Women's Health Fellowship

Goals

To develop physicians with expertise in the clinical, educational, and
research aspects of women's health; and to develop leaders in women's
health care advocacy.

Personnel

  Faculty

Jeffrey P. Levine, M.D., M.P.H., Director

Rhina Acevedo, M.D.

Gloria Bachmann, M.D. †

Ricardo Caraballo, M.D. †

Thomas Kearney, M.D. ††

Michelle McWeeney, P.A.

Butch P allay, M.D.

Randi Protter, M.D. *

Sharon Stechna, M.D. †

* Department of Medicine

† Department of Obstetrics, Gynecology, and Reproductive Sciences

†† Department of Surgery; Cancer Institute of New Jersey

Fellow

  Sally Mravcak, M.D.

Education Curriculum

The department's Women's Health Fellowship Program, developed in 1992, was the first such fellowship in the United States . The program accepts one applicant per year, after a very competitive application process, and offers one-year of fellowship training, with an optional second year to pursue an MPH. The curriculum is customized to meet each fellow's individual needs and enhance their clinical, teaching and research skills. Clinical experience is primarily obtained through patient care activities at the UMG-Primary Care Center at Hillsborough, the Chandler Health Center (CHC), the Family Practice Center (FPC), St. Johns , Trinity, and the Women's Health & Counseling Center (WHCC), as well as several of the Medical School 's Specialty Clinics. The fellow also attends local and regional women's health conferences. The fellow's teaching skills are developed through the Family Health Teaching Skills course, by precepting residents at the FPC, St. John's , Trinity, CHC, and the WHCC, and by their formal presentations on Women's Health issues to family practice faculty, residents and medical students. Research skills are developed through participation in the department's Health Services Research Forums, Research Division Meetings, School of Public Health courses, and by participation in women's health research projects through the Family Medicine and OB/GYN Departments. The fellow is expected to develop, conduct, and present an original, publishable Women's Health-related research project by the end of their training.

Sally Mravcak, MD, completed her one-year fellowship in the Women's Health Fellowship Program this past academic year. Dr. Mravcak is a graduate of the UMDNJ-Robert Wood Johnson Medical School . She completed her training at the Somerset Family Practice Residency Program, where she served as Chief Resident. After completing her fellowship training, Dr. Mravcak will be providing primary care and women's health services at the Chandler Health Center Satellite Clinic.

Research Activities

Justine Wu, MD, our previous Women's Health Fellow, designed and conducted survey research on Abortion Training in Family Medicine Residency Training, the results of which she has submitted the results of her original research for peer-reviewed publication, and she has presented them at several national research meetings during this past academic year.

Sally Mravcak, MD, our current fellow, designed a physician education program on “The Evaluation & Management of Obesity,” which she presented to Family Medicine Residency Programs throughout the state. Dr. Mravcak also developed an effective obesity education and treatment program for women utilizing a group visit format, which she piloted at the UMG-Hillsborough Primary Care Center. She met with Residency Faculty at New Jersey Family Medicine Residency Programs to help them integrate group visits on Obesity into their clinical practice sites. Dr. Mravcak will present the results of her original research at the 2005 Society of Teachers in Family Medicine (STFM) North East Regional Conference and will be submitted for peer-reviewed publication.

Jacqueline Jackson was selected as the COPC student for our WHWW program. Her project involved designing and distributing a knowledge, attitudes, and needs assessment survey, regarding obesity and related cardiovascular disease risks, for female patients at St. Johns Community Health Center. She also interviewed local weight-loss programs (i.e., Weight Watchers, Curves, Overeaters Anonymous, Hospital Nutrition Departments, School of Nutrition ) and solicited their support to improve access for the underserved to their programs. The results of her project will help the staff of St. John's develop an on-site, culturally sensitive, nutrition and weight-loss counseling program.

Dr. Levine, Dr. Wu, and Michelle McWeeney, along with Sarah Marchand (a summer COPC student) completed the final evaluation for their $35,000 Community Health Project Grant from the Foundation of UMDNJ Annual Grants Program, titled “Women's Health Without Walls (WHWW)”- A Program to Provide On-Site Women's Health Care Services, Education, and Training at Local Community Health Centers for the Underserved. This grant enabled the Women's Health fellow to provide onsite specialized women's health diagnostic, treatment, preventive, and counseling services at St. Johns (New Brunswick), Trinity (Perth Amboy), and the Women's Health & Counseling Center (Somerville), thereby eliminating significant barriers to care (i.e, transportation, cost, trust). This grant greatly enhanced our residents' and clerkship students' clinical experience in women's health. The results of this highly successful project was presented at the 2004 Society of Teachers in Family Medicine (STFM) North East Regional Conference and will be submitted for publication. Additional funding to expand the services offered and sites provided by the WHWW program is currently being sought.

