GLOBAL WOMEN S HEALTH FELLOWSHIP

Transcription

1 GLOBAL WOMEN S HEALTH FELLOWSHIP PROGRAM DESCRIPTION BRIGHAM AND WOMEN S HOSPITAL CONNORS CENTER FOR WOMEN S HEALTH AND GENDER BIOLOGY IN COORDINATION WITH HARVARD UNIVERSITY

2 OVERVIEW In recognition of the growing need for physician leadership within the global community and the lack of a comprehensive and integrative training program, the Connors Center for Women s Health and Gender Biology at Brigham and Women s Hospital) has developed an interdisciplinary and cross-collaborative research and training fellowship. This fellowship is designed to enable health care professionals to develop and apply research skills and experience to significantly impact the global community, with an emphasis on women s health. This fellowship is an institutional collaboration of Brigham and Women s Hospital, a major teaching hospital of Harvard Medical School, and Harvard University. It is approved and accredited by Partners Healthcare. The goal of the Global Women s Health Fellowship is to train physicians for successful careers dedicated to furthering the health and well-being of women globally through innovative, meaningful and wide-reaching research. This two-year training program prepares physicians who want to pursue an academic career path in Global Women s Health (GWH) research, understand how best to serve specific populations of women, and contribute to the knowledge base of the field of GWH. The fellowship takes a comprehensive approach to women s health. It includes health issues unique to women (e.g. reproductive health and family planning, female genital cutting, breast and cervical cancer); areas where women experience a disproportionate health impact (e.g. cancer, cardiovascular disease, respiratory disease); and health issues where women experience a disadvantage based on gender inequalities and other social determinants (e.g. HIV and AIDS, displacement due to war and disaster). The fellowship is open to health professionals of all specialties involving women s health, including, but not limited to, obstetrics/gynecology, internal medicine, infectious disease, emergency medicine, medicine/pediatrics, psychiatry, surgery, and anesthesia. The fellowship is designed to provide rigorous training in academic research methods together with formal public health education and mentored research experiences in GWH, including required field-based research. We are poised to take full advantage of the Harvard University community to provide rich and deep mentorship for each fellow. Each fellow will have an individualized mentorship team to ensure academic growth and productivity in specific areas of women s health. The team will be multidisciplinary and will provide guidance when working within the social, environmental, cultural, and political context of GWH. 2 Last Update: 9/18/2018

3 THE NEED FOR GLOBAL WOMEN S HEALTH SPECIALISTS Women are a vulnerable population, most evidently due to the risks associated with maternal morbidity and mortality. In developing countries, the complications of pregnancy and childbirth are among the leading causes of death for women between the ages of 15 to 49. At least 40 percent of women experience complications during pregnancy, childbirth, and the period after delivery, and more than one woman dies every minute in pregnancy and childbirth. Three hundred million women (one out of four adult women) currently suffer from short- or long-term illnesses and injuries related to pregnancy and childbirth. An estimated 15 percent of these women develop potentially life-threatening problems. Long-term complications can include chronic pain, impaired mobility, damage to the reproductive system, and infertility. 12 However, beyond the unique risks associated with reproductive health, particular factors increase the vulnerability of women including gender-based violence, displacement due to war and natural disaster, exposure to HIV and AIDS, human trafficking, and inequities in gender roles that affect access to food, education and other resources important for improving health. For example, at least one in five women and girls worldwide has been physically or sexually abused in their lifetime. Eighty percent of the world s displaced population are women and children. Of the over 20 million women with HIV and AIDS, 70 percent are between the ages of 15 and 25 years old. In southern Africa, women and girls account for 60 percent of all HIV and AIDS cases. Four million women and girls each year are subjected to trafficking and forced into prostitution, slavery, or marriage. 3 Reports on cancers demonstrate that there are gender disparities in the developing world, as well as disparities between women in more versus less developed countries. More than half of cancer cases and 60 percent of deaths occur in the less-developed countries and the outcomes for women are far worse than for men. In some resource-poor countries, social and cultural barriers may impede early detection and effective management of cancer, particularly in women. The World Health Organization World Cancer Report 2008 cites these regional disparities in both incidence and mortality with women far more vulnerable than men. 4 While many of the leading causes of death in women around the world are the same as those for men (cardiovascular disease, HIV and AIDS, cancers, respiratory diseases), some have a greater or different impact on women, and women may face greater difficulties getting access to the health care they need. The factors involved in improving the health of women are multi-factorial, and include reducing gender inequality; improving women's nutritional status; increasing girls' access to education; providing appropriate antenatal, delivery, and postpartum care; and providing access to family planning services and information to all women and adolescents of reproductive age. 5 1 World Health Organization (WHO). The World Health Report 2005: Make Every Mother and Child Count. Geneva, Switzerland: WHO; For more information see Center for Reproductive Law and Policy website: 3 For more information see the UNICEF and UNHCR websites: and 4 World Health Organization (WHO) World Cancer Report Switzerland: WHO; For more information see WHO website: htt:// 3 Last Update: 9/18/2018

