Women’s Health Pathway

PATHWAY STUDENT INTRODUCTION

Ana E. Núñez, MDAssociate Professor, Medicine

Women’s Health Pathway Director

Welcome - What’s value added about the pathway?• Tailored senior experience linked to interests/needs• Helpful nudges to get personal statements, CV’s,

boards done perfect and out in time….• Resources to a national network via the Center of

Excellence’s system of physicians and leaders in medicine in various disciplines

• Participation in diverse, interactive and fun activities• Obtain training in IRB to enable research work now

and in the future• Exploring options in medical education, health policy

and networking as you design your career for the future

• Opportunity to function in a multi and interdisciplinary way

Pathway was created to:

• Advise

• Counsel

• Enable the development of the next generation of physician leaders in sex and gender medicine in every discipline of medicine

Overview

• Overarching Goals and Objectives

• Structure and Function

• Evaluation

Overarching Pathway Goals• Open to all disciplines• Academic advising• Student professional mentorship• Oversight of senior level skills development

WH Pathway Focus on Sex and Gender Medicine

• Students will obtain:– essential skills, body of knowledge, skills and

attitudes needed to deliver advanced, high quality, culturally appropriate care for women

– achieved by required and elective courses in women's health in clinical, basic science, academic, psycho-social and research areas

• Required WH Ambulatory Clerkship– builds on Primary Care Skills– multi-disciplinary approach to health care concerns of

the female patient, beyond their reproductive functions

Example of ObjectivesKnowledge Components

• Diseases that are unique to or more common in women or for which there are differences in diagnosis and treatment for men or women

• How to take an appropriate history from and know how to perform a complete and sensitive physical exam

• The factors determining "women's wellness" over their life cycle and enable women to participate in disease prevention

Skills Component

• Deliver effective, culturally appropriate women's health care in a multidisciplinary setting.

• Increase their abilities to analyze the literature and incorporate into clinical practice

• Synthesize diverse situations and opportunities in women's health

Attitude Components

• Demonstrate an attitude which will ensure appropriate health care for women

• Demonstrate an attitude which indicates an appreciation of the power of the physician

• Display an attitude which indicates an understanding of the diversity of women in the community, based on differences in race, culture, ethnicity and social and economic factors and how this impacts on health care

WH Four Week Rotations Stuff

• Required rotation – WH Ambulatory• Addition rotations:

– Community* – College Health – Block 5 and 8 Only– Archives*– Policy*– Education/Academic*

*Needs preparation prior to rotation to optimize the experience

Required Five Components WH Ambulatory

1. Clinical Activities: Primary Women’s Health Care and Specialized Skills – Tailored to Student’s Needs and Interest

2. Academic Activities: Paper, Women’s Health Resource Materials, and Journal Club, Guiding Questions

3. Community Outreach Experience

4. Mentoring – attending women’s health activities and providing leadership at programming

Clinical Activities

• Primary Women’s Health Care • Inter- and multi-disciplinary primary care

focused• students role model with women's health

experts• increase their knowledge and skills in

clinical care• Specialized Skills in Women's Health

• Students have an opportunity to refine skills such as:• interpretation of mammographic findings• Analysis of pelvic floor dysfunction• Addressing special needs of women with HIV• Other selections tailored to future specialty

Electives

• Education / Academic Elective

• College Health

• Women’s Health and Public Policy

• Women’s Health in the Community

• Women Then & Now: Women and History—A Women’s Health Education & Archives Elective 

Student Responsibilities

With the exception of the WH Ambulatory rotation, students may enroll in any rotation for credit as a core pathway elective if they fulfill the following responsibilities:

• meet with the Pathway Director (PD) and – develop rotation-appropriate women's health objectives;

have mid-point formative feedback; end of the rotation project presentation and summative evaluation.

• meet all required clinical expectations of the rotation• use the WH checklist of competencies and review this with their

clinical supervisor• develop a WH focused project to be completed over the four

weeks• attend women’s health seminar series and WH events/activities• provide leadership to years 1-3 in mentorship opportunities• promote the pathway and sex and gender medicine at Drexel,

regionally and nationally• help identify and recruit new preceptors to the Pathway• help refine and create new educational opportunities

Community Experience and Enduring Materials2. Academic Activities:

• Required answering of guiding questions to readings in women's health

• Focused survey paper – topic based upon student interested and signed off by PD. Their paper will include a review of the literature and synthesize their particular learning acquired during the four–week rotation

• Bulletin board or newsletter that complements the curriculum• Journal Club

3. Community Outreach Experience• Students will spend a portion of their time in a community

setting that compliments their clinical experience4. Mentoring

• Students will attend Women’s Health activities and provide leadership at programming

• Example - Seminar series, journal clubs, health fairs, and workshops

Student Timeline

Spring Year 3 Students select pathway

Spring Year 3 Students participate in orientation meeting

Spring to Summer

Individual student meetings to tailor pathway to interests and cover essential Women's Health concepts

Fall Year 4 Students begin pathway rotations. Mid-rotation evaluations within required Ambulatory Rotation. Paper topic delineated during this session.

