Geriatric Medicine Fellowship Clinical Training
Comprehensive Geriatric Medicine Clinical Training across Ambulatory, Inpatient and Long-term Care Experiences
The Geriatric Medicine Fellowship (Internal Medicine) Program at University Hospitals Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center, in collaboration with Case Western Reserve University, strives to train the next generation of leaders to meet the social and health care needs of elderly people. The clinical component of our Geriatric Medicine Fellowship Training Program includes the following experiences:
- Ambulatory care
- Inpatient care
- Long-term care
At University Hospitals, our dedication to providing our fellows with flexibility to tailor rotation and elective experiences towards each fellow’s interests, educational needs, and career goals helps set us apart from other geriatric medicine fellowship training programs. Each fellow receive 2 months of elective opportunities. We partner with a number of geriatric care centers and programs to give our fellows diverse experiences which they can carry into their careers.
Collaborative Care for Older Adults in Community Settings
The highly collaborative program at the Foley ElderHealth Center and the VA Geriatric Clinic offers coordinated interdisciplinary care to community-dwelling older adults. Within the outpatient care setting, geriatric medicine fellows learn to perform primary care and geriatric assessments as well as individualized care to address issues commonly faced by older adults, including:
- Memory loss and cognitive impairment
- Mood disorders
- Arthritis pain
- Decreased mobility and falls
- Weight loss and malnutrition
- Bowel and bladder concerns
- End of life care
Neurological Training at Brain Health & Memory Center
Geriatric medicine fellows will also work with the neurology faculty and interdisciplinary staff at the Brain Health & Memory Center to evaluate and treat patients with cognitive disorders such as Alzheimer’s Disease, vascular dementia, frontotemporal dementia and parkinsonian-related dementias.
Geriatric Care Coordination at PACE
Program of All-inclusive Care for the Elderly (PACE) is a unique community-based program for nursing-home-eligible seniors designed to function as all of the following:
- Case manager
- Health insurance company
- Primary care provider
Geriatrics fellows experience first-hand how PACE allows patients to receive coordinated medical care so that they can avoid hospitalizations, nursing home placement, and continue to live safely in the community.
Medical House Calls Program at University Hospitals
As part of the in-home geriatric care management fellowship training, fellows will also spend time visiting patients in the University Hospitals Medical House Calls Program, which provides primary health care services to homebound adults. This opportunity allows fellows to learn some of the challenges and benefits of caring for patients in their homes.
Geriatrics Consult and Co-Management Service
Under the supervision of geriatrics faculty, fellows learn how to co-manage patients and provide geriatrics consultation on the Geriatrics Consult/ Geriatrics Co-Management Service for hospitalized patients at UH Cleveland Medical Center.
Palliative Care and Hospice
Fellows work with the palliative care and hospice teams at University Hospitals and at the VA, learning the principles of palliative medicine and end-of-life care. During the palliative care rotations, fellows provide consultative services to acutely ill hospitalized patients. During their nursing home rotation, fellows work with the facility hospice medical director and help care for hospice patients in their homes or assisted living or long term care units.
Fellows rotate for several weeks in geriatric psychiatry, working closely with psychiatry specialists to assess and treat older patients with mood disorders that may be affected by the aging process.
Physical Medicine and Rehabilitation
Fellows spend time on the rehabilitation medicine service at the VA, working with the physical medicine and rehabilitation medicine faculty and physical/occupational/speech therapy staff to care for veterans in both the inpatient and outpatient settings.
Long Term Care
Judson Park is a not-for-profit facility where fellows collaborate with the nursing staff to care for residents in multiple levels of care, including assisted living, memory care, post-acute, and long-term care. Our fellows also work closely with the medical director and learn skills needed for medical directorship.
Community Resources Rotation Elective
During the Introduction to Community Resources rotation elective, fellows meet with community organizations to become familiar with services such as Adult Protective Services, Long Term Care Ombudsman, Alzheimer’s Association and geriatric care management programs. Fellows also learn about the guardianship process by getting an opportunity to observe probate court cases.
Fellows are given 2 months of elective time to pursue clinical, research, or educational opportunities that will enhance their overall training and help prepare them for their career goals. Clinical elective options include wound care, infectious diseases, uro-gynecology, oncology, and cardiology.