As genetics becomes increasingly integrated into all areas of health care and the use of complex genetic tests continues to grow, the clinical genetics workforce will likely face greatly increased demand for its services. To inform strategic planning by health-care systems to prepare to meet this future demand, we performed a scoping review of the genetics workforce in high-income countries, summarizing all available evidence on its composition and capacity published between 2010 and 2019. Five databases (MEDLINE, Embase, PAIS, CINAHL, and Web of Science) and gray literature sources were searched, resulting in 162 unique studies being included in the review. The evidence presented includes the composition and size of the workforce, the scope of practice for genetics and nongenetics specialists, the time required to perform genetics-related tasks, case loads of genetics providers, and opportunities to increase efficiency and capacity. Our results indicate that there is currently a shortage of genetics providers and that there is a lack of consensus about the appropriate boundaries between the scopes of practice for genetics and nongenetics providers. Moreover, the results point to strategies that may be used to increase productivity and efficiency, including alternative service delivery models, streamlining processes, and the automation of tasks.
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GenCOUNSEL was funded through the Large Scale Applied Research Project (LSARP) Genome Canada competition with cofunding from the Canadian Institutes of Health Research (CIHR), Genome BC, Genome Quebec, the BC Provincial Health Services Authority, BC Children’s Hospital Foundation and BC Women’s Hospital Foundation. The GenCOUNSEL Study is led by Alison M. Elliott, Jehannine Austin, Bartha Knoppers, and Larry D. Lynd with Project Manager Alivia Dey, and includes the following coinvestigators: Shelin Adam, Nick Bansback, Patricia Birch, Lorne Clarke, Nick Dragojlovic, Jan Friedman, Debby Lambert, Daryl Pullman, Alice Virani, Wyeth Wasserman, and Ma’n Zawati. We thank the Australian Genomics Health Alliance Workforce & Education program who collaborated with the Human Genetics Society of Australasia, Australasian Association of Clinical Geneticists, and Australasian Society of Genetic Counsellors to collect the Australasian census data. We also thank the Canadian Association of Genetic Counsellors and the National Society of Genetic Counselors for allowing us to include their workforce surveys in our review.
The authors declare no conflicts of interest.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Dragojlovic, N., Borle, K., Kopac, N. et al. The composition and capacity of the clinical genetics workforce in high-income countries: a scoping review. Genet Med 22, 1437–1449 (2020). https://doi.org/10.1038/s41436-020-0825-2
- clinical genetics
- genetic counselor
- clinical geneticist
- human resources
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