Application Process: Apply online » (Applications for 2020 are open)
Duration: Eight weeks: May 18 – July 13, 2020
The Department of Family Medicine and Community Health (DFMCH) has several faculty who are eager to have medical students come join them on people-oriented, clinically relevant, hands-on research projects. Students have ample opportunities to see patients in a variety of settings (office, hospital, others), learn some important concepts and skills about research, and participate in social events with other faculty and students.
Schedule: This is a tentative schedule:
- May 18-20 — Participate with faculty
- May 21/22 — Orientation at the DFMCH, Madison, Wisconsin
- May 26 – June 18 — Participate with faculty
- June 19 — Mid-point seminar in Madison
- June 22 – July 10 — Participate with faculty
- July 13 — Final presentations in Madison
Locations: Madison area, Milwaukee
Director: Sean Duffy, MD
Stipends/Housing/Travel: We have funding available to support up to ten students at $3,200 each for the eight-week session.
Apply online » (Applications for 2020 are open) Thank you for your interest.
Please complete the online application, including your cover letter described at the bottom. As soon as your application is received, copies of your application will be circulated to the faculty with whom you are interested in collaborating with. The faculty members will contact you to set up interviews either in person or by phone. These interviews will allow faculty and students to determine whether there is mutual interest. Faculty and student matches will be consummated by signing an agreement, which shall be considered binding on both parties unless dire, unforeseen circumstances occur. Since agreements between faculty and students may be made at any time, students who submit their applications early are more likely to have their choice of projects. For additional information, please contact Christie Legler at:
Phone: (608) 263-0427
2020 Research Projects
Primary Investigator: Sarina Schrager, MD
Collaborators: Beth Burnside, MD
Location of study: Madison
Background information: Breast cancer continues to be the most common new cancer diagnosis in women. Mammography screening programs have decreased mortality from breast cancer in women of all ages. But, due to the low prevalence of breast cancer among women 40-49 years of age and the high occurrence of false positives, the benefit/harm ratio for screening mammography in that age group is unclear. The USPSTF has recommended that clinicians use shared decision making with women in their 40s to determine whether their individual risk factors and values support screening.
What is the potential student role in the project, including clinical time? Previous work included audiotaping 50 physician-patient interactions with women in their 40s using an online decision aid (HealthDecision) to come to a decision about whether or not to get screened. The student will analyze the transcripts of these interactions to determine whether there are particular patient or physician factors that predict whether or not a woman decides to get a screening mammogram. The student will also be able to look at data to determine how many women actual have their mammogram. The student’s clinical experiences will include time at a family medicine clinic with a physician who focuses her practice on women’s health and time with a breast radiologist.
Primary Investigator: Beth Potter, MD
Collaborators: Mariah Quinn, MD, MPH and Sarah Webber, MD
Location of study: Madison
Background information: Burnout among clinicians (including doctors, nurses, pharmacists, dentists, and medical trainees) has reached epidemic proportions. Some studies show that up to 50% of physicians are burned out – experiencing emotional exhaustion, depersonalization and a low sense of personal accomplishment. The consequences of burnout impact the individual clinician, the care team and patient outcomes. UW Health is a participant in the Stanford Physician Wellbeing collaborative. The Stanford model recognizes 3 areas that contribute to physician wellbeing and fulfillment – culture of wellness, efficiency of practice and personal resilience. UW Health has been focusing on systemic issues related to culture and efficiency. The domain of personal resilience has not been addressed. Each of the academic departments in the UW School of Medicine and Public Health (SMPH) has some type of wellness activity or initiative. Most of these activities are happening at a local level and often the leaders of these initiatives are unaware of similar initiatives in other departments. We feel there are many opportunities for collaboration and research across the departments.
