‘Mom’s Idea’ Yields New Genetic Counseling Program at Washington University
Twenty years ago, Erin Linnenbringer’s mother suggested she start a genetic counseling program at Washington University in St. Louis. “I laughed it off as a crazy mom thing,” she says, “and then suddenly it wasn’t.”
This fall, under Linnenbringer’s guidance, WashU welcomed its first cohort of students into a new Master of Science program in genetic counseling.
Growing up in the rural town of Mount Olive, Illinois, Linnebringer always envisioned a life beyond farming. Her high school class, which consisted of 39 students, offered a limited curriculum, leaving Linnenbringer to hope for more challenging academics. Fortunately, a science teacher noticed her potential and, as an extra assignment, asked her to write a report on the genetic blood disease hemophilia. Researching the impact of hemophilia in royal houses of Europe hooked Linnenbringer, setting the foundation for her career. “I thought the science and the psychosocial impact of the disease was really fascinating,” she remembers.
Linnenbringer’s interest in science led her to WashU, where she majored in biology. During a lecture with noted geneticist Alan Templeton, Linnenbringer first learned of the possibility of a career in genetic counseling. “I envisioned myself adequately conveying really complicated technical information so that it can be beneficial to patients,” she says. After graduation, she applied to genetic counseling programs, hoping to combine her interests in genetics and working with people.
During the application process, Linnenbringer connected with a genetic counselor at the National Institute of Health’s National Human Genome Research Institute (NHGRI). Instead of entering a genetics counseling program, Linnenbringer opted to join a research fellowship program.
A year later, Northwestern University proved a perfect fit as Linnenbringer continued focusing on research, a passion she discovered at NHGRI. In her master’s program, Linnenbringer received clinical training to fully understand the components of genetic counseling sessions, during a clinical rotation with amyotrophic lateral sclerosis (ALS) genetic researchers. Embarking on her own research project, she surveyed prenatal genetic counseling patients and their genetic counselors at Chicago-area hospitals to determine their satisfaction with the counseling session.
With her master’s training complete, Linnenbringer combined her research knowledge and clinical experience as a project coordinator for Boston University’s Alzheimer's Disease Research Center, leading a multi-million dollar study. For the first time in her career, Linnerbringer contributed to research while counseling study participants. However, she realized, “the research part of my job was winning over the clinical genetic counseling part. But I knew that if I wanted to come up with my own research ideas and get them funded independently, I needed a doctorate.”
Attending the University of Michigan in Ann Arbor, a classroom experience expanded Linnenbringer’s opportunities. Arline Geronimus' research on health disparities of African Americans as a consequence of social exclusion, inspired her. “I was really struck by her course on health and poverty in the United States. At the time global health was a big thing, but she made a pretty convincing argument that we have our own health issues and disparities right in our own backyard.” Then a mom of two young children herself, Linnenbringer earned a predoctoral fellowship through University of Michigan’s Population Studies Center to study social demography and health disparities through a genetics lens, ultimately writing a dissertation around breast cancer racial disparities.
The Stars Align
“The stars lined up again,” Linnenbringer says of her return to WashU in 2014. She secured a faculty position in Washington University School of Medicine’s Division of Public Health Science to further Siteman Cancer Center’s health disparities research and reduction efforts. The following year, fate intervened yet again as Linnenbringer attended an online class for her genetic counseling recertification.
While tuning into a session about starting a genetic counseling program, Linnenbringer thought back to her mother’s prior suggestion and quickly realized the advantages of creating one at WashU. “We were having a hard time retaining genetic counselors in St. Louis, which negatively impacted patient care,” she says. Supportive colleagues and supervisors agreed with Linnenbringer’s assessment and encouraged her to move forward. The enthusiasm expanded and Linnenbringer connected with others, including Program Director Rachael Bradshaw and Associate Director Tomi Toler. Both are local genetic counselors who did much of the heavy lifting for the accreditation process, teaching several courses and setting up the clinical training components to help the endeavor.
In addition to her full-time position researching genetic and social risk factors that contribute to disparities in breast cancer, Linnenbringer spent five years working with her colleagues to prepare the program for accreditation. During that time, she and her colleagues designed the entirety of the program, including ensuring financial resources, developing class syllabi, creating a plan recruiting students, establishing tuition requirements and organizing clinical rotations.
In October 2020, while muddling through the pandemic, Linnenbringer learned that the program earned accreditation, the first in Missouri to do so. “It’s very exciting and a little nerve wracking,” she says. This fall, four students out of 100 applicants joined the inaugural semester. “I’m most excited about having a hand in teaching the next generation of genetic counseling students. My role will be providing their research training so I’m excited to share my passion with them.”
As she reflects on creating a master’s program at a major university, Linnenbringer says, “it’s kind of funny that you can speak something into existence. I had completely forgotten my mom’s advice, and twenty years years later it came to pass. It’s really fulfilling to see an opportunity and go for it.”
Leaders of the new Washington University Program in Genetic Counseling include Associate Director Tomi Toler, Assistant Director Erin Linnenbringer, Medical Director Marwan Shinawi and Program Director Rachael Bradshaw.