A licensed genetic counselor or supervised genetic counselor license is required to practice genetic counseling in Maryland beginning on January 1, 2024.

An applicant for licensure as a licensed genetic counselor shall complete an application supplied by the Board and pay the application fee. In addition, the applicant must meet the following requirements:

1. 18 years old or older;
2. Good moral character;
3. Oral and written competency in English as required by the Board;
4. Completion of a criminal history records check;
5. Graduation from an educational program accredited by the Accreditation Council for Genetic Counseling or an equivalent accrediting body recognized by the American Board of Genetic Counseling; and
6. Certification by the American Board of Genetic Counseling, its predecessor, or its successor.

An applicant who meets all requirements for licensure except for certification by a national certifying board may qualify for licensure as a licensed genetic counselor if the applicant:

1. Has worked as a genetic counselor for at least 10 years before January 1, 2024, including at least the five consecutive years immediately preceding the application date;
2. Has graduated from an educational program accredited by the Accreditation Council for Genetic Counseling or an equivalent accrediting body recognized by the American Board of Genetic Counseling; and
3. Submits to the Board three letters of recommendation from licensed physicians who have been licensed for at least five years or certified genetic counselors eligible for licensure who have worked with the applicant in an employment or professional setting for at least three years, and can attest to the applicant's competency in providing genetic counseling services.

An applicant who wishes to apply via this alternative pathway must do so on or before 31, 2024.

For Board staff to determine if the applicant is eligible for licensure via the alternative pathway, all letters of recommendation should include the following information:

1. How long the author worked with the applicant in an employment or professional setting (including specific dates);
2. A description of the employment or professional setting where the author worked with the applicant (including the names of any institutions); and
3. In what capacity the author worked with the applicant.

On average, the licensure process takes between two and four weeks. However, the process may take longer depending on the individual applicant's circumstances or if the applicant does not provide the required documentation on a timely basis.

If, while practicing genetic counseling, a licensed genetic counselor or supervised genetic counselor determines that a patient requires a diagnosis, treatment, or management, the genetic counselor is required to refer the patient to a licensed physician or another appropriate health care practitioner and document the referral in the patient's medical record.

The scope of practice of a licensed genetic counselor or a supervised genetic counselor includes the following:

1. Obtaining and interpreting individual, family, medical, and developmental histories;
2. Determining the mode of inheritance and risk of transmission of genetic conditions and birth defects, including evaluating the risks from exposure to possible mutagens and teratogens;
3. Discussing the inheritance features, natural history, means of diagnosis, and management of genetic conditions and birth defects;
4. Identifying, ordering, coordinating, and explaining the clinical implications of genetic laboratory tests and other diagnostic studies and their results;
5. Integrating genetic laboratory test results and other diagnostic studies with personal and family medical history to assess and communicate risk factors for genetic or medical conditions and diseases;
6. Assessing psychosocial factors;
7. Recognizing social, educational, and cultural issues;
8. Evaluating the patient's or family's responses to the condition or risk of recurrence and providing patient-centered counseling and anticipatory guidance; and
9. Facilitating informed decision-making about testing, management, and alternatives.

An applicant for licensure as a supervised genetic counselor shall complete an application supplied by the Board and pay the application fee. In addition, the applicant must meet the following requirements:

1. 18 years old or older;
2. Good moral character;
3. Oral and written competency in English as required by the Board;
4. Completion of a criminal history records check;
5. Graduation from an educational program accredited by the Accreditation Council for Genetic Counseling or an equivalent accrediting body recognized by the American Board of Genetic Counseling; and
6. Applied for the first available national certifying examination and received active candidate status.

The Board may not issue a supervised genetic counselor license to an applicant if the applicant has failed the national certifying examination two or more times.

A supervised genetic counselor license expires one year after the date of issuance, on notice of the second failure of the certification examination, or upon conversion to a genetic counselor license, whichever occurs first.

A supervised genetic counselor license may not be renewed or extended beyond one year.

A supervised genetic counselor can be supervised by a licensed genetic counselor who has practiced for at least three years after passing the national certifying examination or by a physician who has been licensed in Maryland for at least five years.

A supervised genetic counselor must enter into a written supervision contract with their qualified supervisor. This contract must specify the manner of supervision and identify any alternative qualified supervisors, as appropriate. The supervision contract must be maintained by the qualified supervisor and the supervised genetic counselor and made available to the Board upon request.