 Well, hello, I'm Eric Green, Director of the National Human Genome Research Institute, one of the institutes and centers that make up the U.S. National Institutes of Health. Welcome to our webinar to discuss the key findings from the recently released Human Genetics and Genomics Workforce Survey Report, which lays out a foundation for building the essential genomics workforce of the future. Now, in 2020, NHGRI published a new strategic vision for the coming decade of human genomics. That vision included a core principle outlining the need for an immediate and substantial commitment of attention and resources to bring both short and long-term changes that will make genomics a more equitable, just, and inclusive discipline. And one of the first steps of fulfilling that commitment was to create an action agenda for training, employing, and retaining a genomics workforce that reflects the diversity of the U.S. population, an effort that was led by NHGRI's Acting Deputy Director Vince Bonham. Now, while NHGRI is absolutely committed to providing leadership and resources in this area, ultimate success will depend on the collective efforts of the genomics community and its members. That's why we've invited our colleagues here today to talk more about the results of this Genomics Workforce Demographic Survey. This is underway to address workforce challenges and what lies ahead in the action agenda to build an inclusive, representative, and ultimately, more effective genomics community. So now I want to turn the spotlight over to our moderator for today's webinar, Vince Bonham, who will provide more context and also introduce our panelists. Thanks again for coming, and I'll turn it over to Vince. All right. Great. So great. Thank you, Eric. Thank you to everyone who has joined us today to be part of this conversation. I want to share a few slides to provide some context. So let me bring up my slides and make sure that everyone can see them. So let me just start by thanking you again for attending this webinar today and being part of this conversation with us today. And as we move forward, as we really focus on how do we develop the next generation of the genetics and genomics workforce. I am so pleased to participate as your moderator today, but really this is the opportunity to set some context of the report that we all had an opportunity to review and where we are today with regards to our profession and the future of our profession. So the purpose of our webinar today is to discuss the key findings of the Human Genetics and Genomics Workforce Survey Report and to begin a dialogue regarding the future of the Human Genetics and Genomics Workforce. So again, we are only at the beginning of how we can collaborate and partner to address the challenges that we have. I want to just acknowledge and recognize all that was involved with regards to the development of the report. I particularly want to highlight the institutions that are identified here, the American Society of Human Genetics, the American College of Medical Genetics and Genomics, the National Society of Genetic Counselors, the Association of Professors of Human and Medical Genetics, the American Board of Medical Genetics and Genomics, and the Minority Genetic Professional Network each participated in providing an opportunity for their members or their constituents to participate in the report. And I just want to thank you. And I particularly want to acknowledge and thank the American Society of Human Genetics for providing the leadership for these professional societies with regards to the survey and the development of the report. So I'm going to give you a couple of takeaways from my perspective and hopefully we will hear from each of the panelists of their own views about some of the major takeaways from the report. But one for me is that the report lays an important groundwork for the future assessment and action by individuals, organizations, departments, governmental and nonprofit academic industry sectors in the field of genetics and genomics. So it provides us all data that can help us as we move forward. Second, that the majority of the survey respondents identified were U.S. citizens as we look and understand the diversity of our genetic and genomic workforce, understanding who makes up the workforce is so important. That women made up the majority of the survey respondents and we may get into that conversation as we think about the professions and the majority of the individuals within genetic counseling being women and how we look at this report from the perspective of the different professions. The genetics and genomics workforce is predominantly homogenous with 67% of the respondents identifying their race, ethnicity or ancestry as white. And respondents' occupation areas of genetic counseling, 45% of the respondents made up that their primary profession is genetic counseling, 30% with the research and 23% in academic where the top three primary areas. So these are just some of the takeaways of the importance of the data that we all had an opportunity to review. But I want to put this in context of where we are as a field. And I often go back to October 2020 and the strategic vision that the National Human Genome Research Institute published for the field. And I'm going to take a couple of quotes from that vision statement that I think are appropriate for our conversation today. In essence with the growing insights and structure and function of human genome and ever improving laboratory and computational technologies, genomics has become increasingly woven into the fabric of biomedical research, medical practice and society. The scope, scale and pace of genomic advances to date were nearly unimaginable when the human genome project began in 1990. Even today such advances are yielding scientific and clinical opportunities beyond our initial expectations with many more anticipated in the decade. So a recognition that our field is moving very quickly and the need for the next generation of the workforce is so important as we prepare for all the exciting things that are happening within our field. The second quote is this, both in research and clinical settings, the global genomics workforce as with the general biomedical research workforce falls considerably short of reflecting the diversity of the world's population, which limits the opportunity of those systematically excluded to bring their unique ideals to scientific and clinical research. So this is a challenge that we face as a field and hopefully it can be part of our conversation today. So I'm going to ask each of the panelists to start with this question as they give brief comments in a minute. And my first question is this, what should we do now to create the workforce needed to fully