Newsletter Spring 2021
Message from Department Chair, Deborah Krakow, MD
The past 18 months have redefined so much of our daily lives including how we practice medicine, how we interact with our colleagues, and how we value others in our society. Change impacted almost every component of our universe including clinical care, research, education, even how we hold a meeting, how we shop, or how and where we see a movie. Many new “normals” have been established that will dictate many facets of our future.
Earlier this year a Pew Research Center survey of over 900 experts revealed consensus that the next 3-4 years will bring about broader adoption of “remote” processes including telework, telemedicine, virtual schooling and e-commerce. As we emerge from the worst days of the pandemic, we have already transitioned into many of these new norms in our clinics and labs. Telemedicine visits, which at UCLA were less than 2% pre-COVID, now average about 25% of the care UCLA provides each month. Our researchers have found ways to work effectively with collaborators without personal interaction or contact. Our faculty and our students have skillfully navigated remote learning, continuing to teach and learn while maintaining rigorous academic standards. A great example of this is OBGYN’s Virtual Symposium on Postpartum Maternal Health, an innovative international conference led by Dr. Aparna Sridhar in partnership with the Global Health Program at the David Geffen School of Medicine at UCLA and the Federation of Obstetric and Gynecological Society of India.
The social dynamics of our world have also seen significant change. Political and social upheaval have focused greater attention on the need to take bold steps to embed equality into our social fabric. UCLA’s commitment to this is firm. Inclusive Excellence are addressed in all our areas including education programs, clinical care and research, and preventative health programs. In this edition of OBGYNews you will meet Dr. Lisa Nicholas who has been named UCLA OBGYN’s Vice Chair for Inclusive Excellence. Dr. Nicholas is leading a 16-person committee of faculty, staff and trainees who are focused on improving workforce diversity and advancing healthcare equity.
Also in this issue of OBGYNews, is an overview of our Family Planning Division, information about our new PCORT T32 Fellowship program, and a sample of faculty news and publications over the past four months.
If vaccine rates continue to improve and incidence of COVID continues to decline, it is hoped that by late 2021 our lives will return to a more regular cadence. Among the many lessons learned from almost two years of the pandemic is how we must adapt quickly to an unexpected change in our landscape of life while maintaining a focus on excellence in women’s health care, research, education and community service.
Thank you for all that you do to support our mission in the delivery of care to women.
Deborah Krakow, MD
Clinical Update
UCLA Family Planning: Transforming Healthcare for Our Patients
The UCLA Family Planning Division is leading the way in transforming the future of reproductive healthcare delivery and simplifying access for the people who need it most.
Committed to assisting patients with their family planning and fertility control needs, the UCLA Family Planning Division offers a full spectrum of health care for our patients and other services, including community outreach and education, as well as appointments for contraceptive counseling, abortion care, STI testing and treatment, and other gynecologic care. Our team of experts specialize in caring for patients with complex medical backgrounds and are committed to providing quality and compassionate reproductive health care to patients of all gender identities, including transgender patients.
The UCLA Family Planning specialists provide care at the UCLA West Medical Center OBGYN Clinic with a mission to empower patients to make reproductive health decisions that will support their life goals. , Associate Clinical Professor and Medical Director at the UCLA West Med Clinic shares, “We want our patients to have the family that they want to have in a safe environment, if and when they are ready.”
Center of Excellence
The UCLA West Medical OBGYN Clinic is recognized as a Merck Center of Experience specializing in contraceptive implant insertion and removal. Our Family Planning providers have expertise in localization and removal of the non-palpable implant. Patients who are unable to have their implant retrieved at outside facilities will be referred to the clinic for higher level of care in complex implant removals.
As a Center of Excellence for Complex Contraception, the clinic serves patients with medical factors that complicate their contraception options. Working closely with UCLA OBGYN’s Maternal Fetal Medicine and Reproductive Endocrinology and Infertility specialists, we are able to help patients get contraception and advanced fertility control even if they have complex health problems.
