General Internal Medicine Women's Health Track

Goals

The goals of the women’s health track are to enable residents to:

1. Understand how medical illness affects women differently than men from a medical and psychosocial perspective.

2. Acquire competency and expertise in women’s health beyond that of a general internist.

3. Participate in scholarly work (research project, curriculum development, etc.) related to women’s health.

4. Develop a mentoring relationship with a women’s health expert.

This track is designed to prepare a resident to be a future leader in clinical and/or academic women’s health.

The Environment

1. Center of Excellence: Researchers, clinicians, and educators at Brown University have been leaders in women’s health for many years. In recognition of this, Brown University/Women and Infants’ Hospital has been designated as one of the 19 National Centers of Excellence (COE) in Women’s Health.

   The goals of the COE are to:

   1. Develop an integrated model for the delivery of clinical health care services to women with an emphasis on prevention and early detection of diseases and conditions.
   2. Develop a multidisciplinary research agenda focused on women’s health issues.
   3. Enhance women’s health education at all levels of medical education and to the community.
   4. Foster recruitment and promotion of women in academic medical centers.
   5. Provide community outreach programs.

   Women’s Health residents will have the opportunity to participate in the COE and contribute to one of the Working Groups of the COE (research, clinical care, education, community outreach, leadership). >p>

2. Resources in Research: Numerous researchers at the university and its affiliated hospitals and centers, including Rhode Island Hospital, the Miriam Hospital, Memorial Hospital, Women and Infants’ Hospital, and the Rhode Island Women’s Correctional Facility, focus on women’s health research. The research represents a broad range of investigation including women in prison, menopause, women and alcohol, breast cancer, obesity, depression, HIV, osteoporosis, genitourinary malignancies and pregnancy-related issues (contraception; pregnancy intentions and birth outcomes; diabetes and birth outcomes; low birth weight infants). Memorial Hospital in Pawtucket, Rhode Island is a vanguard site for the Women’s Health Initiative, the largest longitudinal trial of postmenopausal women ever conducted.

3. Clinical Resources: In addition to strong research, the hospitals and faculty offer outstanding clinical services to women. There are three women-specific internal medicine practice sites, including: 1) an academic women’s health practice based at Rhode Island Hospital, 2) an academic practice in consultative and general internal medicine at Women and Infants’ Hospital, and 3) a primary care site at the women’s prison. In addition to these internal medicine sites, there are many additional clinical opportunities in breast health, gynecology, reproductive endocrinology, urogynecology, and psychiatric services for women. General Internal Medicine (GIM) residents in the women’s health track will have an opportunity to work in any of these sites.

How will my curriculum differ from other General Internal Medicine Residents?

The Women’s Health Track will differ from the traditional General Internal Medicine (GIM) Residency program by the addition of 5 key components to further excellence in women’s health: Mentorship, Research, Clinical Experience, Clinical Competence, and Didactics/Education. The majority of the women’s health training will take place during ambulatory block.

• Mentorship
  A faculty mentor will be assigned to each resident at the beginning of his/her PGY-1 year. Mentors will provide assistance with choosing women’s health clinical sites, preparing for didactic sessions, selecting a research project, and identifying each resident’s present and future goals with respect to a career in internal medicine and women’s health. Residents will meet with their mentor each block month throughout residency.

• Research
  Residents will meet with a research advisor (who may be a faculty member other than their mentor) early in their PGY-1 year to discuss ongoing research projects in Women’s Health. Residents will have an opportunity to participate in the research course offered at Women and Infants’ Hospital in the beginning of their second year. At this time, residents will identify their research project. Residents will meet with their research advisor each block month to discuss, outline, and plan their research project. Research can be conducted throughout the PGY-2 and PGY-3 year, and residents may have 2 months in their PGY-3 year dedicated to research. Residents will submit their research to be presented at a national meeting.

• Clinical Experience
  Residents will begin their outpatient experience in a women’s health clinical site in their PGY-1 year. During their 3 block months of internship, they will see patients at a women’s health site for one half-day session/week. At the end of internship, residents will choose a women’s health site as their “2nd site” continuity clinic and will attend that clinic one half-day session/week throughout the PGY-2 and PGY-3 years. During PGY-2 and PGY-3 block months, residents will see patients at an additional women’s health clinical site of their choice for one half-day session/week. Residents will also complete the women’s health elective experience during either PGY-2 or PGY-3 year.

• Clinical competence
  Through clinical experiences, residents should gain experience in the diagnosis and management of the following conditions affecting women:
  • Coronary disease
  • Rheumatologic diseases
  • Endocrinologic diseases
  • Vaginitis/Cervicitis/STDs
  • Contraception/Family Planning
  • Osteoporosis
  • Menopause
  • Violence
  • Chronic Pelvic/ Abdominal Pain
  • Dysfunctional Uterine Bleeding/Amenorrhea
  • Physical exam skills: including breast and pelvic exam
  • Procedural skills: colposcopy, endometrial biopsy (for those interested)

  Residents will receive a Women’s Health syllabus that will include the curriculum and articles about pertinent women’s health topics. The curriculum serves as a reference and should aid in achieving a level of competence in the area of women’s health. Midway through PGY-2 year, residents will have a clinical competence review with their mentors and identify areas in which resident wish to have more guidance and/or exposure. A second review will take place during block 7 of PGY-3 year.

• Didactics/Education
  In their PGY-3 year, residents will lead 2 didactic sessions on a topic in women’s health of their choice with the PGY-1 GIM residents. One session will take place in each of their research months in the PGY-3 year. Residents will meet with an advisor to prepare their lecture and to practice their teaching skills.

• Additional Elective Experiences
  Residents will be able to participate in local and national meetings related to women’s health as the opportunities arise. As mentioned, Women’s Health residents will have the opportunity to participate in the COE in many capacities and may choose to participate in one of the Working Groups of the COE (research, clinical care, education, community outreach, leadership). Residents may gain additional experience in the area of public health, health care policy issues and administrative expertise and fostering leadership for women in medicine. To this end, they may choose to work with the Associate Dean for Women in Medicine, the RI Department of Public Health, Office of Women’s Health and the Brown University School of Public Health.

How do I apply to the Women's Health Track?

The track is open to two GIM residents each year. Applicants select the track soon after matching in the GIM program. Applicants may specify the desire to participate in the track when applying to the residency program as well.

Who runs the Women's Health Track?

Director:

Kelly McGarry, MD
Associate Professor of Medicine
Brown University School of Medicine
Associate Program Director
General Internal Medicine Residency
Rhode Island Hospital
Email: kmcgarry@lifespan.org

Clinical Director:

Iris Tong, MD
Assistant Professor (Clinical)
Department of Internal Medicine
Brown University School of Medicine
Division of Ambulatory General and Consultative Internal Medicine
Women and Infants' Hospital
Email: Iris_Tong@Brown.edu

Research Director:

Jennifer Clarke, MD
Assistant Professor of Medicine and Obstetrics/Gynecology
Brown University School of Medicine
Researcher
Division of General Internal Medicine Research Unit
Email: Jennifer_Clarke@Brown.edu