Introduction
Over the past two decades, there has been a transformation in knowledge of and attitudes about the health of women and gender differences in health. This has led to exciting new opportunities in research and education in these areas.
Women comprise most patients in the United States, because they outlive men, are more likely to be hospitalized, and visit physician offices at a higher rate than men throughout life. For many years, however, women were under-represented in medical research and their health concerns were traditionally minimized.
There is now widespread awareness that knowledge of sex and gender differences is fundamental to understanding normal human physiology and disease. As the Institute of Medicine stated in a 2001 report, “sex matters” – and accounts for differences in the incidence and severity of a wide spectrum of illness. These differences originate at the cellular and molecular level, continue in the intrauterine environment, and are influenced by exposures to different agents and by differing cellular responses to these exposures throughout life. At a more global level, environment, behavior, and socio-cultural expectations affect gender differences in health throughout the life span.
The Pathway in Women’s Health will prepare students who wish to further develop their understanding of gender differences in health and their research skills in women’s health. This pathway will occur over all four years of medical school and will include required didactic coursework, attendance at our multidisciplinary women’s health grand rounds series, and a required research paper under the direction of a faculty mentor.
Goals and Objectives
- To raise awareness of gender differences in health
- To develop a general understanding of the history of women’s health in the U.S.
- To understand how to critically appraise research that applies to women
- To gain a general understanding of the biological determinants of women’s health
- To appreciate the social determinants of women’s health and barriers to health care for women
- To provide students with a general understanding of major policy issues in women’s health
- To develop students’ skills in caring for female patients in a variety of health settings
- To provide students with an opportunity to pursue research and to present their research to faculty and peers
- To allow students to network with peers and faculty who have an interest in women’s health and gender differences in health
Requirements
The Pathway in Women’s Health will provide students with an excellent opportunity to develop their research skills under guidance of a faculty mentor and to join a special community of researchers, educators, and clinicians with an interest in women’s health. There are several requirements that students must complete, however, in order to succeed in the pathway.
Beginning in the second semester of the first year, students will participate in the following.
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Timing
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Requirement
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During the first three months of the pathway (preferably before the end of the student’s first year)
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The student must choose a research advisor and meet with that advisor to map out a research project.
The Institute for Women’s Health will provide students with a list of faculty who have expressed an interest in serving as research mentors and will help the student select an appropriate mentor.
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By the end of the student’s first year
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The student and the mentor should submit a detailed plan of the research project, not to exceed three pages, to the pathway coordinator.
The plan should state the:
- hypothesis;
- specific aims;
- methods; and,
- data analyses proposed for the project.
It should clearly outline the student’s role in the project and a note indicating that the faculty member accepts the responsibility for mentoring the student.
The pathway coordinator will review and provide approval of the research project.
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Upon approval of the research project
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Students are strongly encouraged, though not required, to apply for research distinction through the Office of Medical Curriculum.
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Prior to beginning the research
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Since all research proposals must be approved by the medical school’s Institutional Review Board (IRB), students may want to consider a project that is complementary to an existing IRB-approved project as this may allow them to complete an expedited amendment application, or to do a project such as a chart review, which generally qualifies for expedited IRB review. The mentor and Institute will supervise and help guide students through the IRB submission process, and the mentor should serve as Principal Investigator, in keeping with University requirements. The student will play a significant role in completing the IRB forms and submitting them to the IRB.
All women’s health pathway students must complete the CITI course for medical researchers, which is available at no charge to UM-affiliated faculty and students and takes about five hours. The task of completing the CITI course and the IRB application serves as a useful opportunity to learn about protection of human subjects and research ethics, and provides students with useful experience for future research projects.
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During the summer months before the student’s second year
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Students are strongly encouraged to work on their project during the summer months before the second year, if IRB approval has been obtained.
The project can be community-based; but if so, it must enable the student to work on a site-defined project that provides needed services and allows the student to learn first-hand about social and community factors affecting women’s health.
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Ongoing
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In addition to meeting with their mentor regularly, the student must meet with the pathway director twice a year to discuss his or her progress.
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Beginning in the second year
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Students will be required to attend small group theme discussions, each led by faculty affiliated with the Institute for Women’s Health.
Students will have assigned readings and will be required to complete the reading in advance.
The groups will last one to two hours and will occur monthly, during Independent Study Time. Attendance is mandatory.
