The geriatrics rotation is a rotation lasting one block occurring in multiple sites in the community. The teaching of geriatrics in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series and on other rotations (see other curricula).
- At the completion of this rotation, the resident will have an understanding of the practice of geriatrics in a community setting, which will facilitate appropriate referral practices in the future.
- At the completion of this rotation, the resident will have gained knowledge and skills in the areas of geriatrics pertinent to the practice of family medicine.
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the geriatrics preceptor:
- medical knowledge in geriatrics pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): psychosocial issues of aging; care in the nursing home; “geriatric syndromes” such as incontinence, falls, dementia and behavioral and sleep disorders in the elderly, common issues in geropsychiatry and the use of community agencies in the care of the elderly.
- the ability to perform an appropriate history and physical examination on the geriatrics patient, including the use of formal geriatric assessment tools, and to present these findings in an appropriate manner (PC).
- the ability to interpret appropriate data related to the geriatrics patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits and risks of diagnostic and therapeutic options and co-managing patients appropriately with other specialists (PC).
- the ability to make appropriate decisions to assure high-quality care in a cost-effective manner (SBP).
- communication and interpersonal skills, which facilitate positive and therapeutic relationships (ICS).
- the ability to work cooperatively with other health professionals as part of a healthcare team (PC).
- compassion, respect and integrity; responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; a commitment to excellence and ongoing professional development (P).
- a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices (P).
- sensitivity and responsiveness to a patient’s culture, age, gender and disabilities (P).
There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum, and residents may gain experience meeting these requirements during this rotation.
This is a community-based rotation with multiple sites, and the resident will be provided with a meeting schedule prior to the start of the rotation. The resident will be scheduled to spend time in a nursing home and in the community with the assistance of local agencies providing services to the elderly. The resident will give a fifty minute didactic session over a geriatric topic at the conclusion of the rotation.
The resident is responsible for meeting the requirements of the schedule as provided. If situations arise which would result in the resident missing or being late for an assignment, the resident must promptly notify the appropriate contact person. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty-hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
The geriatrics preceptor will complete an evaluation form at the end of the rotation. Residents will specifically be evaluated on the following ACGME Milestones:
- PC-2: Cares for patients with chronic conditions.
- MK-1: Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine.
- SBP-1: Provides cost-conscious medical care.
- SBP:2: Emphasizes patient safety.
- SBP-4: Coordinates team-based care.
- PBLI-2: Demonstrates self-directed learning
- PROF-2: Demonstrates professional conduct and accountability.
- PROF-3: Demonstrates humanism and cultural proficiency.
- C-1: Develops meaningful, therapeutic relationships with patients and families..
- C-2: Communicates effectively with patients, families, and the public.
- C-3: Develops relationships and effectively communicates with physicians, other health professionals, and healthcare teams.