Women’s health training - priming the pump
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Women’s health training - priming the pump






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    Women’s health training - priming the pump Women’s health training - priming the pump Presentation Transcript

    • Women’s Health Residencies and Fellowships: Priming the Pump for Women’s Health Researchers Melissa McNeil, MD, MPHProfessor of Medicine, Obstetrics, and Gynecology Chief, Section of Women’s Health University of Pittsburgh and VA Pittsburgh Health Care System
    • What Makes a Women’s Health Researcher? Understanding of what women’s health means as a concept: – Diseases unique to women – Diseases that are more common in women – Diseases that are different in women Inquiring mind able to ask interesting questions about important questions Joy and passion for research
    • How to Incorporate Women’s Health into a Curriculum?Questions to consider: What level of training: preclinical medical student, clinical medical student, resident, fellow Separate or integrated educational experiences in women’s health (eg, teaching in categorical residency vs women’s health residency track?) Elective or mandatory experiences?
    • Goals of Educational Experiences at Pittsburgh Often and early exposure Offer both integrated and focused experiences Integration is mandatory for ensuring all learners have exposure to concepts of gender specific medicine Focused experiences important to allow for more in depth study for those with heightened interest Accountability is critical
    • WHT at Pittsburgh Instituted at the request of the Dean First class recruited in 1994 Three spots from the categorical residency designated as “women’s health track” Separate match number Can expand to accommodate demand from within the program
    • WHT Curriculum Weekly WH Seminar Series Unique ambulatory site with “gender based primary care” precepted by WH faculty Specialized rotations in lieu of community based ambulatory blocks – Year 1: Urgent Gyne Clinic – Year 2: Rotating Specialty Block, Mental Health – Year 3: Rotating Specialty Block, Medical Complications of Pregnancy, Student Health
    • WHT: Components of Success Buy in from leadership: Program Director, Division Chief, Chairman, Dean Dedicated faculty with General Medicine Identify partners within medical subspecialties: oncology, cardiology, endocrine, GI, cardiology Identify partners in other departments: obgyne, psychiatry, adolescent medicine
    • WHT: Components of Success First and foremost, goal of the program is to train high quality internists All faculty are internists first; can discuss hyponatremia as well as contraception Avoid the “feminazi” label Close mentoring: WH faculty mentor clinics, senior talks, journal clubs Provides a sense of belonging within a large university residency program
    • WHT as a Springboard forInterdisciplinary WH Research Residents seeking fellowships seek research opportunities and ways of distinguishing themselves from the pack A WH focus allows for a unique identity and the ability to consider the depth and breadth of WH in the care of patients Broadens the scope of what WH research can mean and begins to establish areas of inquiry
    • Interdisciplinary WH Research: Medical Students What is the best/most satisfactory anesthesia for women in labor? What are the views of medical students regarding reproductive choice? What do women domestic violence victims want from their providers? What is the prevalence of the female athlete triad syndrome in high school athletes?
    • Interdisciplinary WH Research: Medical Resident Research What is the impact of inflammatory bowel disease on a woman’s fertility? What is the impact of inflammatory bowel disease on a woman’s sexuality? What is the association between cardiac disease in women and psychosocial conditions? How is congestive heart failure different in men and women?
    • WHT: Benefits to Program Recruiting tool for individuals looking for a unique nitch in medicine Develops a critical mass of individuals with similar interests for seminars, lectures, etc. “Infiltrative” approach to women’s health in the rest of the program Supports the WH fellowship
    • WHT: Measures of Success Continued ability to recruit high quality residents (currently 16 in the three year track) Chief resident from the program every year for the last five years Success in career choice/fellowship: current senior resident career choices: endocrine, rheumatology, GI, WH, CMR
    • Women’s Health Fellowship Initiated in 1994 One of the original VA funded special fellowship programs One fellow each year for a two year fellowship with opportunity for a third year of funding Goals are to train academic physicians— either medical educators or researchers
    • Women’s Health Fellowships Strong environment Educational opportunities: Masters in Reproductive Epidemiology, Master’s in Clinical Science, Master’s in Medical Education Content focus available in each master’s program
    • Women’s Health Fellowships Research Opportunities – Graduate School of Public Health with a focus on women’s health epidemiology – Magee Women’s Research Institute – Pittsburgh Cancer Institute with emphasis on breast and ovarian cancer programs – Women’s Heart Program – Women’s Behaviorcare Program
    • Components of Success Dedicated Funding Included within the broader general medicine fellowships Strong clinical, educational, and research environment Many mentors Critical mass Seed money for research
    • Women’s Health Fellowships 25 % clinical time for research fellows (1/2 day of clinic precepting and ½ day of own clinic, all in women’s health program) Pursuit of master’s degree with training in clinical research methodology Requirement for research project with dissemination (poster, oral presentation, publication)
    • Food for Thought How big is the market? How much interest is there for more and more programs? Separate program or recruit from within? Should we define competencies for a certificate of completion of a WHT for residents or a women’s health fellowship?