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University of Pittsburgh

 

Overview of Program
Clinical Training
Masters Degree Options
Research Opportunities
Collaborations
Mentorship
International Opportunites
Additional Program Highlights
Directors
Research and Clinical Interests of Directors
Current Faculty Research Projects
Clinical Training Sites

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Overview of Program

The Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Pittsburgh offers three programs for physicians interested in a Family Planning Fellowship:

  • FAMILY PLANNING (2 years)
  • Combined FAMILY PLANNING and REPRODUCTIVE GENETICS (3 years)
  • Combined FAMILY PLANNING and REPRODUCTIVE INFECTIOUS DISEASE (3 years)

The Family Planning Fellowship at the University of Pittsburgh is designed to include training in family planning clinical care, experience in gynecologic surgery and related family planning procedures including complications and unusual cases. Also included are participation in the design and performance of clinical trials, and international field work.

The program is intended to foster the pursuit of an academic career by an overall emphasis on and preparation for clinical research and teaching. The fellow will receive specialized training and become very experienced in performing first trimester procedures including manual vacuum aspiration and medical abortions. In addition, the fellow will have similar experience with second trimester abortions by dilation and evacuation (D&E) and dilation and extraction (D&X). The primary foci of the program are clinical research, training to be an academician, and training in all types of abortion.

The Center for Family Planning Research was established in 1994 and has become one of the leading family planning research centers in the United States. Clinical trials involving medical abortion, oral contraceptives, new barrier methods of contraception, emergency contraception, new contraceptive technologies, and social issues related to contraceptive practice are just some of the projects that have been performed to date. In addition, our relationship with the Magee-Womens Research Institute has allowed for the development of basic science research related to contraception and abortion.

Combined Programs
Three-year programs are available for individuals with an additional interest in Reproductive Genetics or Reproductive Infectious Disease. In addition to the Family Planning Fellowship curriculum, individuals in the combined fellowship with genetics will also achieve competency in CVS, genetic amniocentesis, and reproductive and cancer genetic counseling. The Reproductive Genetics fellowship is directed by W. Allen Hogge, MD. The combined fellowship will allow fellows who have completed to satisfy requirements for American Board of Medical Genetics Certification.

Those individuals with an additional interest in reproductive infectious disease will gain experience in sexually transmitted diseases (STD) management and inpatient adult infectious disease services, perform duties in the outpatient perinatal reproductive infectious diseases clinic involving perinatal infections, and acquire comprehensive knowledge of gynecologic infectious diseases including chronic vaginitis, STDs, PID, and pelvic infections. The Reproductive Infectious Disease fellowship is directed by Harold Wiesenfeld, MD, CM. For more information, see the Reproductive Infectious Disease Website.

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Clinical Training

The program at the University of Pittsburgh provides the fellow with the unique opportunity to learn abortion care and provision in all types of care settings.

  • Reproductive Health Clinic: Medical abortion and surgical abortion through 18 weeks gestation is provided at Planned Parenthood of Western Pennsylvania.
  • Hospital clinic/operating room: surgical abortion services through 23 6/7 weeks gestation is provided by the hospital clinic weekly with pre-operative evaluations in the outpatient clinic and procedures the following day in the operating room. The majority of these cases are performed by dilation and evacuation or dilation and extraction. Suction aspiration procedures for women who have complex medical needs are also provided in this setting.
  • Private office: The fellow will learn provision of care to private patients primarily using manual vacuum aspiration up to 14 weeks gestation. During the second year of fellowship, the fellow will have her/his own office hours one half day per week for abortion and gynecologic patients. Additionally, during the two years, the fellow will be involved with care for the large volume of private referral patients with genetic, medical and elective reasons for dilation and evacuation or dilation and extraction procedures. The fellow will learn and provide counseling and provision of services which focus on dilator placement in the private office with procedures the following day in the operating room.
  • Medical abortion: The fellow will provide medical abortion in both a private and research settings at the hospital and at Planned Parenthood. In both clinical settings, the fellow will learn the optimal method of medical abortion provision in a team approach with advanced care practitioners.

The fellow will learn contraceptive specialty services through referral clinics and private patient referrals in consultation with Family Planning faculty. General gynecologic surgery is available, primarily in the second year. No obstetric services or general gynecology call is required. Call is required for the family planning referral service.

