Goal:
To ensure that our residents get optimal exposure in Geriatric Medicine, as this will be a significant part of their future careers. The rotation is designed to incorporate the ACGME requirements for family medicine residency training keeping the 6 competencies in mind in their frame work. The overall experience also encompasses family medicines central philosophy of continuity care.
Experience:
Family Medicine residents get experience in taking care of the elderly through their 3 years of residency. This occurs at a number of venues, allowing for a longitudinal clinical and education experience.
A 4 week rotation in Geriatrics done in the second year. During this time the residents spend 4 sessions a week participating in long term care rounds at the 2 area facilities. They spend 1 session a week at a family medicine geriatric assessment clinic. They also spent time at the ambulatory geriatric center at Amelia court where they work alongside with geriatricians from UT Southwestern`s division of geriatric medicine as well as time with the Geriatric Psychiatrists. The residents also spend 4 weeks working with our hospice and palliative care physician. Our residents also take call for our nursing home patients which gives them the opportunity to prepare for practice realities after residency. Residents also get to do home visits on their own panel of patients throughout their 3 year residency – many of these patients are older.
The residents have their own continuity care panel of patients most of whom are over the age of 65. In the hospital setting the residents work with the hospitalists at Clements University Hospital (1 month) where they get exposed to a mixture of adult patients as well as get hospital adult medicine experience at Parkland (approximately 9 months over 3 years).
Medical students who choose to do additional elective time with the family medicine department can ask to participate in most of the above activities.
Lecture and talks:
The residents are expected to have either listened to lectures or had a small group discussion/talk on the following topics:
- Normal aging
- Delirium
- Dementia
- Appropriate prescribing.
- Osteoporosis (Men & Women)
- Depression in the elderly
- Functional assessment of the elderly
- Incontinence
- Failure to thrive/weight loss.
- Behavior management in advanced dementia
- Ethical issues in the elderly.
- Medicare rules & nursing home regulations
Clinical skills:
The learners are also expected to learn and demonstrate proficiency in the following skills:
- Mini-Cog
- MOCA/MMSE
- Get up and go test
- Depression screening
- Falls assessment
- Discussion of advance directives.
- Breaking bad news