realize the future potential of the genetics and genomics field? And so that is my question that I would like for each of you to start with. And with that, I would like to introduce our panelists. So you've met Dr. Eric Green, the director of the National Human Genome Research Institute. And our first panelist to speak will be Dr. Jasmine Jackson, who's a senior director for DEI for the American Society of Human Genetics, followed by Mark Williams, who is the president of the American College of Medical Genetics and Genomics. And finally, with Heather Zirhat, the director, the president, excuse me, the president of the National Society of Genetic Counselors. We have a great panel to have this conversation today. And with that, I'm going to stop sharing. And I would ask Dr. Jackson to start us off. Hello, and thank you so much, Vincent, and HGRI, Eric, for having today's conversation. I'm happy to join everyone as a panelist today. To start off with your question of what should we be doing now? I think that it's important that we not lose momentum and that we maintain laser focus not only on the importance of diversity, but also the importance of inclusivity and equitability. Diversity, which we've seen in this report that we'll be talking about today, is reflective of the representation of our workforce. And it is foundational that we have meaningful and representation across our workforce. But also, inclusion is just as critical. And to have a realize the future potential of genetics and genomics, we also need to ensure there is belonging and accessibility for our workforce. The inclusivity is that part of our training programs in our workplace. That does give us the retention and recruitment that we want across the human genetics and genomics field. And lastly, I would say that we have to maintain or galvanize our efforts in equity. I think of equity as not only a value, but a strategy. And equity is for all purposes to ensure fair and just opportunities for all. So those are the components that I think will be necessary for us to actually realize this future of our genetics and genomics. Thank you, Dr. Jackson, for those initial comments. So Dr. Williams. Thank you. And thanks for the opportunity to participate in this report and also in the webinar. First of all, I'd like to thank our ACMG representatives, Dr. Fouki Hissama and Dr. Fabiola Quintero Rivera. They also did double duty. Dr. Hissama also represented the American Board of Medical Genetics and Genomics and Dr. Quintero Rivera, the Association Professors of Human and Medical Genetics. I identified three areas in response to the question posed. The first is we established a diversity equity and inclusion committee at the college over three years ago, currently chaired by Dr. Cynthia Zepeda Mendoza. We've identified a number of initiatives, but this report is going to provide a much broader perspective on the workforce initiatives that this committee is considering. And I think it's going to be very useful to take the results and to contextualize those for the college as we look to take the areas that we have primary responsibility for and try and build those out. The second aspect that as we did a self-evaluation in the context of this issue was the lack of representation and diversity, not only in the workforce as a whole, but in particular in the leadership of the college. And as we began to go through how we chose leaders, we realized that we really have to provide opportunities for leadership at the level of committees and working group and tasks for task forces. Because if we don't provide those opportunities, the experience that is needed before becoming a board director or officer is really not available. And so one of the things that we've initiated is that for each committee working group task force that is established, we have a group that reviews that and each proposal has to specifically state what is being done related to diversity of the membership of the group, but also within the context of the proposal, how are aspects of diversity, equity, inclusion being included in the overall project. And I think that's going to be essential to build a diverse pool of leaders within the college that will ultimately help us all the way through our different levels of leadership. And I am very pleased that in our last round of elections, Dr. Hasama, one of the representatives on this report was elected to our board of directors. So that'll be a very welcome. Lastly, I wanted to talk about an internal workforce survey that we've done. So even before we knew about our opportunity to participate in this particular effort, we had initiated a workforce diversity survey for the ACMG. Now, we've held off on publicizing that report because we wanted to make sure that we took advantage of this report. But I think one of the areas that we'll be able to add some additional insight into is the focus on diversity within clinical and laboratory genetics, which, as you saw from the percentage breakdown, was relatively underrepresented in this overall report. And since that's our area of primary responsibility, we wanted to make sure that we focused on this aspect of the workforce, but also made sure that it is in harmony with the broader area. The other thing that that workforce survey has looked at, which is also referenced in this report but has not been mentioned yet, is the maldistribution of genetic services, clinical services within the country. We have vast areas of the country where there are no geneticists, genetic counselors, laboratory geneticists. And that has a real impact on access, which can exacerbate health disparities. So that's an aspect that we're going to also be working on to say, how can we be creative and innovative to reduce these geographic disparities that we've seen develop over time? Thank you. Great. Thank you, Mark. And so, Dr. Zirheit, if you could now, from your perspective, your thoughts. Sure. Well, you started with a quote or some quote. So I'll start with one, too. So one of my favorites is that we can't change what we don't measure. And I think this has been said by many different people in different ways. But the person that I attributed to learning about it is Dr. Rachel Hardiman, who studies the measurement of structural racism at the University of Minnesota. So go go first. That's where I'm from. So I want to thank the genetic counselors that were also on the advisory group, Michelle Techimoto, Barbara Harrison, Nicole Thompson, and the NSGC members and staff who were involved in distributing the survey and also everyone who took the survey because truly we wouldn't be here today without everyone who took the time and energy to to help us better understand our workforce. So but today I'm representing NSGC and one of