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Masters Degree Options

During the two years, the fellow will complete course work at the Graduate School of Public Health at the University of Pittsburgh to satisfy the requirements of a Master's Degree in Public Health. The degree can focus on Epidemiology or Health Policy and Management, or be a Multidisciplinary program (which is what most fellows select).

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Research Opportunities

Each fellow completes a minimum of two research projects for which s/he is the principal investigator. The fellows are co-investigators on all projects in the Center for Family Planning Research office; a team approach is used for all studies. As such, the fellows have the full backing of the office and its 10 full-time research staff. Dr. Creinin involves the fellows in all aspects of grant writing, budgeting, and the IRB process. Research meetings are held every other week with all members of the clinical research team.

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Collaboration

Unique opportunities for collaboration exist because of the wealth of leading faculty at the University of Pittsburgh. The Department of Obstetrics, Gynecology and Reproductive Sciences has over 80 full time faculty and is the number one NIH funded Obstetrics and Gynecology department in the country. Amongst notable collaborators within the Department is Sharon Hillier, PhD, an international leader in Reproductive Infectious Disease and the Director of the NIH Microbicide Trials Network. She has been a great resource for fellows, allowing opportunities for direct involvement in her projects. Drs. Creinin and Hillier collaborate on multiple research projects for which the fellows are also co-investigators. Leslie Meyn, MS, is a statistician who works on the majority of the large family planning trials based at our institution, working regularly with the fellows as both an educational and practical resource. The Center for Family Planning Research also includes involved faculty from outside the department:

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Mentorship

Drs. Creinin, Hayes and Reeves have an open door policy based on the concept that the individual fellow is giving a lot of herself or himself to commit to the fellowship and the least that the faculty can do is to be there for guidance and assistance every step of the way. Family planning call is shared equally between faculty and fellows. A fellow meeting is held every other week (alternating with the research meeting) to discuss recent journal articles, upcoming or ongoing research ideas, and any other fellowship related issue.

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International Opportunities

The fellow will be expected to spend time working in the developing world on advances in contraception and access to care. This international experience is designed to further the fellow's understanding of issues related to the impact of high fertility rates and poor access to reproductive health services for contraception and pregnancy care. The faculty have longstanding connections in multiple international locations and with various international organizations to provide a variety of experiences based on the fellow’s specific interests.

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Additional Program Highlights

  • Fellows are routinely involved in peer review of journal articles.
  • Fellows will have 1-3 review manuscripts or book chapters which they will write in conjunction with family planning faculty.
  • Through Dr. Creinin, fellows will have the opportunity to become involved in national organizations with reproductive health interests.
  • Our department is committed to educating all fellows on how to be an academic leader and role model. The fellows attend once a month in the resident continuity clinic and are in the clinic for two sessions per week with family planning faculty along with the family planning resident. During this time, the fellow receives direct teaching on how to be a teacher. The fellows give conference presentations (at Family Planning Conference) approximately 6 times annually.

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About the Directors

Mitchell Creinin, MD, is a Professor, Director of Family Planning, and Division Director for Gynecologic Specialties in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Pittsburgh School of Medicine. Dr. Creinin also has an appointment in the Graduate School of Public Health at the University of Pittsburgh. Dr. Creinin graduated Alpha Omega Alpha from Northwestern University Medical School in Chicago, IL. He completed his residency in Obstetrics and Gynecology at the University of California, San Francisco. Dr. Creinin completed two fellowships at the University of California, San Francisco: a Family Planning fellowship from the Department of Obstetrics, Gynecology, and Reproductive Sciences and a Clinical Research Fellowship from the Departments of Medicine and Epidemiology and Biostatistics. After one year on faculty at the University of California, San Francisco, Dr. Creinin moved to Pittsburgh in 1994. Since that time, Dr. Creinin has been the director of the second established Family Planning Fellowship program. Additionally, he created a mandatory rotation in Family Planning for residents in the Department of Obstetrics, Gynecology and Reproductive Sciences. He has established one of the premier Family Planning research centers in the country with continuous funding from NIH, USAID, CDC, foundations and industry. Dr. Creinin is on the Executive Board of both the Association of Reproductive Health Professionals and the Society of Family Planning.

