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					Women’s Health Pathway


             Ana E. Núñez, MD
        Associate Professor, Medicine
       Women’s Health Pathway Director
Welcome - What’s value added
about the pathway?
• Tailored senior experience linked to
• 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
• 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
• 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
        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
    Example of Objectives
 Knowledge 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
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
• Demonstrate an attitude which indicates
  an appreciation of the power of the
• 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
• 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
Clinical Activities
•   Primary Women’s Health Care
     • Inter- and multi-disciplinary primary care
     • students role model with women's health
     • 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

•   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
• 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 Materials
2.   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 experience
4.   Mentoring
      •   Students will attend Women’s Health activities and provide
          leadership at programming
      •   Example - Seminar series, journal clubs, health fairs, and
Student Timeline

Spring Year 3 Students select pathway
Spring Year 3 Students participate in orientation
Spring to      Individual student meetings to tailor
Summer         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      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
                   Pathway        Elective                     Year     Path   Elective
30                                                                      No.
25                                                             1999 -
                                                                2000     3       9
                                                               2000 –
                                                                2001     2       7
                                                               2001 –
10                                                              2002     9      14
                                                               2002 –
                                                                2003     6      12
0                                                              2003 –
     1999-   2000-01 2001-02 2002-03 2003-04 2004-5   2005-6
                                                                2004     7      20
                                                               2004 –
                                                                2005     9      10
                                                               2006      6      15
Recent Graduates
Name            Program       Hospital                 City
2003 (6)
Rebecca Smith   Pediatrics    UNC                      Chapel Hill, NC
Haleema Javid   Radiology     Christiana Care          Christiana, DE
Nyali Taylor    Surgery       Pennsylvania Hosp        Philadelphia, PA
Sumana Kesh     Medicine      Brown University         Providence, RI
Nancy Matteer   Medicine      Baylor                   Baylor, Texas
Amy Baranoski   Medicine      Thomas Jeff Univ         Philadelphia, PA

2004 (7)
Faunda CampbellOb/Gyn         Lehigh Valley            Lehigh, PA
Amparo Gordian Medicine       Lenox Hill Hosp          New York, NY
Nkiruka Ohamej Medicine       John Hopkins             Baltimore MD
Stacey Scheib  Ob/Gyn         Thomas Jeff Univ         Philadelphia, PA
Kerri Kissell  Medicine       Univ of Maryland         Baltimore, MD
Anca Barbu     Surgery        Univ Hosp Cleveland      Cleveland OH
Tracie Gong    Pediatrics     UCSF – Fresno            Fresno, CA

2005 (9)
Tracie Bennett Ob/Gyn         Barnes-Jewish Hosp MO    St. Louis, MO
Leelia Franck    Family Med   Univ Mass Med School     Worcester,MA
Cynthia Lim      Medicine     Temple University        Philadelphia, PA
Marin Mercurius Ob/Gyn        St Joseph’s Hospital     Ann Arbor, MI
Amie Miklavcic Ob/Gyn         Virg Commonwealth Univ   Richmond, VA
Kirin Munar      Pediatrics   Miami Children’s         Miami, FL
Meredith Profeta Pediatrics   University of Michigan   Ann Arbor, MI
Natasha Sandy Family Med      Mountainside Hosp        Montclair, NJ
Shalini Shah     Family Med   York Hospital            York, PA
Graduating Pathway Students

Name               Program        Hospital              City
2006 (6)
Sarah Katel        Ob/Gyn         KP Los Angeles        Los Angeles, CA
Dianna Moseley     Ob/Gyn         St. Joseph’s Mercy    Ann Arbor, MI
Nina Nanda         Family Med     UCLA Medical Center   Los Angeles, CA
Gretchen Strahle   Ob/Gyn         Abington Hospital     Abington, PA
Shiv Sudhakar      Internal Med   KP Santa Clara        Santa Clara, CA
Karbo Tam          Ob/Gyn         KP San Francisco      San Francisco, CA
Women's Health Pathway Specialty Selection 2000-2006

                                                        IM- Geriatrics
                                                        IM- GI
Qualitative Feedback
• Most attractive elements of the
  – 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
• More guidance to students entering family
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
   – Pelvic floor rotation (under development)
   – Inpatient women’s health rotation
   – And a bunch of other things…..
2006 Exit Evaluation Data

                                              Agree Neutral
Received useful advice regarding     33%     50%    17%
Senior Course selection from Pathway
Received useful advice regarding     40%     40%    20%
career choices from my Pathway
Found the Pathway helpful in attaining 33%   67%
educational objectives
2006 Exit Evaluation Data
Found faculty in my principal Pathway    Strongly
                                                    Agree   Disagree
to be:                                    Agree
    effective role models                 33%       67%
    effective teachers                    33%       67%

    helpful in providing useful advice    17%       67%       17%
    regarding application to residency
In my Pathway, I:                                   Agree   Disagree
    achieved the goals and objectives     17%       83%
    felt the learning climate was         17%       67%       17%
                   Evaluation of Women's Health Pathway

                Path highly effective

            optimal learning climate

                  Met Goals in Path

Faculty's advice useful for residency

          Faculty effective teachers

      Faculty effective Role models

                Path met objectives

              Useful Career Advice

           Useful Sr Course Advice

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

                                  Strongly agree   Agree    Neutral   Disagree   Strongly disagree

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