Patient Assistance Fund
The UCLA West Medical Center OBGYN Clinic cares for some of the most medically complex and vulnerable patients in Los Angeles. Many of our patients come from hundreds of miles away with little to no resources for food, gas, childcare, or shelter. The was established to provide patients a lifeline in the form of grocery gift cards, gas cards, parking passes, uber rides and hotel vouchers, allowing for members of our community to receive the care they need at UCLA.
Access to Care and Education During the Pandemic
Experts from the UCLA Division of Family Planning served important roles in the historic win to access care during the pandemic by enabling contactless pick-up of the medication mifepristone with a follow-up video visit. In April 2021, the U.S. Food and Drug Administration (FDA) sent a to the American College of Obstetricians and Gynecologists (ACOG) indicating its suspension of a policy that required patients to pick-up mifepristone in-person and risk unnecessary exposure to COVID-19. UCLA OBGYN faculty members Dr. Rajita Patil and Dr. Angela Chen are co-chairs for the Society of Family Planning Telehealth Practitioner’s Special Interest Group that helped advocate for this telehealth effort that reduces barriers to access for those who live far away or logistically unable to get to a provider, especially during the pandemic.
The UCLA Family Planning Division continued to also provide health education workshops in a virtual setting during the pandemic through the Title X Program. For over 30 years, the Title X Program at UCLA has played a vital role in supporting the delivery of high-quality, inclusive, and engaging workshops on a variety of topics, including contraception, healthy relationships, racism in gynecology, and "Self-care as Healthcare," free of charge for our community partners.
In the Summer of 2019, harmful new regulations to the Title X program were announced. As a provider of quality, comprehensive family planning care to some of the most marginalized, medically and socially vulnerable people in the greater Los Angeles area, we have made the difficult decision to step away from the program rather than compromise our commitment to our patients. While these regulations currently remain in place, we are optimistic about future shifts in legislation.
Advocacy on a National Level
The UCLA Division of Family Planning meets with legal scholars, lawmakers, and advocacy organizations to review pending legislation that impacts women's health, with a goal to expand access to care and contraception by fighting challenges to reproductive freedom at the state and national levels. Programs like the and hosted at the West Medical Clinic have great potential to influence access to care locally and develop policies on the national level. The Ryan Residency Training Program is a national initiative to integrate and enhance family planning training for obstetrics and gynecology residents. Dr. Angela Chen founded the “Building a Ryan Program” workshop, which inspires new graduates in the field of family planning to seek academic careers and to build their own training programs in family planning.
Complex Family Planning Fellowship
As an outgrowth of our excellence, our Complex Family Planning Fellowship, now in its 10th year, received ACGME accreditation in 2020. The department and program leadership is excited to build on the foundation set by Family Planning Division Chief and former Complex Family Planning Fellowship Program Director, as they help the fellowship grow and transition into an ACGME subspecialty program now led by , Program Director and Associate Clinical Professor of UCLA OBGYN, and , Associate Program Director and Assistant Clinical Professor of UCLA OBGYN. The ACGME-accredited Complex Family Planning Fellowship offers a wealth of clinical training with family planning as well as research and advocacy training to one fellow per year for a total of 2 years.
Education Update
New Patient-Centered Outcomes Research Fellowship Program
UCLA Obstetrics and Gynecology has expanded our educational program to include a new fellowship that harnesses the research expertise of our department and UCLA Urology’s Health Services research group. The is a T32 mentored training program that prepares postdoctoral scholars for research careers focused on scientific innovations that improve the design, delivery, and outcomes of urologic and/or gynecologic cancer care at the individual, population, and health care system levels.
Through mentored training and career development of the next generation of interdisciplinary leaders in health services and patient-centered outcomes research, UCLA’s PCORT UroGynCan T32 program seeks to increase the pace and volume of scientific discovery and innovation in the diagnosis, treatment, and prevention of urologic and gynecologic cancers and advance our knowledge of delivery and implementation strategies for proven interventions in real-world practice and community settings.