our guiding principles is making sure that we can integrate genetics and genomics to improve health care for all. So this this question is particularly important to us as a society and we can only meet that goal by prompting and having active participation in these types of collaborative collaborations and having leadership of people with diverse identities and perspectives and backgrounds. And that was very much highlighted in this report. So we restart by thinking about within our organization. But as Mark was saying, this really extends to the larger health care systems and research systems where we're actively trying to work to empower our members and advocate others to really help create a community in which we can serve a diverse group of individuals in genetic services and research. And so to think about what we can do now. I usually think in frameworks and models, but I'll try to not show a graphic but explain what I what I mean by this is that there's this complex interplay between us as individuals and how we come to this space. The relationships that we form within our places of employment and where we study the communities that we we work in our professional and health care societies and then societal factors as well. And so what I think we need to do in order to fully recognize our potential is to think about these different levels of influence and how one factor can influence others and really that we need to think across these multiple levels at the same time to continue to move that progress that we were just that Chasman was talking about to really continue with that momentum moving forward on multiple different levels. And so I'll give some specific instances and think about ways that we can create what was I sent think sent in the report as tangible signs that this is a space and a place for inclusive culture. And so one example of the key findings was to look at inclusion and exclusion and reward systems. And I think that we can think about how are we forming relationships and graduate training and in our places of employment? How are we communicating to make sure that we're using inclusive language and how are we engaging in dialogue for some of these critical conversations that need to happen? How are we engaging in these interpersonal dynamics that uplift as Dr. Williams was saying in different positions? And then also, how do we foster that mentorship to do this work and continue to do this work and by celebrating and creating rewards and recognition that also increases that sense of belonging that I also agree we can start to think about it and maybe even measure. And then also thinking about this as another form of one of the key findings, which was data transparency, metrics and accountability and that having these types of public displays of our plans, of our organization, of holding ourselves accountable to our assessments. It can sometimes feel a bit performative as a leader, but it really is our way of trying to communicate what we are really trying to do and being transparent about it. And so I see this as a transition from an assessment to an action plan. And I think each of our organizations is trying to do that and also a way of fostering collaboration. And so the North American Genetic Counseling Organizations have put together a statement of collaboration to specifically measure and report back and have shared learnings on our JEDI efforts. And then lastly, DEI trainings are not enough. One of the other key findings I wanted to uplift some of the words of Dr. Crystal Lunkins at the University of Utah and Dr. Maya Robertson at Vanderbilt University, both who have expressed to me within the last year and has really stuck with me this notion of showing up. So thinking about showing up for these surveys, showing up for our research, showing up for these webinars, showing up for the crucial conversations, showing up for the diverse communities in the areas that we work and really dedicating the energy and resources in the space to do this over time. So I look forward to seeing this full potential and know that it will take time and resources and energy to do so. So thank you. Great. Now, thank you for those those comments. And I've been hearing already from each of you a little bit about some of the takeaways from the report, but I want to give each of you an opportunity if there are other takeaways that you want to highlight from the report. And I'm going to invite Dr. Green to join in the conversation as appropriate. So really just others thoughts on other things about the report that are your takeaways that you want to make sure that this audience is aware of. Vince, if I can step in here. I would also of the many takeaways I wanted to acknowledge that this questionnaire and survey took a stance intentionally from its advisory group to create questions, particularly around demographics, that respondents could see themselves as creating that space where the options weren't some of the standard, for example, standard sense or sense this questions around race and ethnicity uniquely within the human genetics and genomics workforce community. There's often interest to also use descriptors around ancestry. So I wanted to to acknowledge that that advice, I think was receptive in completion and getting the the input that we received around characteristics and composition of the workforce. Great, thank you. And let me just take a second. I'm asking the audience. We have a nice audience for this webinar today. If you have questions, please put your questions in the Q&A and so that we can engage with your your particular questions of interest. So other thoughts, other takeaways from the report. I mean, Vince, I would just add that, you know, the reason NHGRI thought this was a really important survey to conduct was, you know, really just wanted to make sure we we didn't pursue our action agenda flying blind. We felt it was important, you know, to at least have some some some baseline by which we can do future comparisons or we can do future surveys. But, you know, we just thought it was very important that this needs to be data driven to the best of our abilities, even if even if, you know, any data you get might be imperfect. And you always think of ways you may want it to be a little bit better. But, you know, we shouldn't just, you know, pursue an aggressive agenda based on on perceptions or based on anecdotes. And so, you know, I just think we want to be as thoughtful as we can be and have it be based on the most information that we can gather. And so this was a first by no means is the last step, but it was a very important first step. Great. Thank you. You know, if I can build on that, I think the, you know, a takeaway and it's understandable, given the nature and the intent of