Dr. Levine developed and conducted a survey of Family Physicians in New Jersey , to assess the educational needs and barriers to providing prevention education, screening, and treatment for Osteoporosis, as part of an $8000 grant from the Alliance for Better Bone Health. The information gained from this survey will be utilized by the New Jersey Department of Health & Senior Services to develop educational programs and legislative initiatives. The results of this survey will be presented at the 2005 Society of Teachers in Family Medicine North East Regional Meeting and they will be submitted for peer-reviewed publication.

Dr. Levine, Dr. Wu, Michelle McWeeney, and Sarah Marchand utilized an Achilles Scanner (heel ultrasound), received through a grant from the Alliance for Better Bone Health, to screen and treat high-risk un/under-insured postmenopausal women at Community Health Centers for Osteoporosis, as part of the WHWW program. The results of this project were presented at the 2004 North American Primary Care Research Group (NAPCRG) Meeting and will be submitted for publication.

Clinical Activities

Dr. Levine provided outpatient care, as well as medical student teaching at the Department's Family Medicine at Monument Square clinical site. Dr. Mravcak provided outpatient care at the UMG-Primary Care Center at Hillsborough office. Dr. Levine provided three weeks of hospital service at RWJUH and two weeks at SPUH. Drs. Levine and Mravcak also precepted family practice residents and medical students at the FPC and MS offices. Dr. Mravcak also supervised PGY III family practice residents at CHC, St. John's , Trinity, and the WHCC during their Gynecology Rotations.

Educational Activities

Dr. Mravcak helped expand our Women's Health Without Walls (WHWW) Program, including very successful Osteoporosis diagnosis, treatment and prevention education services. Justine developed and presented a well-received Abortion Education Program at Family Practice Residency Programs throughout New Jersey .

Dr. Levine presented at nine national and regional CME programs on various women's health issues. Dr. Mravcak developed a curriculum on Obesity and Group Visits, which she presented at Family Practice Residency Training Programs throughout New Jersey . Drs. Levine, Mravcak, and Wu authored/co-authored five peer-reviewed articles, one book chapter, two invited articles, and presented seven peer-reviewed abstracts/posters. Dr. Levine served on the Planning Committee for the medical school's Human Sexuality Program. Dr. Levine also served as Faculty Advisor for Medical Students for Choice and as Course Director of the medical school's Reproductive Issues in Women's Health elective. He also served as Faculty Advisor to MPH and COPC students conducting women's health related fieldwork, and for fourth year medical students pursuing a career in women's health. Drs. Levine & Mravcak also hosted a monthly Women's Health Series for family practice residents at the FPC and a bimonthly Women's Health Seminar for third year family medicine clerkship students.

Community Activities

Dr. Levine served as Chair of the New Jersey Department of Health & Senior Services' Interagency Council on Osteoporosis (ICO). He also served on the UMDNJ-Robert Wood Johnson Medical School 's Curriculum Committee and as a faculty member for the Center for Marital and Sexual Health. Dr. Levine also served on the Medical Advisory Board of the New Jersey Family Planning League.

Dr. Levine, Dr. Mravcak, and Michelle McWeeney continued to provide specialized women's health services to underserved patients at St. John's , Trinity, and CHC, as part of the Women's Health Without Walls program.

They also planned and hosted a Osteoporosis Awareness Nights for patients at St. John's , providing onsite osteoporosis prevention education, screening, and treatment.