In closing the gap between evidence-based interventions and their uptake across diverse health services settings and populations, including historically underserved populations, this training program seeks to improve health system performance and optimize outcomes and health-related quality of life for patients and their families.
The PCORT UroGynCan fellowship, funded by the National Institutes of Health, will commence with the 2021-22 academic year and will support four postdoctoral trainees per year, each for a 2-year appointment. The Principal Investigators and Program Directors are , Professor and Chair of UCLA Obstetrics and Gynecology and Mark S. Litwin, MD, MPH, Professor and Chair of UCLA Urology.
For more information, please visit our program website.
Global Health Update
Earlier this year, UCLA Obstetrics and Gynecology partnered with the Global Health Program at the David Geffen School of Medicine (DGSOM) at UCLA
and the Federation of Obstetric and Gynecological Society of India (FOGSI) to organize a Virtual Symposium on Postpartum Maternal Health.
, Associate Clinical Professor of UCLA Obstetrics and Gynecology, spearheaded the collaboration and served as the key organizer for the symposium. The following faculty participated with a range of topics presented:
Yalda Afshar, MD, PhD, Assistant Professor of UCLA Obstetrics and Gynecology
Preeclampsia and eclampsia in postpartum period
Joshua Cohen, MD, Associate Clinical Professor of UCLA Obstetrics and Gynecology
MDERAS for post-cesarean section patients
Ram Parvataneni, MD, Associate Clinical Professor of UCLA Obstetrics and Gynecology
Management of post-cesarean section complications
Ilina Pluym, MD, Assistant Clinical Professor of UCLA Obstetrics and Gynecology
Explore the experiences: Postpartum Hemorrhage
Rashmi Rao, MD, Assistant Clinical Professor of UCLA Obstetrics and Gynecology
Explore the experiences: Amniotic Fluid Embolism
Christopher Tarnay, MD, Associate Clinical Professor of UCLA Obstetrics and Gynecology
Urogynecological challenges postpartum
Dr. Kelsey Martin, Dean of UCLA DGSOM, Dr. Deborah Krakow, Chair of UCLA Obstetrics and Gynecology, Dr. Risa Hoffman, UCLA Global Health Program Director and Dr. Alpesh Gandhi, the president of FOGSI, inaugurated the 2-day virtual symposium that was attended by 1,000 obstetric-gynecologists across India.
Lisa Nicholas, MD, Named Vice Chair of Equity, Diversity and Inclusion
In response to the compelling need to address matters relative to racial injustice and inequality in the care of women, the UCLA Department of Obstetrics and Gynecology established a task force to examine areas that contribute to health care inequities and disparities in medical education, patient care, research, and campus climate.
The UCLA Obstetrics and Gynecology Justice, Equity, Diversity and Inclusion Task Force is led by Lisa Nicholas, MD, Associate Clinical Professor and Vice Chair of Equity, Diversity and Inclusion. Dr. Nicholas has long been an advocate for racial justice and health equity both in the workplace - in our clinical practice and in education for our trainees – and in her personal life. She is exemplary of the anti-racism efforts that the department, the UCLA David Geffen School of Medicine and the larger UCLA campus are committed to promoting. Dr. Nicholas, along with the task force committee members, is charged with providing recommendations and strategies that will lead to solutions to close the gap for health care disparities and the combating of racial discrimination. Her transformational change strategy is based on the mantra “change we can believe in.”
Dr. Lisa A. Nicholas has been a practicing physician devoted to obstetrics and gynecology for the past 30 years. She has dedicated her career to providing quality healthcare to women of all ages regardless of race, ethnicity, or economic status. Originally from Buffalo, New York, she earned her medical degree from Boston University School of Medicine. Dr. Nicholas then moved to California for internship and residency training at Martin Luther King, Jr. Hospital in South Central Los Angeles. Her practice experience includes an 8-year association with The Geneva B. Scruggs Community Health Center, previously located in the inner city of Buffalo, New York. This health center was a major contributor of health services to the greater Buffalo community due to its mission of providing quality medical services specifically targeting the indigent and medically underserved population. In 2010, Dr. Nicholas was appointed to the clinical faculty at UCLA in the Department of Obstetrics and Gynecology. While continuing a busy clinical practice, she has shifted her career emphasis to medical education driven by a desire to influence young physicians to practice compassionate patient care.
