Women’s Health Track

PROGRAM GOALS

Our goals are to enable residents to:

• Acquire clinical competence and expertise in sex- and gender-based women’s health
• Participate in a vibrant community of residents and attendings from general medicine and subspecialty fields dedicated to sex- and gender-based women’s health
• Contribute to scholarly work including research, curriculum development and teaching
• Develop a mentoring relationship with a faculty expert

OVERVIEW OF THE PROGRAM

The Brown Women’s Health Track was established in 2012 and trains graduates in general and subspecialty medicine. Each year 6-10 residents per year commit to the WH track starting in their PGY-2 year. Clinical work takes place in primary care and secondary outpatient sites, often precepted by track faculty. All residents complete a WH elective in both their PGY-2 and -3 years, including clinical rotations covering core outpatient topics and individual subspecialty electives. Didactics sessions with track co-directors occur during WH elective blocks. All PGY 2-4 residents are matched 1:1 with a faculty mentor and develop two educational talks with their mentor. Residents are encouraged to pursue scholarly work in their areas of interest with recent examples being work in women’s cardiology and motility disorders of women. Track strengths include an active and engaged general medicine and subspecialty faculty; a robust Obstetric Medicine program including a fellowship; a unique and well-developed Reproductive Gender Clinic which offers gender affirming care and specialized training including endometrial biopsies, contraceptive arm implant and IUD insertion/removal, and medication for miscarriage and abortion care.

• News & Events

  Meghan Geary delivered an oral presentation at the North American Refugee Health Conference July 2023 Calgary, Canada, titled "Reproductive Healthcare for Refugees: Strategies for access, autonomy, ambivalence".

  
  Meghan Geary, Vidya Gopinath, Mindy Sobota and Ella Satish (a phenomenal MS3) were invited to deliver Rhode Island Hospital Medicine Grand Rounds, titled “Reproductive Health in 2023 for the Rhode Island Internist” (May 2nd, 2023). This was an extension of talks given over the last year by Meghan & Vidya at Medicine Grand Rounds at the Massachusetts General Hospital, the Rhode Island Chapter of the American College of Physicians and the New England Regional Meeting of the Society of General Internal Medicine and by Mindy and Vidya at the Annual Meeting of the Society of General Internal Medicine.

  Kelly McGarry (outgoing Governor of RI Chapter of ACP) and Dr. Kwame Dapaah-Afriye (incoming Governor of RI Chapter of ACP) supported state legislation that was signed into law allowing Rhode Island state insurance to cover the cost of abortion-related medical care. Mindy Sobota, along with residents Emily Zhou and Olivia Avidan, collaborated with colleagues from the Rhode Island chapters of the American College of Obstetrician Gynecologists and American Family Physicians to send emails, provide testimony, and meet with key state legislators and leaders in support of the abortion coverage bill before the very divided vote.

  Mindy Sobota, in collaboration with the Rhode Island Pharmacy Association, testified in favor of another bill that passed, allowing certified pharmacists to prescribe hormonal contraception.

  Mindy Sobota, Meghan Geary, Vidya Gopinath integrated the prescribing of mifepristone for medication abortion and miscarriage management at their clinical practice with the support of their family medicine and obstetrician-gynecology colleagues.

  Missy McNeil continues to be extremely prolific! She continues to collaborate with colleagues across the country and in Rhode Island, and be an very sought-after invited speaker nationally and locally. See an excerpt from her CV below. We are lucky to have her as an interim co-leader of our women’s health track!

• The Environment

  Center of Excellence:  Brown University researchers, clinicians, and educators at have been leaders in women's health for years and Brown University/Women and Infants' Hospital was designated as one of the 19 National Centers of Excellence (COE) in Women's Health. Although the COEs no longer formally exist, the Brown Internal Medicine Residency Women’s Health Track was created through this lens.

