. So stay tuned for any announcements on that topic will definitely be sharing that on our social media if that's posted there. Um, so we'll be looking out for that is that you may not be able to answer this, but I have to ask, is that possibly going to affect people that have already signed up for august boards? It should be something that can be changed in the time between now and the deadline for signing up. Okay, that is a good tease. Well, thank you so much again for coming on the show and sharing all of this with us. Best of luck to all the test takers out there um, and we'll be sure to check in and see how the board's exam is going to change in the next few years and really appreciate you coming on to share all of this insight with us. Well, thanks so much for the opportunity to talk.

I think the exam is stronger. The more people that we have involved in, the more diversity that we have among our item writers. So I would encourage everybody to become involved in the BGC as they can learn more about the exam again at a b G C dot net and a bunch of links that we mentioned in this episode is going to be in the show notes which are available at DNA podcast dot com. So you can go there for all the information that we talked about in this episode today. Also if you are interested in your becoming a genetic counselor, we've had quite a few episodes that explore this episode, 87 97 explore the application process and interviews and episode 101 is a match day celebration that was recorded um where we talked about what to expect in your first year of grad school and there'll be many more episodes to come about becoming a genetic counselor. Please follow us on social media. Just search DNA today and any questions you have for myself, adam, any previous guest or you want to connect email in info it. D N A podcast dot com. And I have to ask you for a big favor.

The podcast award nominations just opened and this is a people's choice award. So whatever the listeners like is what ends up winning. So please go to podcast awards dot com and nominate DNA today in the science and medicine category. It's really easy. You just go to podcast awards dot com, quick registration and scroll down to the science and medicine category, selecting today. And if during registration you can click off that box where it says you'd like to be eligible to vote because first nominations happen and then voting to see who actually wins for the Science and medicine podcast award. So please podcast awards dot com selecting it today for the Science of Medicine category. I cannot do it without you listeners. So please and thank you and an announcement. The we've had different series on the show. We started out with the infertility series that had seven episodes where we explored so much like P. G. T and IVF and all kinds of different areas of infertility and genetics. Now, our next series is going to be about direct consumer genetic testing and the test that kind of surround this area.

So that's going to launch next episode on july 17th. So these episodes are going to compare different companies and 23 me is actually gonna be a guest on the show and grab for those who may know of her in the joint counseling community and we're also gonna explore the technology used in these labs. We're going to discover the ways in which DE TCS are utilized, law enforcement, carrier screening, newborn screening, cancer ancestry, ethnicity and so much more. It's going to be a packed series with so many experts on the show sharing their insights and all different angles of DTC s and we kind of had a couple during the infertility series but we're going to launch much more into it again. That series launches next episode on july 17th. I want to also thank Picture genetics for being the sponsor of this upcoming series with their kids. You can join me in using DNA today code for 25% off and free shipping at picture genetics.com but you'll hear much more about that in the direct consumer series that's launching again next episode, are you still drawing pedigrees by hand? It's 2020 and you are overdue for an upgrade.

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