this report. But the takeaway is we've got a lot of work to do. And the actions about what to do next are not immediately apparent from the data that we have in front of us. So it's really on us to develop an action plan within each of our organizations, but I think also in more broadly across all organizations so that we can mutually reinforce the efforts that we're doing to really prioritize what are the things that we all need to be working on together. And then I think to echo what Heather said, which is we need to be measuring it. So we have to go in and we have to define outcomes and we have to measure those outcomes and hold ourselves accountable if we're not achieving those outcomes. If we don't do that, then this report is really going to lose a lot of the impact that it could potentially have. Can I ask the follow up question, Mark? Is are there ways that ACMG is currently approaching that with regards to its survey data and its work within the college? Well, as I mentioned earlier, we did do a workplace workforce survey looking at diversity, equity and inclusion. And so we have looked at those results in a preliminary sense, but to have sort of put that on hold waiting for this larger report to come out. And so our Diversity, Equity, Inclusion Committee and the Board of Directors is going to be now moving forward very rapidly to develop some tangible plans to take what we've now learned and to translate that into action, specifically impacting our fellows and constituents, but also looking farther into the pipeline back into medical education. And presumably even into pre-medical education to say, how can we really get people engaged in this so we can have more broader representation and just more folks that are involved in this extremely exciting field? I just, I don't know, I get excited every day I go to work. I can't imagine that if we can't craft a message that it's not going to be as engaging to everyone and we can really achieve great things. And Heather, I want to talk about NSGC. I mean, you guys have a long history of kind of, you know, measuring the feel. Can you talk a little bit about some of the survey work that you've done over the years? Sure. Yeah. So we have a professional status survey that goes out every other year. And then we also have surveys in those in between years that help us to understand specific things like billing and reimbursement or we did one that was specifically focused on JEDI. And so I appreciate Chasman talking about in that survey. We really thought about increasing the ways that people can identify and express that we actually have some measurements of belonging, for instance, in our survey. But to your question, when we think about our professional status survey data that goes out to all NSGC members, we do see a very high level of white women. So there's a lot of homogeneity. And I saw a question in the Q&A about that history, and I'm happy to talk about that at another time. But one of the things I did want to mention is that we also have data from the National Matching Services, so the genetic counseling field has a match. And we see that even in the last year, we have changing differences in the different diversity dimensions, specifically focused on race and ethnicity. And so we are seeing changes. And one of the things I wanted to highlight, because I was asked by someone who was on this committee to specifically focus, though, is that we still have certain groups where there are less than 2%. So if we look at our Hispanic and our Black students coming into the field, those numbers are still particularly low. So I think we should think about strategies for thinking about how are we increasing diversity and specifically to certain groups. And in our field, one of those categories is also people that identify as male. So I think that that is one of the demographics and things that came up from this survey that I wanted to talk about also was age. So if you see in the genetic counseling field, 70% of genetic counselors are less than 40 years of age, and that was 42% in this report. So we have a positively skewed distribution. And this is different than other health care fields and other types of, I think science fields maybe even as well. And so we have an opportunity there where we have a lot of people that are quickly entering the field. And so we can do some work and hopefully see some change fairly quickly. But that does mean that some of those mentorship opportunities are lower. And so it's putting some energy and thought into how we think about mentorship is also an important point. And I'll stop there, but I really want to talk about employment and the distribution of where providers are. So if I have an opportunity, I'd love to talk about that. All right, we will make sure you come back and talk about that. But you've really kind of laid out a number of challenges for the field of genetic counselors. And I'm really interested in hearing both from Jasmine and Mark, if you could just kind of bring that from other perspectives of the field. What are some of the major challenges that we are struggling as a community today? I think there are a number of challenges. I would like to focus a little on our trainees and early career professionals. As Heather mentioned, the importance around mentorship. I'll go even a step further to add sponsorship. I think that there are obstacles and barriers for many in the workforce to receive that quality mentorship and sponsorship. And I think that that is an area that we can work either independently or collaboratively on. ASHG has in partnership with NHGRI and Biogen and GSK and Merck, a flagship program, which is the Human Genetic Scholars Initiative. And that initiative, which was launched in 2019, really does focus on identifying and mentoring a select group of trainees and early career professionals. And so that has been a lot of our focus in reducing some of the challenges in the pathways that the younger professionals are experiencing. Yeah, just a couple of brief comments. It's interesting to contrast what Heather said about genetic counselors with geneticists. We, unfortunately, are probably skewing the other direction in the age, certainly on the clinical side. And that's going to be an issue for us as we look at workforce going forward, is how can we really attract more young professionals into the career and make sure that they are of diverse backgrounds? I think particularly on the laboratory genetic side, we're probably, we're looking a bit better on the diversity side, because we have a lot of individuals from international backgrounds that are practicing in the field. And as a consequence, we are somewhat less homogeneous when it comes to representation of some aspects of race and ethnicity. But