genetic testing, which is largely paid for out-of-pocket by the client/patient. Training A one-year graduate diploma program was established in 1995, and a two-year Master's level training program was established in 2008. There are currently two Master's training programs in Australia accredited by the Human Genetics Society of Australasia (HGSA). Credentialing/certification/licensure New graduates practice as an Associate Genetic Counselor under the supervision of a certified genetic counselor and a clinical geneticist. They can submit to the HGSA certification process via a portfolio application after one year of practice. Recertification is currently voluntary and available by completing continuing education units (CEUs). Reciprocity (internationally and locally) Genetic counselors with training from the UK, Europe and Australia are eligible for registration and GCs from other countries are considered on a case-by-case basis. More information can be found through the Australasian Society of Genetic Counsellors, a special interest group of the Human Genetics Society of Australasia. North America Education A genetic counselor is an expert with a Master of Science degree in genetic counseling. Programs in North America are accredited by the Accreditation Council for Genetic Counseling (ACGC). There are currently 52 accredited programs in the United States, four accredited programs in Canada, and four programs with the intent to become accredited. Students enter the field from a variety of disciplines, including biology/biological sciences and social sciences such as psychology. Graduate school coursework includes topics such as human genetics, embryology, ethics, research, and counseling theory and techniques. Clinical training including supervised rotations in prenatal, pediatric, adult, cancer, and other subspecialty clinics, as well as non-patient facing rotations in laboratories. Research training typically culminates in a capstone or thesis project. State licensure As of May 2019, 29 states have passed genetic counselor licensure bills that require genetic counselors to meet a certain set of standards to practice. These states are Alabama, Arkansas, California, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, and Washington. Almost every other state in the United States is in the process of obtaining genetic counseling licensure. Although genetic counseling has been established over four decades, the first licenses for genetic counselors were not issued until 2002. Utah was the first state to do so. The American Society of Human Genetics (ASHG) has since encouraged more states to license genetic