Table 2.

Themes, sub‐themes, and sample quotes from respondents

1. The current state of medical genetics services
1.1 Medical geneticists provide genetic counseling 1.2 Shortage of medical geneticist jobs and regional distribution issues 1.3 High number of missed visits because patients cannot afford travel or cost of services 1.4 Limited genetic testing options	“... for example at the [public sector] it [the wait list for an appointment] can be three months to almost a year. We have had various cases of patients who are fighting the waitlist, especially in regional hospitals. Since there are very few cities with medical geneticists, (patients) take a long time to get to us, and they have to cross half of the country to arrive at this service.”
2. Impact of education about medical genetics practice
2.1 Physicians receive limited genetics training 2.2 Courses not required for all medica students 2.3 Courses often non‐clinical in focus and/or taught by non‐clinicians 2.4 Lack of education about medical genetics leads to limited referrals 2.5 Medical geneticists desire more GC training for themselves	“The main barrier is that many medical students in the country do not take clinical genetics. So, a limiting factor that we have even outside of the institution is that the physician does not have the awareness to refer patients to genetics, even for malformations.”
3. Patient features that impact provision of medical genetics
3.1 Low health‐literacy 3.2 “Magical” beliefs 3.3 Lack of preventative healthcare culture 3.4 No perceived significant impact of religion on acceptance of services	“In Mexico we do not have a preventative medicine culture. This is to say, we do not treat symptoms until they are at advanced stages, and so I think that genetics is a very important change beyond a family or individual level, but more at a level of the health sector.”
4. Views towards a genetic counseling profession and program
4.1 Positive attitudes overall 4.2 Concern about impact on medical geneticist workforce and workflow 4.3 All agreed classroom and rotation based teaching feasible 4.4 Recommended GC training involve a 2 years masters for health professionals	“The demand for genomic diagnostic testing is increasing and so the results will have to be managed and explained by people who have the capacity, and medical geneticists will not be able to do all of that. So, I think that is one of the things that will catalyze this… that could catalyze it.”

Additional quotes provided in Supplementary material 6.