As Vice Chair of Equity, Diversity and Inclusion for UCLA OBGYN, Dr. Nicholas leads a 16-person committee comprised of faculty members, trainees and staff driven by a mission to guide departmental structures, policies, and practices to a) improve department workforce diversity relative to racial/ethnic, gender, and socioeconomic status, b) promote and improve obstetrics & gynecological health and healthcare equity, c) promote research and d) engage the community. Current projects are already underway in the area of patient care through our involvement with the UCLA Perinatal Coalition, in education through our establishment of a Visiting Student Scholarship program for outstanding final year medical students from underrepresented backgrounds, as well as culture and awareness by exploring reproductive injustice through a departmental screening of Belly of the Beast, a documentary exposing a pattern of illegal sterilizations in California’s women’s prisons.
Dr. Nicholas’ belief that “respect, fairness, consideration, and kindness will propel our society towards equity, excellence, and justice” is exemplified in all the work she does at UCLA.
For more information about the UCLA Obstetrics and Gynecology Justice, Equity, Diversity and Inclusion Task Force
New and Noteworthy
UCLA faculty who have been recognized for excellence in clinical care, research and teaching.
HONORS AND AWARDS:
UCLA Health CICARE awards are given to providers who are recognized by patients and peers for their extra effort to fulfill UCLA Health’s vision of healing humankind, one patient at a time, by improving health, alleviating suffering, and delivering acts of kindness. We are proud to share that Angela Chen, MD, MPH, UCLA OBGYN Associate Professor, received a CICARE Award for excellence in patient care.
Daniel A. Dumesic, MD, UCLA OBGYN Professor, was the recipient of a Star Award for more than 10 years of contributions to research for the American Society for Reproductive Medicine. He was also invited to be a reviewer for the Iris Cantor-UCLA Women’s Health Center/CTSI Program Pilot Review Committee.
Lauren Nathan, MD, UCLA OBGYN Professor and Vice Chair of Education, and Carla Janzen, MD, PhD, UCLA OBGYN Associate Professor, have been appointed as “Core Faculty Educators” for the Scientific Foundations of Medicine Course for the David Geffen School of Medicine at UCLA. They will jointly run the new "Reproduction Block" that has been added to the curriculum.
Rajita Patil, MD, UCLA OBGYN Assistant Clinical Professor, and Angela Chen, MD, MPH, UCLA OBGYN Associate Professor, have been named co-chairs for the . This is a 2-year national leadership position that will work towards creating best practices and accelerating advocacy efforts for abortion and contraception telehealth services. This year the group will be working to create a telehealth resource directory and a guiding principles document.
Aparna Sridhar, MD, MPH, UCLA OBGYN Associate Professor, has been appointed as Chair of the ACOG - FIGO collaboration sub-committee Global Women’s Health Expert Work Group at the American College of Obstetrician and Gynecologists, as well as a member of ACOG’s National CREOG Examination Committee. She was also featured on , an online resource for practicing obstetricians and gynecologists who want to better understand issues around racial and gender disparities affecting themselves and their patients.
GRANTS:
Daniel A. Dumesic, MD, UCLA OBGYN Professor, is the investigator for “Androgen Excess Causes Adipogenic Dysfunction in PCOS Women,” Project IV of the Hyperandrogenemia, Diet and Female Reproductive P50 Specialized Cooperative Centers Program in Reproduction and Infertility Research awarded to UCLA by the National Center for Translational Research in Reproduction and Infertility (NCTRI).
Deborah Krakow, MD, Professor and Chair of UCLA OBGYN, and Rashmi Rao, MD, Assistant Clinical Professor of UCLA OBGYN, received funding from the National Institutes of Health for their research studying the effect of Osteogenesis Imperfecta on pregnancy.
