The influence of licensure on ABGC certification examination outcomes

The genetic counseling field established ABGC certification and state licensure as professional standards for practice. All current state licensure laws require passing the ABGC certification examination, although states differ in their requirements regarding how soon after graduation the examination must be taken. Graduates in states without licensure can schedule the certification examination at their preference. This study explores the influence of licensure requirements on timing to take the examination and likelihood of passing the examination. Genetic counselors who graduated between 2017 and 2021 were invited to complete a 20-question survey that included demographic information, first-time pass rates, year of graduation and the month and year they took the certification examination. Usable responses were received from 246 genetic counselors who responded to the survey, a minimum response rate of 12.9%. Participants were largely female (92.7%), white (88.6%), and almost evenly divided between those whose first job was in a state with licensure (56.3%) and one without licensure (43.7%). Those who worked in states with licensure took the examination significantly sooner than those who worked in states without licensure (p = 0.028) and were 2.4 times more likely to fail the first attempt [95% CI = 1.08-5.49]). When asked about personal preference on timing of the examination, those who "would have waited if there were no licensure requirement" were almost 7 times more likely to fail the first attempt (RR = 6.81, 95% CI = 3.10-14.97). This study identified an association between state licensure requirements, genetic counselors' timing of taking the ABGC examination, and their examination performance. The data suggest that the element of choice is an important factor in pass rates. New graduates need to be aware of state-specific licensure laws' impact on their ability to choose when to take the examination.