Grants Awarded

“Reproductive Health Options Training Grant.” Grant to fund elective program designed to train Family Medicine and Ob/Gyn Residents & Faculty to provide comprehensive women's reproductive health services including contraception, pregnancy options counseling, medical abortion, MVA, and post-abortion care. State of New Jersey . PI: Levine JP. Awarded May 2005. Amount: $165,000

“Osteoporosis Point of Care (OsteoCare) PDA Program Development Grant.” Grant to fund the development, testing, and distribution of an interactive PDA program to improve clinicians' ability to diagnose and manage Osteoporosis. Allliance for Better Bone Health & NJAFP. PI: Levine, JP. Awarded March 2005; Amount: $25,000

“Use of On-Site Heel Ultrasound to Improve Screening of Postmenopausal Women for Low Bone Density in Central New Jersey Community Health Centers for the Underserved.” Women's Health Without Walls Program. P&G Community Health Grant. PI: Levine JP. Awarded April 2003 - September 2005. Amount: $14,600.00 (Achilles Scanner)

 Publications

A. Peer-Reviewed Journal Articles

Wu JP, Bennett I, Levine JP, et al. The Effect of a Simple Educational Intervention on Interest in Early Abortion Training Among Family Medicine Residents. Contraception. (Submitted for Publication June 2005)

Hamilton JL, Levine JP. Opening Pandora's Box: Neo-Pagan patients' preferences for physician discussion of religion and spirituality during grave illness. NJAFP Perspectives. (Accepted for Publication June 2005)

Mravcak S. Health Care Needs of Women who have Sex with Women. American Family Physician. (Accepted for Publication June 2005)

Levine JP, Sinofsky FE, Christ MF, et al. Assessment of Implanon ™ Insertion and Removal. (Accepted for Publication May 2005)

Mravcak S. Cervical Cancer Screening: Revised Guidelines. The Female Patient. December 2004;29(12):37-42.

Levine JP. Nondaily hormonal contraceptives: Establishing a fit between product characteristics and patient preferences. The Journal of Family Practice. November 2004;53(11):904-13.

Wu J, Levine JP. Cardiovascular disease in women: prevention and screening. The Female Patient 2004;29:34-43.

Heath C, Acevedo R. Preconception Screening and Counseling. The Female Patient 2004;29(10):42-45.

Wu J, et al. “Emergency contraception: knowledge and attitudes of family medicine providers. Journal of Family Practice. (Accepted for publication).

B. Invited Articles

Levine JP, et al. “Osteoporosis & Primary Care.” Osteoporosis CME Video Program. M2 Communications, June 2005.

Levine JP. Osteoporosis Insights 2004. University of Texas Southwestern Medical Center Continuing Education/Enduring Materials. M2 Communications Inc. Jersey City , New Jersey . October 2004;Volume 1:Issue 12.

Levine JP, Wu J. Section III: Women's Health. Swanson Family Practice Review: A Problem-Oriented Approach. 5 th ed. Mosby, Inc. Philadelphia , Pa. 2005.

Abstracts

Wu J , Fleischman J, Levine JP, et al. Abortion Training in Family Medicine: A Survey of New

Jersey Family Medicine Programs. Paper on Completed Research. 32 nd Annual Meeting: North

American Primary Care Research Group. Orlando , Florida , October 11 th , 2004.

Levine JP, Wu J, McWeeney M, Morchen S. Identification of Postmenopausal Women at High

Risk for Osteoporotic Fracture Utilizing Onsite Heel Ultrasound Screening at a Community

Health Center for the Underserved. Paper on Completed Research. 32 nd Annual Meeting:

North American Primary Care Research Group. Orlando , Fl, October 12, 2004.

Wu J, Levine JP, et al. From Interest to Implementation: A Guide to Developing Abortion Training in New Jersey Family Medicine Residencies. Poster Presentation. 23 rd Annual Society of Teachers of Family Medicine: NorthEast Region Meeting. Ryebrook , NY , October 30, 2004.

McWeeney M, Wu J, Patil S, Reddy G, Levine JP. A Successful Initiative to Provide Women's health to an Underserved Population: The Women's Health Without Walls Program. Paper Presentation. 23 rd Annual Society of Teachers of Family Medicine: NorthEast Region Meeting. Ryebrook , NY , October 30, 2004.

Wu J , Fleischman J, Levine JP, et al. Abortion training in family medicine: A survey of New Jersey family medicine programs. Poster Presentation. Annual Meeting, American Public Health Association, Washington , D.C. , November 9 th , 2004.

McWeeney M, Wu J, Morchen S, Levine JP. Identification of Postmenopausal Women at High Risk for Osteoporotic Fracture Utilizing Onsite Heel Ultrasound Screening at a Community Health Center for the Underserved. Poster Presentation. Research Day. UMDNJ-Robert Wood Johnson Medical School , New Brunswick , NJ, November 15, 2004.