Dr. May Sudhinaraset from UCLA’s School of Public Health and Rajita Patil, MD, UCLA OBGYN Assistant Clinical Professor, received a from the Society of Family Planning in support of the M-POWER STUDY: Medication abortion – Person-centered telemedicine Options Working for Equity and Reproductive justice. This study will compare patient experiences and clinical outcomes of NTTA to clinic-based medical abortion.
PRESENTATIONS:
Joshua Cohen, MD, UCLA OBGYN Associate Clinical Professor, and Morcos N. Nakhla, MS, a second-year student at the David Geffen School of Medicine at UCLA present Surgical Outcomes for Frail Patients with Ovarian Cancer at the Society of Gynecologic Oncology 2021 Virtual Annual Meeting on Women’s Cancer. As a result, Morcos appeared on the to discuss data showing that a higher surgical volume is associated with better outcomes for frail patients undergoing surgery for ovarian cancer.
Ritu Salani, MD, UCLA OBGYN Professor:
- Frontline Treatment of Cervical Cancer. 6th Annual Meeting Master Class for Gynecologic Malignancies Riyadh, Saudi Arabia (Virtual), March 2021.
- Recurrent Treatment of Cervical Cancer. 6th Annual Meeting Master Class for Gynecologic Malignancies Riyadh, Saudi Arabia (Virtual), March 2021.
- Maintaining a long-distance relationship: Telehealth in cancer care. Alaska Let Every Woman Know Survivor Conference (Virtual), January 2021.
- Exploring the Practicalities of Gynecologic Cancer Management as New Options Emerge Ovarian Cancer Tumor Board (Virtual), January 2021.
- Recurrent Ovarian Cancer-Current Landscape and Future Directions. Opinions in Gynecologic Malignancies: An Interactive Forum (Virtual), January 2021.
Aparna Sridhar, MD, MPH, UCLA OBGYN Associate Professor:
- A Sridhar, C Nameth, Hwang Y. Real-time, Remote and Recorded: Medical Student Experiences When Teaching with Smart Glasses. Oral abstract presentation at the Council on Resident Education in Obstetrics and Gynecology (CREOG) & Association of Professors of Gynecology and Obstetrics (APGO) Annual 2021 Meeting.
- J Kim, A Sridhar. Game On: Surgical Instruments Teaching via Gamification in Obstetrics and Gynecology Clerkship. Oral abstract presentation at the Council on Resident Education in Obstetrics and Gynecology (CREOG) & Association of Professors of Gynecology and Obstetrics (APGO) Annual 2021 Meeting.
- MDouglass, NiinoC, Bryan K, Herbert L, Sridhar A. Development and Comparison of an Audio and Video Podcast for Contraception Education. Poster presentation at the Council on Resident Education in Obstetrics and Gynecology (CREOG) & Association of Professors of Gynecology and Obstetrics (APGO) Annual 2021 Meeting.
- A session on oral contraceptives on the popular podcast, .
Amy Rosenman, MD, UCLA OBGYN Clinical Professor:
- A Urogynecologist's 20-year experience with hysteropexy for prolapse. Annual Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Scientific Meeting. February 26, 2021
Mae Zakhour, MD, UCLA OBGYN Assistant Clinical Professor:
- Nyakudarika NC, Marsh LA, Moatamed NA, Zakhour M. Pandemic paradox: shorter times from consult to gynecologic oncology treatment during COVID-19. 52nd Annual Meeting of the Society of Gynecologic Oncologists, Virtual Meeting, March 2021.
- Manrriquez E, Tatsugawa Z, Mendoza M, Holschneider CH, Zakhour M.Ovarian-cancer associated germline mutations in a predominantly non-White patient population. 52nd Annual Meeting of the Society of Gynecologic Oncologists, Virtual Meeting, March 2021.
