In 1991, SLCHGP faced an unexpected force: competition. Some 15 programs were up and running in North America—from McGill University in Montreal, to the University of South Carolina, from Howard University to the University of California at Irvine. Many of the competing programs attracted students with their combined offerings of large financial aid stipends and low state tuition.

Over the course of the 1990s, the need for genetic counseling would grow. Nearly all chronic diseases were shown to have an incidence of a strongly inherited predisposition. As a result, SLCGHP graduates would find a growing number of opportunities to serve in different areas of the field.

SLCHGP, under the leadership of Joan Marks, continued to dominate the field. Of the 850 active counselors, 450 had been trained in Bronxville. Still, the prevalence of sister programs made SLCHGP redouble its efforts at improving facilities, recruitment, housing and funding. And as students remained predominantly younger, financial aid became a greater priority.

The Schultz Foundation’s support in 1992 thus came at a crucial time. The Foundation pledged more than $500,000 to build a cutting edge genetics lab in SLC’s new Science Center. In addition, the grant created an endowment fund to provide yearly scholarships to students.

New faculty members such as Eva Griepp, M.D., of Mt. Sinal School of Medicine, and Sue Gross, M.D., of Albert Einstein, were recruited to enhance the program with important areas of study such as Reproductive Genetics and Human Embryology.

There were some setbacks to the M.S.-level genetic counselors. In 1992, the American Board of Medical Genetics, responding to pressure from the American Board of Medical Specialties, moved to exclude genetic counselors from existing accreditation by the ABMG.

On the whole, however, the program and the larger field experienced growth. The advent and expansion of managed care highlighted the relative cost effectiveness of genetic counseling. And new areas were opened to exploration. In 1994, when 250 graduates assembled at SLC to celebrate the program’s 25^th anniversary, there were 20 sister programs nationwide; six were run by SLCHGP graduates. The number of applicants to SLCGHP rose 58 percent between 1991 and 1995.

The program continued aggressively to seek funding for new initiatives. In 1994, the U.S. Department of Energy granted the program $20,583 to offer a week-long workshop on Molecular Diagnostic Techniques for practicing genetic counselors in the tri-state area. And a 1996 grant from the National Cancer Institute, NIH, allowed SLCHGP and the University of Washington to collaborate on a five-year a study of breast cancer in Jewish women in hospitals in New York City and Long Island, with Mary-Claire King, a University of Washington geneticist, and Joan Marks as co-directors. Subsequent funding has been received for four years from the Breast Cancer Research Foundation.

By 1996, the genetic counseling profession numbered more than 1,000. And within it, Sarah Lawrence’s 500 graduates explored broader horizons. Most continued to be employed as genetic counselors. Indeed, a 1995 survey of 100 alumnae, found 89 percent employed as genetic counselors, with 57 percent of the jobs funded by hospitals. Teaching and research were also important components of their careers. Some 55 percent were involved in training other students, and 73 percent reported they had articles published in scholarly journals.

Consistent with the expanding horizons of the field, graduates found new opportunities. They took positions as in-house genetic counselors at institutions serving the mentally retarded. Some opened their own clinics, or worked for pharmaceutical companies or became affiliated with commercial genetic counseling facilities. One flew around rural Missouri in a chartered plane, as part of a medical genetics team serving far-flung communities.

In 1997, SLCHGP became the first program to be accredited by American Board of Genetic Counseling. By 1998, the field was well established.