“Opening Pandora's Box: Neo-Pagan patients' preferences for physician discussion of religion and spirituality during grave illness.” Poster Presentation. New Jersey Academy of Family Physicians Annual Scientific Assembly, Atlantic City , NJ , May 20, 2005. Hamilton JL, Levine JP. *Awarded “Best Poster Presentation.”

Peer Reviewed Presentations

Opening Pandora's Box: Neo-Pagan patients' preferences for physician discussion of religion and spirituality during grave illness. Poster Presentation. New Jersey Academy of Family Physicians Annual Scientific Assembly, Atlantic City , NJ , May 20, 2005. Hamilton JL, Levine JP. *Awarded “Best Poster Presentation.”

McWeeney M, Wu J, Morchen S, Levine JP. Identification of Postmenopausal Women at High Risk for Osteoporotic Fracture Utilizing Onsite Heel Ultrasound Screening at a Community Health Center for the Underserved. Poster Presentation. Research Day. UMDNJ-Robert Wood Johnson Medical School , New Brunswick , NJ, November 15, 2004.

Wu J , Fleischman J, Levine JP, et al. Abortion training in family medicine: A survey of New Jersey family medicine programs. Poster Presentation. Annual Meeting, American Public Health Association, Washington , D.C. , November 9 th , 2004.

Wu J, Levine JP, et al. From Interest to Implementation: A Guide to Developing Abortion Training in New Jersey Family Medicine Residencies. Poster Presentation. 23 rd Annual Society of Teachers of Family Medicine: NorthEast Region Meeting. Ryebrook , NY , October 30, 2004.

McWeeney M, Wu J, Patil S, Reddy G, Levine JP. A Successful Initiative to Provide Women's health to an Underserved Population: The Women's Health Without Walls Program. Paper Presentation. 23 rd Annual Society of Teachers of Family Medicine: NorthEast Region Meeting. Ryebrook , NY , October 30, 2004.

Levine JP, Wu J, McWeeney M, Morchen S. Identification of Postmenopausal Women at High Risk for Osteoporotic Fracture Utilizing Onsite Heel Ultrasound Screening at a Community Health Center for the Underserved. Paper on Completed Research. 32 nd Annual Meeting: North American Primary Care Research Group. Orlando , Fl, October 12, 2004.

Wu J , Fleischman J, Levine JP, et al. Abortion Training in Family Medicine: A Survey of New Jersey Family Medicine Programs. Paper on Completed Research. 32 nd Annual Meeting: North American Primary Care Research Group. Orlando , Florida , October 11 th , 2004.

CME Presentations

“Update on Contraception 2005.” UMDNJ-RWJMS Visiting Professor Program. Ortho-Janssen Pharmaceuticals, Raritan , NJ , February 24, 2005. Levine JP

“Control: Opening the Dialogue on Bladder Health.” Postgraduate Institute for Medicine. Stage Left, New Brunswick , NJ , February 23, 2005. Levine JP.

“Urinary Incontinence in Women.” Women's Health Series. UMDNJ-Robert Wood Johnson Family Practice Residency Program. New Brunswick , NJ , February 18, 2005. Levine JP, Carabello R.

“Osteoporosis & Primary Care.” Osteoporosis CME Video Program. M2 Communications, Los Angeles , CA . February 11, 2005. Levine JP

“Obesity: Diagnosis & Management.” Saint Mary's Family Practice Residency Program, Hoboken , NJ , February 8, 2005. Mravcak S.

“Evaluation Management of Cervicitis.” Hurtado Student Health Center . Rutgers University, New Brunswick, NJ, February 4, 2005. Mravcak S.

“Obesity: Diagnosis & Management.” Overlook Family Practice Residency Program, Summit, NJ, January 14, 2005. Mravcak S.

“Contraceptive Update 2005.” Human Sexuality Program. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, January 7, 2007. Levine JP

“Medical and Surgical Abortion.” Human Sexuality Program. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, January 5, 2005. Mravcak S.

“Clinical Issues & Concerns Panel.” Human Sexuality Program. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, January 5, 2005. Levine JP

“Obesity: Diagnosis & Management.” Somerset Family Practice Residency Program, Somerville, NJ, December 15, 2004. Mravcak S.