Spring Year 4 Group Pathway meeting

Spring to Graduation

Individual Exit Interviews

Reciprocal Relationships

• Collaborative arrangements– Obstetrics/Gynecology– Pediatrics

– Meaning that Women's Health Pathway students interested in Ob/Gyn or Peds are invited and fully included in Ob/Gyn or Peds Pathway activities.

• New collaborators welcome

Pathway Trends

Year Pathway No.

Elective No.

1999 - 2000 3 9

2000 – 2001 2 7

2001 – 2002 9 14

2002 – 2003 6 12

2003 – 2004 7 20

2004 – 2005 9 102005-2006 6 15

0

5

10

15

20

25

30

1999-2000

2000-01 2001-02 2002-03 2003-04 2004-5 2005-6

Pathway Elective

Recent Graduates Name Program Hospital City2003 (6)Rebecca Smith Pediatrics UNC Chapel Hill, NCHaleema Javid Radiology Christiana Care Christiana, DENyali Taylor Surgery Pennsylvania Hosp Philadelphia, PASumana Kesh Medicine Brown University Providence, RINancy Matteer Medicine Baylor Baylor, TexasAmy Baranoski Medicine Thomas Jeff Univ Philadelphia, PA

2004 (7)Faunda Campbell Ob/Gyn Lehigh Valley Lehigh, PAAmparo Gordian Medicine Lenox Hill Hosp New York, NYNkiruka Ohamej Medicine John Hopkins Baltimore MDStacey Scheib Ob/Gyn Thomas Jeff Univ Philadelphia, PAKerri Kissell Medicine Univ of Maryland Baltimore, MDAnca Barbu Surgery Univ Hosp Cleveland Cleveland OHTracie Gong Pediatrics UCSF – Fresno Fresno, CA

2005 (9)Tracie Bennett Ob/Gyn Barnes-Jewish Hosp MO St. Louis, MOLeelia Franck Family Med Univ Mass Med School Worcester,MACynthia Lim Medicine Temple University Philadelphia, PAMarin Mercurius Ob/Gyn St Joseph’s Hospital Ann Arbor, MIAmie Miklavcic Ob/Gyn Virg Commonwealth Univ Richmond, VAKirin Munar Pediatrics Miami Children’s Miami, FLMeredith Profeta Pediatrics University of Michigan Ann Arbor, MINatasha Sandy Family Med Mountainside Hosp Montclair, NJShalini Shah Family Med York Hospital York, PA

Graduating Pathway Students

Name Program Hospital City2006 (6)Sarah Katel Ob/Gyn KP Los Angeles Los Angeles,

CADianna Moseley Ob/Gyn St. Joseph’s Mercy Ann Arbor, MINina Nanda Family Med UCLA Medical Center Los Angeles,

CAGretchen Strahle Ob/Gyn Abington Hospital Abington, PAShiv Sudhakar Internal Med KP Santa Clara Santa Clara,

CAKarbo Tam Ob/Gyn KP San Francisco San Francisco,

CA

Women's Health Pathway Specialty Selection 2000-2006

Ob/Gyn

IM

FM

Peds

Surg

Neuro

IM- Geriatrics

Ortho

IM- GI

Rad

Qualitative Feedback

• Most attractive elements of the pathway:– Good resources, good opportunity to

share resources– Diversity of electives and opportunities

to explore areas outside of your chosen specialty

– Guidance– Personal approach of office– Students receive autonomy to choose

paper topic– Professional development

Suggested Changes:

• Limited staff makes organization and timeliness frustrating

• More guidance to students entering family medicine

Future Plans

• Formalize recruitment of new faculty preceptors and clinical sites

• Develop new elective opportunities– Introduction to clinical trials research– Evidence based medicine review– Interventional aspects in sex and gender

medicine– Pelvic floor rotation (under development)– Inpatient women’s health rotation– And a bunch of other things…..

2006 Exit Evaluation Data

Strongly Agree

Agree Neutral

Received useful advice regarding Senior Course selection from Pathway Advisor

33% 50% 17%

Received useful advice regarding career choices from my Pathway Advisor

40% 40% 20%

Found the Pathway helpful in attaining educational objectives

33% 67%

2006 Exit Evaluation Data

Found faculty in my principal Pathway to be:

Strongly Agree

Agree Disagree

effective role models 33% 67%

effective teachers 33% 67%

helpful in providing useful advice regarding application to residency programs

17% 67% 17%

In my Pathway, I:Strongly Agree

Agree Disagree

achieved the goals and objectives 17% 83%

felt the learning climate was optimal

17% 67% 17%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Useful Sr Course Advice

Useful Career Advice

Path met objectives

Faculty effective Role models

Faculty effective teachers

Faculty's advice useful for residency

Met Goals in Path

optimal learning climate

Path highly effective

Evaluation of Women's Health Pathway

Strongly agree Agree Neutral Disagree Strongly disagree