  
  Clinical Resources: The training program is part of a robust care service network. There are multiple core internal medicine practice sites providing sex- and gender-specific women’s health care, including our faculty-resident academic practice and integrated reproductive gender clinic. There are additional clinical opportunities through our women’s health including in breast health, cardiology, endocrinology, gastroenterology, gender-affirming care, neurology, psychiatry, urogynecology. There is an obstetric medicine program at our partner hospital Women and Infants' Hospital that offers is a month-long rotation for residents.

  Resources in Research:  Women's health focused research at Brown University represents a broad range of investigation including the disproportionate effects of alcohol and other addictive substances, depression, HIV, breast and gynecologic malignancies, osteoporosis, menopause, obesity, pregnancy and reproductive health. Residents are encouraged to pursue scholarly opportunities.

  Advocacy: Women’s health faculty are active in advocacy through the American College of Physicians and the Reproductive Health Access Project. State-based advocacy has been successful, with the passage of legislation to legalize and protect abortion rights (2019), require state insurance to cover birthing doulas (2021), eliminate a ban on the use of state funds to pay for abortion (2023) and allow pharmacists to prescribe hormonal contraception (2023).

  Didactic Education and Community: All residents participate in at least half of the following monthly didactics to build community and expertise in women’s health content. We also have a WhatsApp group for residents to share pearls, events, and talks they may have missed.

  • Noon conference series – PGY2s present a topic monthly
  • Evening dinner seminar series - PGY3s present a topic monthly

• How would 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 their PGY-2 year. Mentors will provide help with choosing women's health clinical sites, preparing for didactic sessions, identifying research mentors, if desired, and identifying each resident's present and future goals with respect to a career in internal medicine and women's health. Residents will meet at least twice yearly with their mentors.

  • Scholarship
    Beginning early in their PGY2 year, residents will meet with their mentor to discuss clinical interests and potential scholarly opportunities. Scholarship can be conducted throughout the PGY-2 and PGY-3 year, and residents may have up to 2 months in their PGY-3 year dedicated to research, if desired. Residents are encouraged to submit their scholarship to be presented at a regional and/or national meetings.

  • Clinical Experience
    The following clinical experiences are available to our women’s health track residents:

    Residents will have continuity clinic in a site with attendings skilled in providing gender-focused primary care.

    At the end of internship, residents will choose a women’s health focused "2nd site" for clinic, which can be based in primary care or sub-specialty medicine. Second site occurs one half-day/week throughout their PGY-2 and PGY-3 years.

    During PGY2/3 years, residents will complete an elective in women's health and/or obstetric medicine.

    Residents are encouraged to choose from a directory of gender-focused clinical experiences to tailor their ambulatory and/or elective rotations. Our strengths include refugee health, addiction medicine and reproductive & gender-affirming care. We are one of the only US internal medicine residencies that can train residents to competency in both advanced contraception procedures (subdermal implants and IUDs) and medication abortion.

  • Clinical Competence
    We structure the women’s health track to graduate residents with clinical competencies as outlined by the Society of General Internal Medicine, including:

    
    breast cancer screening guidelines and risk reduction

    cardiovascular disease prevention/risk reduction

    cervical cancer screening and screening options 4

    endometrial and ovarian cancer risk reduction

    contraception counseling, including emergency contraception

    preconception care

    pregnancy options

    intimate partner and family violence, history of trauma

    menopausal symptoms and hormonal/non-hormonal management options

    osteoporosis screening and treatment recommendations

    urinary incontinence screening and treatment options

    gender-affirming treatment options

  • Didactics/Education
    The Women’s Health Seminar series meets monthly and aims to provide clinical content, collegiality and mentorship.

    
    In their PGY2/3 years, residents will develop and lead a total of 2 didactic sessions on a topic of their choice.

    Residents can choose from additional didactics offered by the 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 any resident in the internal medicine residency program at the end of their PGY1 year. Applicants may specify the desire to participate in the track when applying to the residency program as well.

• Who are the Core Faculty in the Women's Health Track?