Topics to be discussed during these small groups may include:
- The Physiologic and Genetic Basis of Gender Differences in Health and Disease
- An Overview of Women’s Health Concerns at Different Stages of Life
- Historical Aspects of Women’s Health
- Research Methods in Women’s Health
- Social Determinants of Women’s Health
- Epidemiologic and Population Health Aspects of Women’s Health
- Psychological Aspects and Determinants of Women’s Health
- Common Diseases Specific to Women
- Gender-Specific Differences in Diseases Prevalent in Women as well as Men (e.g., stroke, lung cancer)
- Major Policy Issues in Women’s Health
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Over the course of the three years in the program
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Students will be required to attend a minimum of eight “Women’s Heath Grand Rounds” during their time in the program.
These lectures occur at noon once a month, usually on the third Thursday of each month. They do not occur in July, August or December.
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During the third and fourth years
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Students must choose four weeks of a designated women’s health-related elective.
A women’s health elective at another medical school can be substituted, if it is approved by the pathway director and in adherence with the policies for externship procedures outlined in the UMMSM Medical Student’s Rights and Responsibilities Handbook.
Designated electives at UMMSM include:
- Student Health Clinic (two weeks) – Dept. of Medicine
- Clinical Gyn (four weeks) – Dept. of OB/Gyn
- Emergency Gyn (two weeks) – Dept. of OB/Gyn
- Gyn Oncology (four weeks) – Dept. of OB/Gyn
- Maternal Fetal Medicine (four weeks) – Dept. of OB/Gyn
- Reproductive Health (two weeks) – Dept. of OB/Gyn
- Reproductive Endocrinology and Infertility (two weeks) – Dept. of OB/Gyn
- Adolescent Medicine (two or four weeks) – Dept. of Pediatrics
- Taylor Breast Health Center (two or four weeks) – Dept. of Surgery
- Female Urology (two or four weeks) – Dept. of Urology
- Urogynecology-Female Medicine and Reconstructive Surgery (two or four weeks) – Dept. of OB/Gyn
- GYN Sub-Internship – Dept. of OB/Gyn
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During the fourth year
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Students will be asked to attend and help lead at least one small group theme discussion for the second year medical students.
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During the final semester of the fourth year
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Students must present their research project at the Institute for Women’s Health’s “Women’s Health Research Day” or at the Eastern Atlantic Student Research Forum.
Students must submit a final paper describing their research project to the pathway director.
The paper must include:
- an abstract;
- a paragraph summarizing the research’s relevance to existing literature;
- a statement of the hypothesis;
- specific objectives for the project;
- data collection, analysis of the data, and methods used;
- interpretation of the results; and,
- the conclusions and implications derived from the research project.
Students will receive feedback on their paper and are strongly urged to submit it for publication in a relevant journal, if appropriate.
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Support and Assistance
The Institute for Women’s Health will provide students with administrative support and statistical assistance as they pursue this pathway.
The Institute cannot provide a stipend for research, though it will help students with administrative expenses such as materials and postage. (Students should obtain approval for itemized expenses in advance in order to obtain reimbursement.)
Some mentors may be able to provide additional support and many fellowships are available for student research. Students are strongly encouraged to contact the Office of Professional Development and Career Guidance about applying for these fellowships.
Other Activities
Students who participate in the program will receive funding to defray the costs of travel to one women’s health-related professional meeting during their time in the pathway. The meeting must be approved by the pathway director in order to qualify for funding support. It is strongly encouraged that the student travel to a meeting at which he or she can present his or her research project, preferably during the fourth year.
Evaluation
At the end of the second year and beginning of fourth year, students will receive an evaluation summarizing their accomplishments in the program and areas that need improvement. A copy of this letter will be sent to the Associate Dean for Student Affairs, for inclusion in the medical student performance evaluation letter.
Failure to attend small groups during the second year or to submit an acceptable research proposal may result in dismissal from the pathway.
Graduation Credit
Students who successfully complete the program will receive a certificate upon completion. We anticipate that participation in the program will enhance a student’s application to residencies and training programs in women’s health and prepare them for future research careers.
Application to the Pathway
We anticipate that we will be able to accept up to five students in the pathway each year. Applicants will need to complete an application form and meet with the pathway director.
Students will be accepted to the program based on demonstrated interest in women’s health and availability of a suitable mentor based on the student’s research interests.
Pathway Director
Erin N. Marcus, M.D., M.P.H., F.A.C.P.
Associate Medical Director,
Institute for Women’s Health
Phone: (305) 243-2576
1120 NW 14th Street (M-716)
Clinical Research Building, Suite 1140
Miami, FL 33136
Download a PDF of the 2009 Application.
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