Division of Community Women's Health

Erin Armao, Summer 2013

When I started my Urban Health Project internship with UC Obstetrics and Gynecology, I anticipated an eye-opening and educational summer. I figured I would learn a great deal about pelvic exams, pregnancy, and common lab tests. By the end of the summer, I imagined, I would know exactly what a tenaculum does, how to find a fetal heartbeat, and what medications to prescribe for common gynecologic complaints. Nine weeks later, I found I was right: I did learn all of that technical information, and much more. What I did not expect, though, was how much more I would learn about the population of women I served over the course of the summer. Through watching the many different physicians, nurse practitioners, and midwives at the three different Neighborhood Health Care and four different Cincinnati Health Department locations where I worked this summer, I learned how to care for these women, who were mainly low-income, under- or uninsured African-American and Hispanic women. I began to understand more of the social context for these women: the common barriers they faced, the relationships they had and how those affected their health, their values and needs and how those played into their care. I also became more aware of the administrative aspects of healthcare and how all of the care that these women received existed inside that structure.

Throughout my internship, I had weekly assignments; each of these directed me to spend time with and interview people in different roles in the clinic. One week I followed a patient from start to finish throughout her time at the office. Another week I interviewed several different staff members- case managers, nurses, MAs- on their roles and responsibilities in the clinic and their thoughts on their jobs. I even spent time in the off-site call center, watching how the women there fielded and directed patient calls. At the beginning of the summer, I knew I wanted to learn about the practice of obstetric and gynecologic medicine, and about how to care for a population with significant challenges and barriers, but these interview experiences led me in a surprising new direction. I decided to spend time taking a closer look at the administrative structure of the clinics where care took place: learning about the workflow, the different roles and responsibilities of different employees, the non-clinical work like inventory and scheduling, and generally everything that goes into creating a space where medical care could take place. I saw a great deal of hard work, dedication, and compassion in my observations of the clinics; I also saw room for improved communication and organization. For my final project, I created a questionnaire aimed at staff members, with the goal of evaluating how well each staff member understands the responsibilities associated with his or her own job and those responsibilities carried by their co-workers.

I was exactly right in my initial thoughts on my UHP internship: I did spend my summer learning an unbelievable amount about the practice of obstetrics and gynecology. I just hadn't realized exactly how much more goes into that practice outside of the actual medicine. I loved the time I spent with UC OB/Gyn, and am deeply thankful to the physicians, nurses, midwives, and staff members who taught me so much this summer. I would absolutely recommend this internship to anyone interested in women's health.