What is the potential student role in the project, including clinical time? 1. The student will identify existing wellbeing programs and categorize them. 2. The student will survey/interview department chairs and other pertinent leaders (division heads, for instance) and department wellbeing leaders to understand what resources exist and where there are gaps in resources to help distressed physicians. 3. The student will help design an online repository of these programs to share with departments and to enable dissemination and collaboration. The student will have the opportunity to work with Dr. Potter at Wingra clinic – outpatient family medicine. If interested there would be the opportunity to work with Dr. Quinn – outpatient internal medicine and Dr. Webber – pediatric hospitalist.
Primary Investigator: Julia Lubsen, MD
Collaborators: Mia Morrisette, CSW, MBA
Location of study: Madison and Belleville, WI
Background information: End of life care has improved with the availability of hospice and palliative care, but many Americans still receive unwanted aggressive medical care at the end-of-life. Advance care planning (ACP) is “a process across time of understanding, reflecting on and discussing future medical decisions, including end-of-life preferences” (Honoring Choices Wisconsin). This process often leads to creating written advance directives. ACP improves the likelihood that end-of-life wishes will be known and honored and is associated with less in-hospital death and increased use of hospice. ACP remains underutilized. At UW Health, only 40% of patients over 65 have advance directives. UW Health has piloted workflows to increase rates of ACP and facilitates ACP conversations for a small group of vulnerable patients and their family members. This project aims to quantify the effectiveness of these interventions by looking at changing rates of ACP documentation over time. The second aim of the project is to pilot-test a physician education intervention at the Belleville Clinic to increase rates of ACP.
What is the potential student role in the project, including clinical time? The student will work with population health data analysts to evaluate existing ACP interventions. They will assist with implementing a physician education session about ACP and evaluate its impact through surveys and examining rates of ACP before and after the intervention. Clinical opportunities include shadowing at the Belleville Family Medicine Clinic and local nursing homes – seeing patients of all ages, with an emphasis on geriatrics. There will also be opportunities to work with social workers who facilitate ACP visits.
Primary Investigator: KJ Hansmann, MD, MPH
Collaborators: Sarina Schrager, MD (Faculty, Northeast Clinic), Rachel Deterding (Community School Resource Coordinator, Lake View Elementary School), Shawn Koval (Program Coordinator, Safe Routes to School)
Location of study: Madison
Background information: In 2012, Northeast Clinic “adopted” nearby Lake View Elementary School to promote health and wellness at the school and in the community around our clinic. Lake View, now one of Madison’s official “Community Schools”, has been continuing to build its capacity as a community resource including starting a Walking School Bus pilot program this fall as part of a Safe Routes to School initiative. Lake View and Northeast are both working to engage students, parents and other community members in discussions about what their health needs and questions are, what the community’s assets are and how we can continue to work together to build partnerships to promote wellness for students and families. In 2020 we are hoping to engage with community members to learn what local resources are important to their health, what resources they have difficulty accessing and what questions they have about living healthy lives in their community.
What is the potential student role in the project, including clinical time? For this project, the student will help lead discussion groups with community members about their wellness resources and needs. Using this information, they will work with clinic and community partners to create a Northside Wellness Guide. We will seek to use our experience from these activities to create a toolkit for other primary care clinics to engage community members in building similar wellness guides. In addition, this student would have the opportunity to work with physicians at Northeast Clinic, observing primary care and learning more about what health information might be most useful to include in a community-based wellness guide.
Additional comments: End-products of this project could include a poster for presentation about this community-clinic collaboration, participating in a literature review of evidence-based practices in community-clinic collaborations for submission to a peer-reviewed journal and/or helping to write a commentary on the role of clinics to engage in community wellness for journal submission.