- Manrriquez E, Holschneider M, Pineda E, Holschneider CH, Zakhour M. Telehealth during the coronavirus pandemic: access, attitude and experience of gynecology and gynecologic oncology patients in a large public safety-net hospital system. 52ndAnnual Meeting of the Society of Gynecologic Oncologists, Virtual Meeting, March 2021.
UCLA OBGYN Recent Publications
- Yalda Afshar, MD, PhD, was featured in for her work on capturing data on pregnancy and COVID-19. Dr. Afshar is the Co-PI of PRIORITY (Pregnancy CoRonavirus Outcomes RegIsTrY), a nationwide study of pregnant women who are either under investigation for COVID-19 or have been confirmed to have COVID-19. This study is overseen jointly by UCLA and UCSF researchers.
- Boitano, T. K. L., Smith, H. J., Cohen, J. G., Rossi, E. C., & Kim, K. H. (2021). Implementation and evaluation of a novel subspecialty society fellows robotic surgical course: the SGO minimally invasive academy surgical curriculum. Journal of gynecologic oncology, 32(2), e26-e26.
- Al-Safi Z, Dumesic DA. Laboratory evaluation of the female patient with suspected reproductive disorder. In: Oxford Textbook of Endocrinology and Diabetes, Third Edition. In press 2020
- Chang RJ, Dumesic DA. Polycystic Ovary Syndrome and Hyperandrogenic States. In: Yen and Jaffe’s Reproductive Endocrinology: Physiology, Pathophysiology and Clinical Management, Ninth Edition. Strauss JF III, Barbieri RL, Dokras A, Williams CJ, Williams SZ (eds). Elsevier Saunders, Philadelphia, 2021, in press
- Willging MM, Abbott DH, Dumesic DA. Intergenerational Implications of PCOS. In: Polycystic Ovary Syndrome - Current and Emerging Concepts. Lubna Pal, David Seifer (eds). Springer Nature, Switzerland, 2021, in press
- Patil R. “Early experience with no-test telemedicine abortion during the COVID-19 pandemic.” Abstract accepted for ACOG May 2021 annual meeting.
- Chase DM, Salani R, Farley J, Torres T, Stone J. Gynecol Oncol. 2021 Mar;160(3):646-648. doi: 10.1016/j.ygyno.2021.01.009. Epub 2021 Jan 20.PMID: 33485640 No abstract available.
- Hampel H, Pearlman R, de la Chapelle A, Pritchard CC, Zhao W, Jones D, Yilmaz A, Chen W, Frankel WL, Suarez AA, Cosgrove C, Backes F, Copeland L, Fowler J, O'Malley D, Salani R, McElroy JP, Stanich PP, Goodfellow P, Cohn DE. Gynecol Oncol. 2021 Jan;160(1):161-168. doi: 10.1016/j.ygyno.2020.10.012. Epub 2020 Oct 21.PMID: 33393477
- Quick AM, Dockter T, Le-Rademacher J, Salani R, Hudson C, Hundley A, Terstriep S, Streicher L, Faubion S, Loprinzi CL, Coleman JS, Wang KC, Lustberg M.Maturitas. 2021 Feb;144:37-44. doi: 10.1016/j.maturitas.2020.10.018. Epub 2020 Dec 2.PMID: 33358206
- Manrriquez E, Mandelbaum A, Aguayo E, Zakhour M, Karlan B, Benharash P, Cohen JG. Factors associated with high-cost hospitalizations in elderly ovarian cancer patients. Gynecol Oncol. 2020 Dec. 159(3): 767-772.
- Greenberg DC, Kamara D, Tatsugawa Z, Mendoza M, Pineda E, Holschneider CH, Zakhour. The role of the genetic testing industry in patient education of hereditary cancer: An observational study assessing the quality of pre-test patient education videos. Gynecol Oncol. 2021 Feb
- Armstrong A, Watanabe M, Bhattacharya D, Zakhour M, Kroener L. Disseminated peritoneal coccidioidomycosis in pregnancy following fertility treatment: A case report and literature review. Case Reports in Women’s Health. 2021 Apr.