4 PROGRAM DESCRIPTION The defining goal of the Brigham and Women s Global Women s Health Fellowship is to train physicians for successful careers dedicated to furthering the health and well-being of women through innovative and effective research. This two-year training program will prepare graduates to pursue an academic career path in GWH research, understand how best to serve specific populations of women, and contribute to the knowledge base of the field. The scope of the program spans in-field experiences to in-class didactics. The core curriculum is organized into four major themes: 1) research; 2) leadership; 3) program planning; and 4) key issues in GWH. All fellows are expected to leave the fellowship with a basic understanding of: reproductive health and family planning; HIV and AIDS; gender-based violence; maternal mortality and morbidity; health, human rights and humanitarian law; sex trafficking and the informal labor sector; mental health and aging; women and poverty; and, health policy and advocacy as it relates to women. There will also be academic training through courses offered through the Harvard T.H. Chan School of Public Health and Harvard Catalyst (Harvard s clinical and translational science center). The objectives of the program, in relation to the goals listed above, will be to train leaders in GWH who: 1. Achieve successful careers dedicated to furthering the health and well-being of women globally. After the fellowship, fellows will be well prepared to launch a career in GWH. This may be a well-trodden research pathway, a pathway dedicated to developing and evaluating GWH programs, or a newly carved pathway that has not yet been taken. Fellows will leave the fellowship with a broad-based understanding of fundamental academic skills for carrying-out GWH research, requirements for getting promoted within an academic institution, and a deep familiarity of the landscape of GWH research, seminal conferences and seminars for their area of interest, and knowledge of key players of that field. 2. Conduct clinical and field research based on solid quantitative and analytic research skills. Fellows will take the summer Global Health Delivery Intensive (GHDI) Program offered through Harvard T.H. Chan School of Public Health and enroll in learning courses offered through Harvard Catalyst. Through this coursework, fellows will develop the framework for a research project as well as have the opportunity to engage with fellow students and faculty on their projects. They will be expected to take these skills to the field as they continue to develop their research project. Within the first few months, fellows are expected to develop their research question, conduct literature reviews and build relationships with potential mentors and collaborators. The next couple of months will be spent on refining their research question, developing the study design, and determining the resources needed (access to data, IRB approvals, in-country site) to conduct a study. It is important to note that each fellow s research pathway is unique. The Fellowship Director will work with each fellow as they identify research opportunities based on their area of interest and specialization. Developing a relationship with a senior research mentor is a critical part of the training process. Many fellows enter the fellowship program with established areas of interest and connection with a research mentor. 4 Last Update: 9/18/2018

5 3. Obtain fundamental knowledge and understanding of global health issues that uniquely affect the health of women within the context of social, cultural, and political environments. Fellows will participate self guided course work in GWH topics organized into four major themes: 1) research; 2) leadership; 3) program planning; and 4) key issues in GWH. They may fulfill this requirement through monthly education seminars, journal clubs, grand rounds presentations and web-based learning. Participation in the two-week Humanitarian Studies Initiative at Harvard is optional. Educational rotations at agencies such as CDC and WHO or non-governmental organizations (NGOs) are encouraged. Fellows are encouraged to attend the London School of Hygiene s Researching Gender-Based Violence: Methods and Meaning short course. 4. Develop administrative leadership skills through understanding how to assess, build, implement, monitor, and evaluate GWH programs. Each fellow is required to complete at least one research project in GWH under the guidance of an experienced faculty mentor of sufficient quality for publication, as well as work on one grant proposal related to original research prior to completion of the fellowship. All fellows will need to go through IRB Human Subjects Research Training and obtain IRB approval for their studies. Part of developing this competency will be having experience reviewing publications and/or grants; undergoing grantwriting and grantsmanship training; polishing presentation skills; and, attending leadership and management workshops. PROGRAM SCHEDULE AND BENEFITS The fellowship begins July 1 and lasts two years. Fellows divide their time between international research projects, GHDI/Harvard T.H. Chan School of Public Health and Harvard Catalyst classes, other learning and networking opportunities, and clinical service within their discipline. Fellows receive a competitive salary based on the Partners HealthCare System PGY salary scale, and a generous package of benefits. The fellowship covers: full tuition and fees related to the Harvard T.H. Chan School of Public Health Global Health Delivery Intensive program, including the cost of required textbooks; fellowship-related travel costs, including airfare, room and board, global malpractice coverage, and international medical and evacuation insurance; and CME funds. Four weeks of vacation are allowed per year. PROGRAM CORE CURRICULUM 1. Understanding the Landscape of Global Women s Health Learning Objectives: Fellows should have a solid understanding of the major issues in Global Women s Health and how they are being played out on the world s stage today. Fellows will become familiar with accessing information from and understanding resources including: Global Health Information (i.e. The Human Poverty Index; Global Burden of Disease, etc) Human Rights Perspectives (i.e. UN Declaration of Human Rights; CEDAW; UN Declaration on the Elimination of Violence Against Women; UN Division for the Advancement of Women) 5 Last Update: 9/18/2018

