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 unparalleled 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 students and fellows with comprehensive geriatric care management training helps set us apart from other geriatric medicine fellowship training programs. 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 elder issues, including:

  • Arthritis pain
  • Decreased mobility
  • Polypharmacy
  • Memory loss
  • End of life Care

Diverse Clinical Training in Geriatric Evaluation Management Unit

As part of their geriatric care management training, fellows will work with the Geriatric Evaluation Management Unit at the Louis Stokes Cleveland VA Medical Center. This is an inpatient service designed for the evaluation and rehabilitation of frail, older veterans. Supervised by full-time members of the Geriatric Medicine Division, fellows lead a highly knowledgeable and dedicated team of medical students, residents and nurse practitioners in caring for these older adults.

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.

Geriatric Inpatient Service with Acute Care for Elders

Fellows spend several weeks on the Geriatrics Inpatient ACE (Acute Care for Elders) Service, where they work closely with the geriatrics attending to care for hospitalized older patients and assist in teaching medical/pharmacy/PA students and the medicine house staff that comprise the ACE service team.

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 rotate through palliative care and hospice learning the principles of palliative medicine and end-of-life care. During the palliative care rotation, fellows provide consultative services to acutely ill hospitalized patients. During their hospice rotation, fellows experience caring for patients on the inpatient hospice unit and in the home.

Geriatric Psychiatry

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

McGregor Overlook Nursing Home is a not-for-profit facility where fellows collaborate with the nursing staff to care for residents in long-term care. Fellows also help to manage skilled nursing facility (SNF) patients at Judson Park.

Community Resources Rotation

During the Introduction to Community Resources rotation, 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.

Elective Experiences

Fellows are given elective opportunities in wound care, peri-operative medicine, infectious diseases, rheumatology, uro-gynecology and research.

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