The Division of Women’s Health/Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital is the home site for the Harvard Medical School-wide award from the NIH Building Interdisciplinary Research Careers in Women’s Health (BIRCWH). Entitled “Hormones & Genes in Women’s Health: From Bench to Bedside”, the BIRCWH program supports scholars investigating the role of hormones and genes in understanding sex differences in disease and those disorders specific to women by providing up to five years of funding and mentored research from Harvard faculty in basic, translational, or clinical aspects of women’s health. The success of the program is measured by the ability of the scholars to develop careers as independent investigators, including successfully obtaining research support and publishing high quality work with substantial contributions to understanding issues important to women’s health.
Under the direction of Jill Goldstein, PhD (Principal Investigator) and Ursula Kaiser, MD (Program Director), the program draws on research leaders and mentors from a variety of disciplines across Harvard affiliates and is based on a translational approach to understanding sex-specific vulnerabilities and disorders specific to women. The program is modeled in the context of a lifespan perspective to identify etiologic mechanisms during fetal development, puberty, adulthood, and aging, with some focus on periods specific to women such as child-bearing, perimenopause and menopause. Our underlying assumption is that understanding the roles of hormones and genes will provide the basis for understanding sex-specific vulnerabilities to clinical disorders.
We have chosen to focus on the following disorders, given either the known higher incidence in women than in men or the known differential expression of the disorder in women as well as the strengths of the Harvard community in these areas of women’s health: cardiovascular disorders (including diabetes and obesity); reproductive endocrine and neuroendocrine disorders; neuropsychiatric disorders (e.g. mood and substance use disorders); autoimmune disorders (e.g. multiple sclerosis); and female cancers (e.g. breast, ovarian and uterine).
The BIRCWH program provides an important foundation for faculty academic advancement, recognition within the academic medical world, and a foundation for fundraising to support additional scholars. We believe that the collaborative research structure will serve as an important model at BWH and across the nation.
The Gretchen and Edward Fish Center for Women’s Health teaches eleven residents in internal medicine as well as fellows in psychiatry, neurology, and gastroenterology, and students on rotations in endocrinology and dermatology. In addition, Fish Center physicians and medical staff attend bi-weekly education sessions, taking an interdisciplinary approach to each topic to understand the symptoms, evaluation, testing, treatment, and potential long term effects of disease from the perspective of the different specialties that are part of the practice. Faculty present on a myriad of issues related to the health of women, including diabetes management, knee and joint pain, pelvic floor dysfunction, contraception use, mental health, eating disorders, and issues for women with chronic disease.
The Fish Center is committed to routinely applying emerging knowledge of women’s health to the delivery of care, and to evaluating the outcomes of care to advance research and knowledge of women’s health. Essential to this effort is the formation of clinical research groups in key areas such as diabetes, musculoskeletal health, cardiovascular disease, and nutrition. Each group brings particular experience in women's health, working collaboratively across clinical and research "silos" to advance women's care and inform research questions that will guide the future of women's health.
The CME program, Women’s Health Clinical Seminars, was introduced in November 2005 and takes place at the Gretchen and Edward Fish Center for Women’s Health. The seminars are held every other week at lunch time, and have three objectives: 1) to become familiar with interdisciplinary approaches to Women’s Health; 2) to learn key principles of clinical quality improvement as they relate to Women’s Health; and 3) to participate in interactive dialogue with peers and experts regarding interesting and challenging clinical problems.
Under the directorship of Paula A. Johnson, MD, MPH, the seminars have been led by forty-six HMS faculty and fifteen other outside experts in a variety of areas including diabetes, osteoporosis, hepatitis, headache, integrative medicine, obesity and cardiovascular disease, aging, sports injuries, breast cancer, dermatology, arthritis, abortion, medication management during pregnancy, celiac disease, eating disorders, colon cancer screening, and quality improvement, to name a few. Speakers are asked in advance to address not only the particular clinical topics and area of expertise, but also to address in the seminar 1) sex differences in risk, prevalence, response to treatment, and outcomes; and 2) an interdisciplinary approach that considers how the clinical issue/disorder and the implications of disease progression and/or treatment are seen, evaluated and addressed by different specialties. Formats include presentations, presentations combined with case discussions, and case discussions.
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