Primary Investigator: Sean Duffy, MD, MPH
Collaborators: Jim Svenson, MD, MS Jessica Schmidt, MD, MPH
Location of study: San Lucas Toliman, Guatemala
Will housing be provided? Yes
Background information: More than two thirds of the 1.13 billion people worldwide living with hypertension, the leading preventable cause of death and disability, live in low- and middle-income countries (LMIC), such as Guatemala. Less than 40% of patients with hypertension in LMIC are aware of their condition and less than 10% have good control of their blood pressure. Health systems in LMIC, which suffer from inadequate and maldistributed health care infrastructure and workforce, are ill-equipped to address the rise in chronic non-communicable diseases such as hypertension. With our local partner organization, the San Lucas Mission, we successfully implemented a diabetes program serving the rural communities of San Lucas Toliman, Guatemala. This innovative program is led by community health workers and enabled by a smartphone application. While our program has helped patients in these communities to gain better control of their diabetes, there are many people living with untreated hypertension and we seek to expand the program model to meet this need.
What is the potential student role in the project, including clinical time? We are seeking a highly-motivated student with strong Spanish language skills to assist with this project. Participation will involve work in Guatemala.
Possible activities include assisting with program planning and logistics, algorithm development for hypertension management, smartphone application prototype testing, and grant writing. In addition to working on the diabetes project, the student will be able to participate in the UW Service Learning Experience in San Lucas. While in Madison, the student will have the opportunity to work with Dr. Duffy at Wingra Clinic, a federally-qualified community health center with a diverse patient population, including many Spanish-speaking patients.
Additional Information: Students working in San Lucas during the summer typical stay with a local family, which typically costs about $100 per week for room & board and meals.
Primary Investigator: Valerie Gilchrist, MD
Location of study: Madison
Background information: There is a continuing need for primary care physicians to meet patient’s need to be seen for visits. It is unclear however how much of that need could be met by another member of the medical team – nurse or Advance Practitioner, or by remote care such as electronic consultation with ‘My Chart’ or by telephone consultation with or without face time. How many people also manage their symptoms with an internet search? It is also unclear how much the choice of visit type is influenced patient characteristics (age, gender, location), by symptom characteristics (urgent or not urgent as perceived by the patient) or by the relationship with the practitioner (established with a particular physician or not).
What is the potential student role in the project, including clinical time? The student will familiarize themselves with the literature on patient desire for medical visits survey design and pilot a survey exploring the issues of patient access.
Additional comments: The student should enjoy talking to patients about their health care decision making.
Primary Investigator: Bruce Barrett, MD, PhD; Maggie Grabow, MPH, PhD
Location of study: Madison
Background information: M
indful Climate Action (MCA) is an 8-week mindfulness-based eco-wellness program aimed at improving mental, physical, and ecological health. During the summer of 2020 we hope to engage a medical student in: 1) analyzing pre-post qualitative/quantitative data from the second MCA pilot study which was carried out in 2019, and 2) conducting a systematic scoping review examining published reports of similar projects.
Significance: Climate change threatens human health, and is driven to a large extent by behaviors related to transportation, diet, and energy use. We hypothesize that substituting active transport (biking and walking) for automobile transport, and eating more plant-based foods will support mental and physical health while also reducing carbon footprint. Mindfulness-based trainings have been successful in changing behaviors to enhance mental and physical health but have not been rigorously tested for impact on ecological health and sustainability.
Specific aim #1: Analysis of MCA pilot data will focus on pre-post changes and associations among:
- Increases in knowledge of climate change, carbon footprint, and energy use;
- Reductions in automobile and air miles traveled;
- Increases in physical activity and active transport;
- Reductions of high carbon footprint foods in diet;
- Reductions in household consumption of gas, electricity, and water;
- Increases in self-reported general mental and physical health, self-efficacy and happiness.
Specific aim #2: Scoping review of studies with both sustainability and health indicators as outcomes.
- Conduct review to find all reports of intervention research aimed at health/climate change;
- Use best scoping review methods to refine search terms and selection and review process;
- Assess titles, then abstracts, then full published reports;
- Analyze and interpret included studies aiming towards next phases of needed research.
What is the potential student role in the project, including clinical time? Working with Dr. Barrett and post-doc fellow Maggie Grabow MPH PhD, the medical student will assist with assessment of the MCA pilot study data, and will conduct a scoping review of similar “eco-health” behavioral interventions. The student will also work with Dr. Barrett at the UW Health Verona clinic.
