Training the Next Generation of Leaders in Clinical Preventive Services
Meredith Gilliam, an M.D./M.P.H. student at the University of North Carolina, first learned about the potential harms of cancer screening tests in a class taught at the Gillings School of Global Public Health by Russell Harris, M.D. Gilliam decided to become a research trainee at the Research Center for Excellence in Clinical Preventive Services (ReCPS), led by Harris, because she knew it would be a great opportunity to learn more about this important topic.
As a ReCPS trainee, Gilliam worked with a group of M.D./M.P.H. students and Harris to develop a model highlighting the potential harms at each point of care once a patient enters the "screening cascade." The harms described at each point include: hassle or inconvenience, psychological effects, financial strain, opportunity costs, and physical harms or discomforts. Gilliam and the other trainees then performed a systematic review of the evidence on harms used to develop U.S. Preventive Services Task Force recommendations for screening tests. Each of the trainees chose two screening services, evaluating the existing evidence and looking for gaps in what is currently known; Gilliam focused on breast cancer screening and osteoporosis screening. Along with the other students, she presented the findings in a poster at the UNC School of Global Public Health's Spotlight on Student Research, and to ReCPS advisory committee, a group comprised of preventive screening experts from around the country. A paper based on this systematic review is currently in review at a respected journal.
While it was difficult to balance this research work with her busy schedule as a medical student, Gilliam describes it as, "Overall, a great experience!" This experience also helped solidify her career goals. Before working at ReCPS, Gilliam was not particularly interested in primary care. Now, she is aware of "the abundance of opportunities available to conduct research in primary care and health services." Gilliam has now begun her residency in internal medicine at University of Michigan, and is considering a career in geriatric primary care. Eventually, she wants to work in both research and clinical practice, and possibly teach medical students and residents as well.
For more about the Research Center for Excellence in Clinical Preventive Services and its training programs, please visit their Web site: http://smart-screening.org/.