Jennifer Hayes, MD, MPH, joined the faculty at the University of Pittsburgh in 2005 as an Assistant Professors in the Department of Obstetrics, Gynecology, and Reproductive Sciences. She attended medical school at Tufts University School of Medicine, and residency at Tufts-New England Medical Center in Boston. She completed her Master’s Degree in Public Health and Family Planning Fellowship at Emory University in 2005. She is the Co-Director of the Magee-Womens Hospital Outpatient Clinic, and serves on the Board of Adagio Health, the Title X provider for Western Pennsylvania. Her specific research interests include post-partum IUD insertion and cervical preparation for first trimester abortion.

Matthew Reeves , MD, MPH, joined the faculty of the University of Pittsburgh as an Assistant Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences in 2006. Dr. Reeves is the director of the Center for Family Planning Research at Magee-Womens Hospital and assistant director of the Global Reproductive Health Program in the Department of Obstetrics, Gynecology, and Reproductive Sciences. Dr. Reeves attended medical school at Harvard Medical School during which time he worked in Malawi and conducted research at the University of Nagoya, Japan. He completed a residency in obstetrics & gynecology at the University of California, San Francisco (UCSF) in 2003. He then completed a Fellowship in Ultrasound at the UCSF Department of Radiology in 2004 and earned a certificate in Advanced Training in Clinical Research from UCSF. He moved to Pittsburgh in 2004 where he completed the two-year Fellowship in Family Planning & Contraceptive Research and the multidisciplinary MPH program at the University of Pittsburgh. Dr. Reeves’ research interests include cost-effectiveness and decision analysis modeling, international provision of family planning services, post-abortal IUD insertion, and application of ultrasound to family planning and early pregnancy.

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Research and Clinical Interests of the Directors

  • Medical abortion : new regimens, side effects, infectious risk and acceptability
  • Surgical abortion : cervical preparation, antibiotic prophylaxis, contraception in the immediate post-abortal period
  • Contraceptive advances : new female and male barrier methods, microbicides and spermicides, implants, intrauterine devices, vaginal rings, transdermal patches, oral contraceptives, female sterilization methods, and emergency hormonal contraception.
  • Abnormal intrauterine pregnancy : understanding hCG changes/diagnosis, medical management of early pregnancy failure.
  • Contraceptive decision making : why women choose to be in contraceptive studies, cost-effectiveness of immediate versus delayed insertion of intrauterine devices

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Current Faculty Research Projects

  • A multicenter, randomized, double-masked, comparator study of the safety and contraceptive efficacy of C31G vaginal gel compared to Conceptrol ® vaginal gel (NIH Contraceptive Clinical Trials Network)
  • Mifepristone and misoprostol for the treatment of early pregnancy failure in a clinical setting
  • A randomized trial of buccal compared to oral misoprostol following mifepristone for medical abortion up to 63 days gestation
  • A multicenter, open-label, uncontrolled study to investigate the efficacy and safety of a 4-phasic oral contraceptive SH T00658ID estradiol valerate/dienogest in a 28-day regimen for 13 cycles in healthy females
  • A randomized multi-center trial to evaluate a monophasic combined oral contraceptive containing 2.5 mg nomegestrol acetate and 1.5 mg estradiol compared to a monophasic coc containing 3 mg drospirenone and 30 µg ethinyl estradiol.
  • Baseline colposcopic findings in women entering vaginal product studies using the WHO/CONRAD colposcopy criteria
  • Assessment of markers of inflammation after vaginal product use
  • Contraceptive effectiveness and safety study of the SILCS diaphragm
  • Single dose and 14-day once or Twice-daily Pharmacokinetic Study of the Vaginal Microbicide Agent 1% Tenofovir Gel
  • Efficacy and side-effects of two dosing regimens of doxycycline at surgical abortion: a randomized double-blind trial (in viet nam)
  • Immediate versus delayed IUD insertion following suction aspiration between 5 and 12 weeks gestation
  • Immediate versus delayed IUD insertion following dilation and evacuation procedure
  • Immediate versus delayed IUD insertion following vaginal delivery

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Clinical Training Sites

  • Magee-Womens Hospital of the University of Pittsburgh Medical Center (primary)
  • Planned Parenthood of Western Pennsylvania

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