  Melissa McNeil, MD MPH MACP
  Co-Director
  Professor of Medicine, Clinician Educator Track
  Alpert Medical School of Brown University
  Email: Email
  https://vivo.brown.edu/display/mmcneil4

  
  Mindy Sobota, MD MS MPhil FACP
  Interim Co-Director
  Procedural Director
  Associate Professor of Medicine, Clinician Educator Track
  Alpert Medical School of Brown University
  Email: Email
  https://vivo.brown.edu/display/msobota

  Iris Tong, MD
  Clinical Director
  Associate Professor of Medicine, Teacher-Scholar Track
  Alpert Medical School of Brown University
  Email: Email

  Meghan Geary, MD
  Care of Vulnerable Populations Director
  Assistant Professor of Medicine. Clinician Educator Track
  Alpert Medical School of Brown University
  Email: Email

  Additional Faculty:
  Michelle Anvar, MD
  Stephanie Braunthal DO
  Christine Duffy, MD MPH
  Laura Edmonds, MD
  Jennifer Jeremiah, MD
  Lucia Larson MD
  Nancy Lasson DO
  Leah Marano MD
  Peg Miller MD
  Nika Meta MD
  Kelly McGarry, MD
  Lauren Schlanger MD
  Mariah Stump MD MPH
  Amelia Tajik MD
  Noor Tell MD

• Recent Women's Health Track Resident Presentations

  COPD in women

  
  Debunking urban legends about the vagina

  Endometriosis Fertility care Lifestyle-first obesity management in women

  Management of miscarriage

  Non-obstructive coronary artery disease in women Sarcopenia

  Zain Alfanek & Manasa Srivillibhuthur, MD

  “Gender affirming care” – Delivered to Women’s Health Summit half day and in pre-clinic conference

  Charity Sylvester

  “Plan A: making medication abortions accessible to patients in the primary care setting”. Oral Presentation, Society of General Internal Medicine Annual Meeting, Aurora Colorado. Also delivered to the Women’s Health Track Summit, June 2023.

  Leanne Duge, MD

  “Breast cancer screening” - Delivered to the General Medicine residents

  “Polycystic Ovarian Syndrome” – Delivered to the General Medicine residents

  Ashley Nguyen, MD

  “Allergy and women’s health” - Delivered to the General Medicine residents

  “Adolescent women’s health” - Delivered to the General Medicine residents

  Lakshmi Ravindra MD

  “Diabetes in pregnancy” – Delivered to General Medicine Residents

  “Secondary osteoporosis” - Delivered to the General Medicine residents

  Julia Solomon MD

  “Pearls for trauma-informed care” - Delivered to the General Medicine residents

  “RI after Roe” - Delivered to the General Medicine residents

  Amelia Tajik, MD

  "A Case of Extensive Venous Thromboembolism after initiation of Combined Oral Contraceptives for Treatment of Menorrhagia in a patient with Undiagnosed May Turner Syndrome".

  “Abnormal uterine Bleeding”, Pre-clinic curriculum

  “Menopause”, Pre-clinic curriculum

  Noor Tell, MD

  “Pelvic floor disorders” - Delivered to the General Medicine residents

• Recent Graduates & Where They Are Now

  Zain Alfanek MD - Hospitalist at Boston Medical Center

  
  Talah Bakdash MD - Cardiology Fellow, St Louis University

  Samantha Bales DO - Primary Care Physician, Massachusetts General Hospital

  Sarah Dwyer-Holland MD - Gastroenterology Fellow, Brown

  Christina Kerner - Primary Care Physician, Massachusetts General Hospital

  Jaineel Kothari, MD - Medical Director, Teamshealth, NH

  Rosymar Marcucci-Rodriguez, MD - Primary Care Physician, Brown

  Gladys Obaji, MD - Rheumatology Fellow, Penn

  Cecilia Paasche, MD - Obstetric Medicine Fellow, Brown

  Kaitin Pataroque, MD - Primary Care Physician, Leahy Hospital, Burlington MA

  Grace Sun - Oncology Fellow, UC Davis

  Charity Sylvester, MD - Rheumatology Fellow, Duke

  Yongkang Zhang - Hospitalist, Boston Medical Center

  Cynthia Zheng, MD