certainly, I think we continue to be underrepresented compared to the United States population in individuals of African descent and those of Hispanic Latinx descent. So those are areas where we clearly have not done as good a job. And one of the interesting things that we found out as we were sort of exploring pipeline issues is that we reached out to the five medical schools associated with historically black colleges and universities. Not one of those colleges and universities has a board certified laboratory or clinical geneticist as a faculty member. So we have no one there to even represent the profession to these individuals to get them excited about it. So we're now partnering not only with those colleges and universities, but also with other medical schools that do not have board certified genetics professionals on their faculty to have the college provide opportunities for education around genetics that they can use as part of their curriculum. And so we're hoping that that will develop some more interest at the medical student level, as well as funding some student interest groups and genetics at medical schools, which are funded through the American College of Medical Genetics and Genomics Foundation. So these are some grassroots efforts that will take a few years to hopefully bear fruit, but certainly are things that we're very interested and very active in studying how that's going to impact not only getting more younger folks interested in the profession, but also a diverse more diverse group. Great. Thank you. So we've gotten a number of questions in. So I'm going to start to just kind of go through some of the questions that we have from our audience today. And if you can respond. So my first question here is with regards to how can the long standing telehealth genetic counseling options augment the access efforts mentioned by Mark Williams? So Heather, this is a question for you. How can telehealth and genetic counseling be a benefit to health equity? Yeah, I mean, as post pandemic, telehealth has absolutely changed the way that genetic counselors are practicing. I think nearly 70% of even clinical genetic counseling is done with a remote component some of the time. And so I do think that does help for some. There is other when we talk about those different levels, there's other things like societal issues, like getting broadband access and getting the abilities to get to various different places to provide a full telehealth experience. There's obviously telephone things like that. So there are ways that we are absolutely expanding access to rural areas. I will say, though, however, getting support to community based clinics continues to be a significant challenge. And this is really important and it goes back to the access issues that we were talking about and gives me the perfect opportunity to get in that fact that I wanted to about employment. So in this report, 13% of people that responded were employed at a private or community based clinic and only 1% in a government hospital. And we see similar data in our PSS where we just are not able to be able to support genetic counselors and community care. And that is where the majority of people are getting services in this country. And so if you're not at an academic health center, which has the ability to compensate for those services and other types of revenue streams, you are not able to provide that service to the people where they need it and when they need it on a regular basis. And so we really need to think about expanding our positions. And in order to do that, a critical issue is ensuring that we have insurance coverage that payers are also paying for those services and that we're being recognized by the federal government by the Center for Medicaid and Medicaid Services. And so the ability to bill and reimburse would allow us to expand where we are able to practice services and also where we are then able to recruit because you want to see someone who is able to understand what the genetic counseling is and get access to referrals to care in the communities where you are most comfortable. So thank you for that question. Thank you. So this is a question, you go ahead. If I could just add on just a couple things. First of all, this is, I think, one area where we can at least hold up a little bit of a placard of success. Telegenetics has actually been in use in some parts of the country for over 20 years. So Maine was one of the original leaders and then genetic services in the Pacific Islands, both the clinical genetics and genetic counseling has been studied in these settings. And actually with the exception of a few things that involve physical examination, the outcomes that have been achieved are essentially equivalent to in-person. So I think we actually have some good data that this is an effective thing. And we had some opportunities that Heather alluded to with the pandemic where a lot of the regulations that were impeding our ability to provide telemedicine services were relieved in the context of the pandemic. Now the problem is, is that regulations are trying to go back to where we were before the pandemic. And I think that's a really bad idea. So we've been advocating very strongly at the legislative level to try and keep the ability to access telemedicine services as they are. And Heather put her finger on it, the digital divide is a big issue. The fact that you can have telemedicine doesn't mean that you are somehow fixing the access problem because there's lots of people in lots of parts of the country that do not have access to high-speed internet and don't even have reliable cell phone service. So we can't consider this to be a panacea. Thank you. So the next question is for the group. How do we reach the people who need to hear the messaging from the report but who are not at this webinar? And there are thousands of those individuals, our colleagues across the country and across the world. What can we do? I think it's a great start that we're having this initial conversation at the webinar. But as you just inferred that this needs to be a continuous discussion, I think that it's also important that we use all of our channels, including social media. I think also having opportunities to hear from our communities and in a listening session type mode and aware that many of our organizations have not only reported out but really value that input that we necessarily need to make some of these changes. So I would say beyond the webinar itself, the continuation of dialogue and using all of our platforms to reach as many people as we can. Are we going to tick-tock? Should we make it tick-tock? Yeah, go for another. No, we're not going to do that. I'll just say one more thing. I think that it's important to integrate into