Primary Investigator: Kristi Hallisy, PT, DSc
Collaborators: Tiffany Houdek, PT – UW-Health Pain Management Physical Therapy Clinic
Location of study: Madison
Background information: Joint hypermobility syndromes (JHS) are a group of rare inherited conditions that impact connective tissue. Persons with JHS have ligamentous laxity, joint hypermobility, loss of proprioception, joint pain, and difficulties in muscle force transmission and postural and movement control. There is some evidence that people with JHS improve with exercise but there is limited evidence for optimal mode, frequency, dosage or type of exercise. Tai chi (TC) is a mind-body intervention that may be suitable for patients with JHS. It is a functional exercise that influences pain, strength, balance, endurance and movement incoordination. TC appears to be safe; demonstrates positive results, especially over the long term. Likewise; group therapy can be costeffective for patients with chronic pain. This project seeks to evaluate the benefits of group TC classes for persons with JHS. The participant will compare group TC with standard of care for JHS.The medical student will participate in one group TC class series (five, 1-hour classes), review the literature related to JHS and TC and answer the question, “Is Tai Chi an effective intervention for joint hypermobility syndromes?”
What is the potential student role in the project, including clinical time? Expectations/Experiences of the SSRCA 1) Per SSRCA guidelines, shadowing DFMCH Physicians in clinic 2 half days per week. NOTE: SSRCA organizers will determine what clinic would be best for this Medical Student. 2) To understand the Tai Chi intervention, the medical student will attend one “group session” of Tai Chi Classes for Persons with joint hypermobility syndromes at the UW-Health Pain Management Center Physical Therapy Clinic (five, 1-hour classes). Shadowing of one-on-one PT sessions with Tiffany Houdek, PT, is highly probable. 3) The research component of this SSRCA project involves literature review and writing to answer the question, “Is Tai Chi an effective intervention for persons with joint hypermobility syndromes (JHS) and Ehlers-Danlos Syndromes-hypermobility type (hEDS)?” This project offers the potential for a medical student to complete a Family Physicians Inquiries Network (FPIN) paper on this topic. This review of literature could also be useful for a case study report on Tai Chi for persons with hypermobility syndromes; lay groundwork for next steps in EMR data extraction from TC patients at the UW-Health Pain Clinic or development of research proposal.
Additional comments: Since inception (Hallisy, 2008-2012) to date (Houdek, 2013-present), over 1,000 patients have gone through the Tai Chi-based group “Movement Awareness and Exercise Class for Clients with Chronic Conditions” at the UW-Health Pain PT Clinic. Three weekly diagnostic group sessions now exist:
1) clients with hypermobility syndromes; 2) patients with any chronic pain and 3) mixed group of persons with hypermobility and other conditions. The Tai Chi group class uses a rolling enrollment that has improved attendance and decreased attrition rates. Class sessions are 60 minutes and allow for up to 12 patients/group. The program consists of five Tai Chi exercise sessions combined with five educational topics delivered for each participant no matter when they enter the program. Education sessions include: 1) Diaphragmatic Breathing and Mindfulness; 2) Functional Applications (daily exercise ideas; 3) Joint Protection Strategies; 4) Pacing Strategies and 5) Pain Neuroscience. Tiffany Houdek, PT, estimates that modifications in curriculum/delivery has decreased the number of visits for these difficult to manage clients from 18-20 visits to 12-16 visits per patient episode of care. Patients with high fear avoidance behavior questionnaire (FABQ) and pain-catastrophizing, seem to benefit most from the group class. Clients are showing improvements in overall pain ratings, leg strength, gait/mobility and balance and gaining self-efficacy for exercise. We suspect that opioid prescription is down, but this measure needs to be objectified by future data analysis. If possible, Dr. Hallisy would like to start a similar Tai Chi group class at the UW-Health Spine PT Clinic with David Anderson PT, OCS (soon to be a certified Tai Chi Fundamentals instructor). These group Tai Chi Pain class clinical findings bode well for a future line of research related to the non-pharmacological management of patients with chronic pain – something of great national interest in lieu of the present opioid epidemic. Data analysis of Pain Clinic EMR may elucidate if Tai Chi for pain management is a credible line for NIH- or NCCIH- funded research.