6 Major Global Health Players (i.e. National Ministries of Health, UN Agencies (UNAIDS; UNICEF), NGOs, Inter-University Programs, etc) Funding Resources (i.e. government, foundations, NGOs, contracts/subcontracts, etc) 2. Women s Health and Human Rights Learning Objectives: Fellows will gain a better understanding about the status and rights of women around the globe systematic rape and sexual slavery in situations of war and armed conflict; domestic violence in countries where women are not considered to be equal to men; women and girls who are bought, sold and trafficked into forced prostitution; and the inability to make one s own reproductive choices. 3. Key Issues in Global Women s Health Learning Objectives: Fellows are expected to have an advanced understanding of key global health issues that affect women in the world today. Topical issues in the field of Global Women s Health include, but are not limited to: violence against women; sex trafficking; maternal mortality and morbidity; female genital mutilation; the intersection of health, rights and poverty; sexual and reproductive rights and family planning; women and war; the informal workforce; and issues related to mental health and aging. They will be expected to learn about outstanding debates in the field, the most pressing knowledge gaps, effective evidence-based interventions, current challenges and the most promising public health approaches to overcome them. 4. Methods of Global Health Research Learning Objectives: In addition to the courses offered through the GHDI Program at Harvard T.H. Chan School of Public Health, fellows will be engaged in quantitative and/or qualitative studies that seek to address women s poor health outcomes as a result of inequities in gender roles, access and rights. Fellows will gain skills in Global Health research methods through a combination of their infield experience; engagement with a mentor team; preparation of grants, publications, and presentations; and, the execution of their research projects. If it is a part of the Fellows interest/research, specific research methodology applied to research in sexual and gender-based violence and human trafficking will be offered. Fellows must: Take the summer Global Health Delivery Intensive Program (in the first summer of the fellowship) Attend the Connors Center Annual Research Retreat Attend at least 5 GWH seminars that meet the objectives as outlined above Submit at least 1 grant focused during fellowship Have published at least once by the end of fellowship Go through ethics training (CITI or equivalent) and submit at least one IRB application 5. Monitoring and Evaluation of Global Women s Health Programs Learning Objectives: Improved monitoring and evaluation is not only necessary to report back to funders, but also to provide gold standard health information to the world. Fellows are expected to gain skills that allow for monitoring and evaluation of women s health programs through coursework at Harvard T.H. Chan School of Public Health and in-field training and mentoring. It is important to understand how to assess a program s efficiency, effectiveness and impact. Fellows 6 Last Update: 9/18/2018

7 will design appropriate conceptual frameworks for evaluation to be presented as part of their overall in-field research program. 6. Leadership Skills Learning Objectives: Fellows are expected to become leaders in the field of Global Women s Health. As such, it is important that they understand what it means to be a leader and how to lead successfully. Specifically, Fellows will learn how to communicate and listen effectively; work in teams; have a better understanding of their own strengths and weaknesses; have the ability to navigate in complex social and political systems; be able to mobilize others; learn to negotiate and resolve conflicts; and understand the contextual situations in which they are operating. Exposure to basic managerial skills is also considered important and includes: budget development and management; HR skills; strategic planning and marketing; overall project management; and, a basic understanding of organizational behavior. PROGRAM ACTIVITIES Global Health Delivery Intensive Program - The Global Health Delivery Intensive (GHDI) Program at Harvard aims to systematize the study of health care delivery and stimulate collaboration among educators, researchers, stakeholders, and implementers. The GHDI program is one of Harvard s efforts to expand the educational opportunities in global health delivery, and to convene a new cadre of health professionals trained in the major concepts and skills in delivering value-based health care within their own contexts. GHDI is intended for global health professionals who seek training in global health delivery concepts and skills. Participants take three courses during the program: Epidemiological Methods for Global Health, Introduction to Global Health Care Delivery, and Management Practices in Health Care Delivery. To find out more about the Harvard summer program in Global Health Delivery: Harvard Catalyst Online Learning: In keeping with its core educational mission, Harvard Catalyst offers dozens of training programs, ranging from short courses on translational and clinical research to multiyear advanced education and training programs. Fellows are strongly encouraged to explore and participate in courses offered by Harvard Catalyst to bolster their knowledge of clinical and translational research. Other Learning Opportunities: The fellowship will also distribute information regarding seminars, lectures, and courses addressing GWH-related topics that occur regularly around Harvard and Harvard-affiliated institutions so that fellows may take advantage of the wealth of opportunities across institutions. Fellows are encouraged to attend clinical grand rounds series in their area of expertise so that they remain current with important clinical issues in women s health. Connors Center Programming: Fellows will participate in a half-day Connors Center Research Retreat. The retreat will allow fellows a chance to present their research in progress and obtain timely feedback from other Connors Center investigators. Fellows will also be expected to attend other Connors Center programs periodically throughout the year when their travel schedule allows. 7 Last Update: 9/18/2018