continuing education and to really take the stage, like be on the plenaries, be on the important talks, be on the ones that everyone's listening to. And we've seen that be really, I think, helpful for our organization. Everyone's at a different point in their journey, but to have everyone in your organization at a large event be a part to hear what your organization is doing and how you're doing it. And then the other thing I'll just say, I was kind of joking about tick-tock, but kind of not. And that we have to make this information easy and accessible. So infographics, dashboards, quick things that people can reference that aren't highly detailed, but that can link to the details for everyone else, I think has been really effective for us as well. Maybe this is an opportunity for collaboration among the organizations to kind of create some of these resources that could be used across them. Great. So the next question is really more about our field. So it says, do you think human genetics and genomics training is a barrier to diversifying the workforce? And if so, what can human genetics and genomics training programs do to promote diversity? Well, Heather referenced quotes that she likes. I reference a quote that I like by Deming, an engineer who said, systems are perfectly designed to give you the results that you see. So I would say our human genetics training programs are perfectly designed to give us the level of diversity that we're currently seeing. So I think in that way, the answer to the question is probably yes. Now, having said that, understanding why and how we can re-engineer these programs to change that, I think is the really challenging part. Measurement of the baseline is an important first step. And so that's why this report is going to be so foundational. But I think now that we are clearly aware and have quantified the problem, we're now going to have to do the deep dive and say, what is it about the way we structure our training and our recruitment of trainees and our messaging around our field that is basically creating the scenario and what do we need to do to change it? Any other thoughts from the panelists? I can jump in. Twofold kind of what Mark was also saying in that we used to use the term pipeline, but that made one access point coming in. And now we've tried to use pathways and growing and being again, it's kind of intentional about where we're going and how we're thinking about our field. In genetic counseling, we actually have about 50% of the people that apply or get into the matching services who are not matched, which means we have an overabundance of people that are interested in genetics and genetic counseling. And so how do we think about, as we were saying, collaboratively coming together and thinking about what are the different types of roles within the genetics workforce and maybe also encouraging some people that may genetic counseling may not be for them or that may not be, how do we work together to bring people into the field and making sure that our pipelines are not just getting bigger, that we are actually making pathways, I think is one of the things I think about. And the two areas where I think we need to think about barriers from this data specifically is in those that identified as disadvantaged, whether that's economic or low income or rural areas, foster care or not having a parent or legal guardian that has a bachelor's degree, I think that's an area where we see differences also in racial differences and that maybe that we're able to support recruitment into the field for those that identify as white but less so for racial or minoritized individuals and also those that identify as a disability with 3% of individuals in this report identifying that way. And also there was comments about being afraid to disclose disability status as well as not having accommodations. So those are direct examples of ways in which we know that there's barriers and that people are identifying them in the report. Thank you. So the next question is related to the professional societies directly. Have the societies connected with traditionally minority serving institutions? And then it goes on as NHGRI leading this work and how could the groups work together to build a more diverse group of professionals entering the field and getting excited about genetics and genomics and what barriers exist to improving these relationships? Well, I'll start from an NHGRI perspective. So the Genome Institute has been involved in a variety of engagement with minority serving institutions as well as other institutions that are not research intensive institutions that are a part of our general grantee portfolio. And so one of the initiatives that I would just highlight is the Great Award Program where we are both targeting minority serving institutions but also ideal states. So as the state of Montana and Wyoming and Idaho and the institutions in those states as states to engage around working with research intensive genomic institutes to bring exposure to their students. So that's one step and one example of what we're doing in that strategy of working with institutions that may not be traditionally part of the research institutions that receive funding from our institute. One recent example that I can highlight is a collaboration between ASHG and NSGC in our efforts to exhibit and attend SACNIS and ABRACAM which are conferences that include trainees and students and faculty from minority serving institutions or from peoples who have been historically excluded within the field. And so that's been a consecutive number of years that we've been engaging in that even through the pandemic. As also as a part of ASHG's diversity equity inclusion action plan it is our efforts in the coming months to create our bridge and avenue to engage with minority serving institutions in particular starting with our historically black colleges and universities. So that is a part of our action agenda. Thank you. Anything else anyone wants to share on that topic? I was just going to highlight what Jasmine said. So thank you for doing it for me. And then also that we have a lot of partnerships and collaborations. So as a professional organization we really help to support the other groups that are doing it like MGPN and I'll just say that there's still a lot of work that needs to be done in resourcing and funding these types of master's programs in genetic counseling even with the exponential growth. And particularly at historically black colleges there was a partnership with Xavier University and I think they were looking for a program director so I'm just giving them a shout out if they're still looking for a program director I don't know if they are but like we need to support the people that are really doing