Primary Investigator: Alyssa Tilhou, MD, PhD – Addiction Medicine Fellow in the Department of Family Medicine and Community Health
Collaborators: Amy Baltes, MPH candidate; Bri Deyo, Research Program Coordinator; Randy Brown, MD, PhD
Location of study: Madison
Background information: Illicitly manufactured fentanyl (and its analogues) entered distribution in the U.S. drug supply in 2013. Since that time, overdose deaths attributable to fentanyl have grown exponentially. Fentanyl is estimated to be 50 times more potent than heroin and up to 100 times more potent than morphine.
Public health campaigns, opioid prescribing regulations, and increased prescription drug database monitoring have failed to adequately curb these trends.
People who use drugs, such as heroin or methamphetamine, often do not know if fentanyl is present in the drugs they consume. Fentanyl test strips are a new technology that provide rapid detection of fentanyl in a drug substance and in urine after use. However, little research has investigated attitudes and behaviors of people who use drugs with access to this technology. This project aims to address this gap by surveying people in Dane County who use drugs and have used fentanyl test strips about their attitudes and behaviors surrounding use of fentanyl test strips.
What is the potential student role in the project, including clinical time? We are looking for a summer student to participate in survey development and administration. Depending on timing, we hope the student can participate in analysis of results. We anticipate this project would result in the production of an original research manuscript for submission to a peer-reviewed journal in the field of addiction medicine. The student would be invited to participate in manuscript writing. Clinical opportunities focus on caring for persons with addiction(s) including alcohol and other drugs. The student would work alongside Alyssa Tilhou, MD, PhD, Addiction Medicine Fellow, and Randy Brown, MD, PhD, Associate Professor in the Department of Family Medicine. Drs. Tilhou and Brown staff an addiction consult clinic at Wingra
Family Medical Center and the inpatient consult service at University Hospital. Other clinical opportunities include the following specialty clinics: pain management, behavioral health, and infectious disease.
Primary Investigator: Zorba Paster, MD
Collaborators: James Conway, MD
Location of study: Dharamsala, India
Is housing provided? Yes
Background information: Tibetans have one of the highest rates of TB in the world – the rate in India ~150/100,000 while the rate in the Tibetan diaspora is ~750-900/100,000. The project involves educating Tibetan children in domiciled schools, and adults in monasteries and nunneries about the importance of detecting and treating latent TB. At present, in some adult religious facilities, only 55% accept treatment; the number for residential children taking curative meds is also suboptimal.
We have improved compliance through surveys, workshops and other educational programs but this still falls short of our goal of universal treatment. The goal of the project is to develop other educational methodologies, both in writing, and social media, that that will improve compliance essential for eradicating this devastating disease.
What is the potential student role in the project, including clinical time? Over the previous two years students from the UW have addressed this problem with success. Our goal is for this year’s students to incorporate their work and improve upon it. We still have too many who do not take treatment which leads to an ~95% risk reduction in getting TB; our goal is to have every child and adult embrace treatment. The UW students, in the past, have always given a fresh perspective on how to improve education, the key to compliance.
Additional comments: The previous students, starting 5 years ago, have all added value to the project and all have received value in learning how to combat a serious community problem, i.e. TB, in a low resource environment with minimal financial support. They have all been extremely happy with the opportunity to work with Tibetans and especially Dr. Tsetan, the chief medical office at the Tibetan Delek Hospital – he holds and MD degree from Pondicheery medical school, one of the premier medical schools in India, with additional certification in infectious diseases from London and an MPH from Harvard, as well as a degree in traditional Tibetan Medicine. He has been a great mentor to the students.