8 Mentored Research Each fellow will be expected to pair with a primary research mentor and/or mentorship team. Fellows will spend most of their time conducting research under the supervision of one or more faculty mentors who have a special interest and expertise in the fellow s area of interest. Developing a relationship with a research mentor is an important part of a fellow s training experience and can be a lengthy process. Even before the start of the fellowship, the Fellowship Director will discuss with the fellow about developing plans for connecting with possible research mentors. Being able to develop a good match depends on the fit between the fellow s interests and skills, the mentor s capacity to take on additional trainees, and the mentor s expertise and ongoing research project needs. The Fellowship Director will work closely with each fellow to cultivate these relationships. Over the two-year fellowship, each fellow will design, implement, analyze, and complete a minimum of one publishable original research project under the supervision of a faculty mentor. Fellows are typically involved in two to three research projects over the course of the two years. Their research projects will utilize the qualitative, quantitative, and analytic skills learned from their MPH and through the program curriculum. The Fellowship Director will closely guide the choice of research projects. The Connors Center Project Manager can assist you with the administrative aspects of your fellowship, such as navigating BWH Research Administration and Human Resources and searching for funding opportunities. Career Mentorship the Fellowship Director will also function as the overall career mentor to ensure each fellow is on a coherent pathway towards independence. The Fellowship Director will do an initial needs assessment with the fellow to get a sense of their overall schedule, their career plans (short- and long-term), and get a better sense of their research interests as well as helping the fellow to further refine their niche. The Director will meet with the fellow monthly in person or via Skype to ensure goals are being met and/or adapted based on individual and ongoing needs; to review with the fellow the focus and appropriateness of the overall research project; and to mentor the fellow in taking steps towards an independent research career. Humanitarian Studies Initiative Training Programs Fellows are given the option of participating in the intensive two-week course in the management of humanitarian crises as well as the weekendlong simulation. These courses are designed to give fellows a better understanding of the evolving and multidisciplinary field of humanitarian studies. As part of the coursework, fellows will learn about: fundamentals of humanitarian disaster relief work; controversies and challenges; research methods; funding flow; how to implement rapid health assessments; communicable diseases; issues concerning the environment in humanitarian crises; applied technology; mental health and psychosocial aspects of disaster; security and protection issues; food aid and food security; logistics and coordination; methods in cluster sampling; shelter, water and sanitation; interaction with media; budgeting issues; and, monitoring and evaluation of relief programs. Human Research Training and IRB Approvals Each fellow must take the University of Miami CITI Course (on the responsible conduct of research as per NIH guidelines offered by BWH, MGH 8 Last Update: 9/18/2018