this work too to start these new initiatives because it's a lot of it's a lot of uplift to get something like that started. So thank you and thank you for that shout out to Xavier University. So the next question is how do you plan to disseminate your action points and plans beyond just engaged parties? I think there may be eager people who want to engage in Jedi efforts but the ones we need to reach you often aren't showing up and don't prioritize these efforts. Any successful examples so far? I'll just mention again our intentional effort to make sure that we have diversity represented on all of our committees and working groups that has necessitated in some cases outreach from fellows of the college that are involved in these activities to individuals that haven't necessarily raised their hand to volunteer through the regular volunteer channels and so we've been very intentional about trying to reach out and that's really grown our pool of individuals that are available to participate in the work that not only brings that important perspective to all of the work that we're doing but also provides these individuals opportunities to co-author high impact publications to advance academic careers, develop visibility in the field and in the long run should help us to be able to develop a great cadre of leaders going forward that is going to continue to multiply these efforts. I can just add that we finalized our JEDI action plan over this past year and one of the exercises that we did was review all of our committees and their charges and see where that action plan kind of came together and so if you're involved and you're volunteering with NSGC you're going to see that it's interwoven throughout our committees and our charges and then also see the accountability each year or each half of a year or even quarter that we're going to be doing with Pulse surveys and so I think that just that continual momentum that Chasman talked about that continually showing that we're doing work and that we're integrating it throughout our organization as well as our educational opportunities so that people are seeing it within their space and their work and their specialties and they can actually see how it's integrated and applied has been one way that I think we've been trying to think about it at the organizational level that we hope goes through them you know the level to the individual and at ASHG I want to frame it that we have an organizational strategic plan 2019 to 2023 and one of the key goals in that strategic plan was is ASHG being a recognized leader in valuing, embodying and driving diversity, equity and inclusion in human genetics and genomics and so what that means for us is that it's a part of our mission and vision and so it is infecting the policies that we promote the programming that we do our annual meeting and so structurally we have a DEI task force that reports to our board and each of the task force members are represented across the committees of our organization but there's also through that action plan and because it is integrated as part of our function and work as an organization there's many opportunities for our membership and colleagues to engage and participate in advancing diversity, equity and inclusion I want to talk about early in the pathway one of the things that the Genome Institute decided to do with this action agenda is to start with a goal of exposing the general public and K-12 education to the fields of genetics and genomics and potential career opportunities and thinking about the pathway very early on and we're all you know really focused on at the time of either transition into clinical practice and clinical professional positions or research positions can you talk a little bit about what we should be doing with the general public and our efforts that we should be doing early and at early education thinking about K-12 education are there strategies and approaches that you think we should be addressing? I can start I think that one just even promoting the excitement around human genetics and genomics for high schoolers or students earlier in the pathway is important one aspect which I think several of peer associations as well as NHGRIs doing is utilizing things like DNA Day as an avenue to introduce the field as an opportunity and sparking the interest pretty early on that continuation I think those types of activities are important so that for those who may not be aware or even have access to what's available that early in the pathway So I'm just going to let everybody know I'm going to come at the end and give everyone an opportunity to make some closing comments so you can start thinking about your closing comments but I got a question and I'm going to expand the question that I got because the question was focused just on genetic counseling but I'm going to really expand it to the broader field of genetics and genomics that we're exploring today and how we can learn from history and the question with regards to how do we get to where we are here in 2022 with regards to what our workforce looks like and are there lessons that we can learn from that as we go forward to make sure that the workforce looks much more like our country and so any thoughts on this you know the question directly was related to you Heather the history of the genetic counseling program but I think we need to think about it more broadly and so I would love any comments from the group I can paraphrase and I can't from a talk that was at the recent NSGC meeting by Michelle Takimoto who was talking about the history of the field and before the MGPN Minority Genetics Professionals Network was put together and how coming into the field there really wasn't a place to have that community to speak about the different identities that people had and how that was influencing their experiences and so when I think about the history in genetic counseling there was a lot of people that tried to do this work ahead of us that had done a tremendous amount and that we didn't gather the ability to do so and so again that's when I think about the various different factors that need to happen and it started with finding a place for people to come together to try to make actual progress and have the data to do it and to think about what are the most important things that we need to think about as we move forward and as an outcomes researcher I think about interventions and how do we create mentorship and one of the things that Michelle talked about is having MGPN as a space for mentorship that's a form of a way that we can intervene to try to make a big change or that funding can help to do that so that's a grant funded group and similar to Golden and some of these other groups I'm going to get the name wrong but it's the