“Obesity: Diagnosis & Management.” Mountainside Family Practice Residency Program, Monclair, NJ, December 8, 2004. Mravcak S.

“Obesity: Diagnosis & Management.” UMDNJ-RWJMS Family Practice Residency Program, New Brunswick, NJ, November 19, 2004. Mravcak S.

“Obesity: Diagnosis & Management.” Warren Family Practice Residency Program, Phillipsburg, NJ, November 17, 2004. Mravcak S.

“Obesity: Diagnosis & Management.” JFK Family Practice Residency Program, Edison, NJ, November 4, 2004. Mravcak S.

“Clinical Update on Sexual Health.” 23 rd Annual Society of Teachers of Family Medicine: NorthEast Region Meeting. Ryebrook, NY, October 30, 2004. Levine JP, Sadovsky R

“To HRT or Not HRT: An Evidence-Based Approach to Helping Your Patients Decide.” Hurtado Rutgers Student Health Center. New Brunswick, NJ, October 22, 2004. Levine JP

“A Family Physician's Approach to the Diagnosis of Osteoporosis.” AAFP Scientific Assembly. Orlando, Fl, October 15 & 16, 2004. Levine JP and Lambing C

“Gynecologic Procedures Workshop.” AAFP Scientific Assembly. Orlando, Fl, October 13 & 14, 2004. Heath C, et al.

“Women's Sexual Health.” New Jersey Physician's Assistants Annual CME Conference. NJ Hospital Association, Princeton, NJ, October 9, 2004. Levine JP

Resident Presentations

“The IRB Research Study Submission Process Made Ridiculously Simple.” Resident Research Seminar Series. UMDNJ-Robert Wood Johnson Family Practice Residency Program. New Brunswick, NJ, January 28, 2005. Papagnia P, Levine JP.

“Group Visit for Weight Loss in Patients with Hypertension and Obesity.” University Medical Group, Hillsborough, NJ, January 27, 2005. Mravcak S.

“Improving the Recognition and Management of PMS & PMDD.” Women's Health Series. UMDNJ-Robert Wood Johnson Family Practice Residency Program. New Brunswick, NJ, January 21, 2005. Levine JP.

“Evaluation and Treatment of Vulvovaginitis.” Women's Health Series. UMDNJ-Robert Wood Johnson Family Practice Residency Program. New Brunswick, NJ, December 17, 2004. Levine JP.

“Gyn Jeopardy: Family Practice In-Training Exam Review.” Women's Health Series. Family Practice Residency Program. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, October 29, 2004. Levine JP.

Medical Student Presentations

“Osteoporosis Case Study.” Second Year Medical Student Small Group Sessions. UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, February 23, 2005. Mravcak S.

“Update on Contraception 2004.” Women's Reproductive Health Issues Elective Program. UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ, October 7, 2004. Levine JP.

“Women's Health Issues Throughout the Lifecycle.” Third Year Family Practice Clerkship. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, Six Presentations (1.5 hrs every eight weeks). Levine JP.

“Cervical Cancer Screening and Evaluation and Management of Abnormal Pap Smears.” Third Year Family Practice Clerkship. UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, Six Presentations (1.5 hrs every eight weeks). Mravcak S.

Other Invited Presentations

“Use of PDAs to Improve Point of Care Diagnosis and Management of Osteoporosis.” Alliance for Better Bone Health Annual Regional Osteoporosis Board Meeting. Orlando, FL, November 20, 2004.

Faculty Advising - Women's Health Research Projects

Mravcak, Sally - Integrating Group Visits for Obesity into FM Residency Training Programs

Wu, Justine - Abortion training knowledge, attitudes and interest in NJ family practice residency programs.

McWeeney, Michelle - Improving access and delivery of women's health services.

Jackson, Jaqueline - Improving Obesity Evaluation and Management for Underserved Women

Marchand, Sarah - Utilizing Heel Ultrasound to Evaluate Osteoporosis Risk Among Underserved Women

Constance-P eters, Gregorie MD & Gachette, Emanuel MD- Assessing Sexual Dysfunction in Postmenopausal Women

Patel, Rahil MD - Comfort Levels Among Family Medicine Residents Assessing Sexual Dysfunction

Serrano, Esmeralda MSI – “Patient Knowledge, Attitudes, and Behaviors Regarding STD Prevention.”