9 and BIDMC. This program offers a web-based tutorial on ethical principles governing research on human subjects, informed consent, research with vulnerable human populations, use of tissues and genetic samples, survey research and FDA rules and requires the user to pass a web-based exam. The certification must be kept current for the duration of the fellowship. Fellows may also complete a similar web-based program offered by Harvard Ethics Training in Human Research (HETHR). Instruction in research ethics also occurs in the Program in Clinical Effectiveness Epidemiology course at HSPH. Fellows must submit IRB applications for all research projects and regularly monitor and update their protocols. Collaborative Publication Each year, the senior fellow is expected to take the lead on a collaborative publication with the junior fellow and others interested in collaborating. These can be editorials, book chapters, reviews, or lectures about and contributing to the field of GWH writ large. The Connors Global Women s Health Fellowship should be acknowledged as a source of support in all communications. Online Publications - GWH Fellows are required to contribute to an online global health blog or other lay press at least once per year, with the goal of bringing global women s health issues to a wider audience, fostering new collaborations, and raising the visibility of their work. Options include BWH s global health blog (bwhglobalhealthhub.org), which serves as a place for employees and trainees to share their global health experiences and foster collaborations with others involved in similar work, as well as other online venues such as STAT (statnews.com), the Huffington Post (huffingtonpost.com), and the Hill (thehill.com). The Connors Global Women s Health Fellowship should be acknowledged as a source of support in all communications. Graduation - At the end of the Fellowship, fellows are invited to join a graduation ceremony along with those completing Connors Center Family Planning and Women s Mental Health Fellowships. At the graduation, fellows give an oral presentation highlighting their accomplishments over the two-year fellowship period. 9 Last Update: 9/18/2018

10 PROGRAM EVALUATION Evaluation of Fellows The fellows will meet monthly with the Fellowship Director to receive immediate feedback regarding progress on their research project and career plans. Faculty and mentors will be asked every six months during the fellowship to give formal written feedback about the performance and progress of the fellows. The mid-term evaluation will assess the fellow s ability to identify research goals, collaborators and mentors, and develop a reasonable and achievable career plan. The last formal evaluation will occur near the end of the fellowship and evaluate if the fellow reached his/her research and learning objectives (including publications, presentations, and grant submissions), career plans and overall development as a GWH leader. Evaluation of Mentors Fellows will have an opportunity to evaluate their mentors at the end of each year through an online survey. Evaluation of Fellowship Program At the end of each year of the Fellowship, each fellow will have the opportunity to evaluate the program through an online survey. The fellows will be asked for feedback on strengths and weaknesses of the program and opportunities for improvement. The Fellowship leadership team will review the summary of responses and discuss associated action plans and implementation timelines. The Fellowship Director also welcomes feedback during monthly meetings to enable changes and improvements on an ongoing basis. 10 Last Update: 9/18/2018

11 ANNUAL SCHEDULE October (prior to start of Fellowship) Applications due November (prior to start of Fellowship) Interviews December (prior to start of Fellowship) Informed re: acceptance into Fellowship Clinical placement search begins February (prior to start of Fellowship) Appointment paperwork initiated HSPH GHDI application due May (prior to start of Fellowship) Initial needs assessment with Fellowship Director Fellow and Director develop initial two-year plan Fellow begins to build mentoring team and network June (prior to start of Fellowship) Final contracts in place July Welcome session On-boarding of fellow HSPH GHDI begins Fellow and Director Research Proposal Phase I begins September Fellow and Director Research Proposal Phase II begins November Connors Center Research Retreat December Mid-year evaluation of Fellow June Fellowship graduation with project presentations Year-end evaluation of fellow Fellow s evaluation of mentors Fellow s evaluation of fellowship program APPLICATION REQUIREMENTS Note: Basic schedule repeats over 2 nd year Applicants must be board certified or board eligible in their trained specialty when they begin the fellowship. Successful applicants will also (1) receive a research appointment with Brigham and Women s Hospital (as initiated by the Fellowship); (2) receive a research appointment with Harvard Medical School (as initiated by the Fellowship); (3) obtain a Massachusetts medical license (candidate s responsibility); and (4) be accepted into the Global Health Delivery Intensive Program at the Harvard T.H. Chan School of Public Health (candidate s responsibility). Please note that all application materials must be received by October 7 for the Fellowship beginning July 1. Fellows will be notified on their acceptance into the Fellowship by December 15. Please submit the following items by to Julie Alperen (info below): 1. An application form 2. CV 11 Last Update: 9/18/2018

12 3. Personal statement (one page maximum) 4. Three letters of recommendation (one from Residency Director or Chairman) 5. Official transcript of USMLE results 6. Official medical school transcript You must also apply separately to the Harvard T.H. Chan School of Public Health Global Health Delivery Intensive Program by February 1. Application for admission is available through the Schools of Public Health Application Service (SOPHAS) Express. For the most current information, please visit: For additional information, please contact: Hanni Stoklosa, MD, MPH Global Women s Health Fellowship Program Director Connors Center for Women s Health and Gender Biology Brigham and Women s Hospital 1620 Tremont Street, 3 rd Floor Boston, MA hstoklosa@bwh.harvard.edu Julie Alperen, DrPH Administrative Director Connors Center for Women s Health and Gender Biology Brigham and Women s Hospital 1620 Tremont Street, 4 th Floor Boston, MA jalperen@bwh.harvard.edu 12 Last Update: 9/18/2018