genetics I wrote it down just so I would have it the genetics opportunities learning development and empowerment network which is specifically focused on thinking about pathways for individuals that come from Black or African-American backgrounds and so I think we have a history to look back on and see what didn't work well and make the really interventions that need to happen and that requires financial resources a long-term commitment and infusing it throughout all of our organizations and really creating this space for people to come together that really have the solutions and the experience to do that Great, thank you So I'm going to ask you History relates to evolution versus design you know our fields you know sort of evolve from interested individuals pulling together different things and they just sort of self-assembled as Heather said but we are at a point now where we cannot rely on that to move us to the next level we have to be very intentional about saying we've gotten to this point but we've also got the results that we got because we used the prior methods how can we intentionally redesign what we're doing to make ourselves inclusive and to attract people that you know otherwise would not be aware of what we're doing or not be interested in doing what we think is really exciting because the way we've self-assembled has just excluded them by the inherent nature of the biases that were built into that so I think again that the time is now to be intentional about what we're going to be doing next Great, thank you so I'm going to ask last comments from each of you give each of you about a minute for any last comments that you would like to share with the audience and I'll start with you Dr. Jackson as the first speaker My parting comment is one of gratitude I want to acknowledge and thank NHGRI for seeing the need to bring associations like us together in this collective effort to look at the future of the field and hopefully it being more diverse and inclusive and equitable I also think you know based on some of the conversations and saying though the challenges a takeaway for me is the opportunities that we can share together we each are doing important work we have action plans and strategies as independent associations there's great value and even some of the questions that have been raised here today of opportunities that we can join for us together so I would end with with you know an emphasis on creating a better future not only with with a diverse representation of the workforce but in a culture and climate that is inclusive and equitable and let's do it together Dr. Williams I didn't quite have enough time to google the Institute of Medicine a quote from the crossing the quality chasm which is what I really needed because it's so beautifully expressed but essentially what it says is you know it is not enough to talk about it it's now the time to do it and so we have the baseline we've got a great start with this report and the work that all of our organizations have done individually and together now we have to build on that and say what are we going to do next how are we going to do it how are we going to measure it and how are we going to help everybody learn from our successes and from our failures because we're going to have a lot of both right Dr. Zera I think in our report it was less talk more action that was the quote from our report but I I did focus a lot on barriers but I do see so many opportunities and I in my state of the society as I closed off the year I was reminded that yes we really need to have a focus on how we're thinking about equity and so thank you for for reminding me of that and I'll just stress that again to realize the interconnectedness of these issues and that they there's multiple layers to them and thinking about them across all of those layers and trying to do trying to think about how we're going to do all of them across addressing them at these multiple levels all at the same time and I also hope that as I was thinking it one of the questions we were asked to think about was to the future and how do we start measuring the outcomes of these now key findings so thinking about belonging inclusive spaces recognition microaggressions and really defining what we mean by belonging and so I also have to do one more thing and this is completely counter to who I am as an outcomes researcher but action is happening and sometimes it actually is hard to define and measure and deep debaubu the incoming president of NSGC I would be remiss if I didn't say this because she reminds me that there are many things that are impactful and that we cannot always measure those and culture changes one of them and I appreciate being a part of this and hopefully a part of that culture change moving forward so thank you again for the invitation thank you and thank you for each of you so a couple comments and then I'm going to give it over to Dr. Green to close us out one is we got a number of other questions that we weren't able to answer so we will have conversations and we will make sure we share back responses to some of those questions we want to just again thank everybody who participated today and I'm looking forward to the collaborations that we're going to have as professional societies and organizations and really trying to make change so on behalf of the TIDE office the training diversity health equity office and NHGRI I'm looking forward to working with each of you and your organizations as we go forward so with that Eric for any closing comments absolutely thank you Vance avoid that hour flew by and we really covered a lot of ground um let me first thank our partners who came and spoke today and shared their thoughts I think you can very much appreciate the fact that these different organizations including our own are using different lenses to look at this landscape and different perspectives and considerable overlap but also some unique features and that's what makes us very synergistic and very collaborative and so I sort of want to echo Vance's enthusiasm for continued interactions among these groups and continued collaborations I certainly want to thank well over a hundred of you who have participated in this we were quite impressed with how many joined us today we hope this was helpful and we hope it'll be the first of many conversations we'll continue to have with you and I want to thank Vance for moderating it and really spearheading a lot of this and organizing it and with with his leadership has been pivotal for seeing us move forward to this action agenda and stimulate these interactions among the community so with that I'll bring this to an end thanking everybody one last time and the key is to be continued because that's where we're heading thank you thank you