UCSF is a world-renowned education powerhouse achieving superlative rankings across its Graduate Division and four professional schools of dentistry, medicine, nursing and pharmacy.
The same is true in the women’s health educational programs. Within the UCSF School of Medicine, the women’s health specialty program ranks second nationwide, according to the US News & World Report 2010-11 survey of best graduate schools. Excellence in educational training is a core UCSF strategy for advancing women’s health.
Stephanie Garcia, a third-year medical student and member of the PRIME program.
“The key to sustainable and continuous improvement in women’s health is to attract and train the best and the brightest individuals for careers in science and health care focused on women,” says Nancy Milliken, MD, vice dean of the UCSF School of Medicine and director of the National Center of Excellence in Women’s Health (CoE).
This philosophy spans the comprehensive women’s health education and training found at UCSF – in the professional schools, residency and fellowship programs, faculty career development initiatives, and internships for high school and college students. Successful programs are available to those at every stage of their education and professional development.
Medical School Curriculum
Because women seek care from every specialty in medicine, it is important for all students to understand that the differences between male and female patients extend beyond their reproductive systems.
With increasing numbers of clinical trials specifically designed to assess outcomes in women, there has been an acceleration of knowledge regarding women’s health. With this new knowledge comes the responsibility of incorporating the information into the curriculum of professional schools in the health sciences. Thus, one of the first initiatives of the UCSF CoE was to assess the inclusion of women’s health in the four-year curriculum of the UCSF School of Medicine; subsequent initiatives have helped to fill the gaps.
“Our goal has been to make sure that we are teaching our students the latest knowledge available,” says Milliken. “Equally important is to instill in them, as second nature, the question ‘Is the treatment, test, or prevention strategy the same for women as for men?’ When this question is asked, the care for both women and men improves.”
Specialty Training in Nursing
Significant women’s health training occurs in the highly ranked programs of the UCSF School of Nursing, including its nurse-midwifery and nurse practitioner programs. Midwives approach birth not as a medical event, but as a normal physiological process. Since its inception in 1975, UCSF’s midwifery faculty have delivered more than 15,000 babies, and the school has graduated hundreds of nurse-midwives from the two-year master of science degree program.
“The UCSF midwifery education program provides a much broader array of experiences than other midwifery programs,” says Mary Barger, CNM, MPH, PhD, assistant professor in the Department of Family Health Care Nursing in the UCSF School of Nursing. “As an example, all students learn to provide prenatal care in an innovative care model called the CenteringPregnancy® Program, in which women, after their initial prenatal visit, meet in groups of eight to 10 for subsequent appointments. This model has been shown to improve pregnancy outcomes and increase satisfaction of women.”
In the UCSF School of Nursing, the Perinatal Clinical Nurse Specialist program is a specialty focus within the master of science program. Perinatal clinical nurse specialists work both in hospitals and in clinics serving pregnant women. The program prepares students as advanced practice nurses and for certification in this nursing specialty in California. It is one of the only programs of its kind in the United States. Audrey Lyndon, RNC, PhD, directs the program.
Residency in Reproductive Medicine
The UCSF program for resident physicians in obstetrics and gynecology is highly competitive and selects nine participants annually. An important part of the training is the experience that residents (doctors who have received a medical degree and now are undergoing specialty training) gain in a variety of hospital settings, including UCSF Medical Center, San Francisco General Hospital, Kaiser Permanente’s HMO in Walnut Creek and Alta Bates Summit Medical Center in Berkeley.
“Residents get to care for women in the community and also see different health care systems,” says Amy Autry, MD, director of the obstetrics and gynecology residency program.
There also is increased interest by residents in global experience during their training. At least 75 percent of residents spend some time abroad working on global health issues, and all residents implement community projects in the Bay Area. “Helping the underserved and vulnerable is a top priority for us,” says Autry. “These experiences often profoundly connect the trainees with the core values that led them to a career in medicine in the first place.”
Women’s Health Research Careers
Successful careers in research require the acquisition of research training and experience and good mentoring. The National Institutes of Health (NIH) has established two programs to promote successful careers of junior faculty pursuing research in women’s health. UCSF successfully competed for funding from both of these programs.
- Obstetrics and gynecology physicians are selected to receive training for successful research careers through the NIH-funded UCSF Women’s Reproductive Health Research Career Development Center under the leadership of Linda C. Giudice, MD, PhD, chair of the Department of Obstetrics, Gynecology and Reproductive Sciences. This program is dedicated to bridging the gap between research and clinical training through translational medicine by mentoring junior faculty to become science investigators in women’s reproductive health.
- Through Bridging Interdisciplinary Research Careers in Women’s Health, another NIH-funded career development program, UCSF and Kaiser Permanente Northern California’s Division of Research are increasing the number, quality and breadth of women’s health researchers who are not in the field of obstetrics and gynecology.
- Under the leadership of Ruth Greenblatt, MD, and Joe Selby, MD, MPH, early career investigators from the schools of dentistry, medicine, nursing and pharmacy are tackling some of the most important problems in women’s health across the life span under the guidance of senior investigators. The ultimate goal of the program is to expand the pool of successful, independent researchers whose work is focused on the health of women and girls.
Nancy Milliken, MD, director of the CoE, started the Young Women’s Health Leadership Summit a decade ago in partnership with then California State Senator Jackie Speier to empower young women to make informed choices about their health.
The Next Generation
An important focus of the UCSF CoE is filling the health sciences pipeline with young women from diverse populations – including those who may have thought they could not aspire to be scientists and clinicians. A variety of internship programs for high school and college-age women help accomplish this goal.
UCSF CoE Women’s Health Internship Program: Designed for those exploring a possible career in health care, the program has accepted more than 300 interns in the past 15 years. Interns receive leadership training and are connected with women’s health professionals and projects throughout the San Francisco Bay Area, where they gain hands-on work experience. They graduate with greater knowledge regarding women’s health as well as increased self-knowledge and confidence with which to make career choices.
The projects include the UCSF CoE Young Women’s Health Leadership Summit, which has brought a total of 15,000 San Francisco female high school students together over the past decade for an annual daylong conference exploring health issues most important to young women. Sponsored by a variety of foundations, the event is planned by a youth steering committee composed of students who work under the guidance of Judy Young, MPH, assistant director of the UCSF CoE. “In all our programs, we use a positive youth development model, and believe that everyone has something to teach and everyone has something to learn,” Young says. “Students are exposed to accurate health information to help them make healthy choices and to role models and information about possible careers in science and medicine.”
UCSF-Kaiser Women’s Health Undergraduate Research Internship: Open to UC Berkeley premed undergraduates with a special interest in women’s health, pediatrics or primary care, this program is a collaboration between UCSF and Kaiser Permanente in Oakland. Sixteen students are selected annually to participate in a summer program of rigorous clinical and research opportunities. The program was developed by Patricia Robertson, MD, professor and director of medical student education in the Department of Obstetrics, Gynecology and Reproductive Sciences, and Juan Guerra, MD, a volunteer clinical faculty member in the department, with the goal of promoting diversity and accelerated training in women’s health, pediatrics and primary care research. My most exciting days are when I have the opportunity to spend time with the curious and committed young women who are part of these programs,” says Milliken, vice dean of the UCSF School of Medicine and director of the National Center of Excellence in Women’s Health (CoE). “They are the future, and no matter what careers they pursue, it is my hope that they will use what they have learned to advance women’s health and well-being.”