Training in Geriatric Medicine
To develop research projects focused on older cancer patients, it is essential that UNC-GO trainees have knowledge of basic Geriatric Medicine principles including hands-on care of Geriatric patients.
- Principles of Geriatrics (compulsory): Each UNC-GO trainee will complete this on-line course at the start of the training program. These modules were developed as part of the Center for Aging and Health’s Reynolds grant (see Section 1c1) and provide the basic building blocks of geriatric care.
- Inpatient and Outpatient Geriatrics Rotation: All trainees will spend four weeks seeing patients with Geriatric fellows and their preceptors in the Geriatric Specialty Clinic. This clinic meets two half-days a week year-round and sees patients in consultation and patients who come to UNC for their primary care. The Clinic specializes in patients with multi-morbidity and in those with cognitive and functional losses. UNC-GO fellows will also spend two weeks with the Geriatric In-Patient Team doing assessments for delirium, cognitive decline, functional decline, and frailty. UNC-GO fellows may also spend 2-4 weeks with the in-patient palliative care team and at the UNC Hospice with the Home Hospice interdisciplinary team participating in patient assessment and symptom management. In all of these settings, UNC-GO fellows will participate in goals of care discussions with patients and families.
- Geriatric Conferences (Compulsory): UNC-GO fellows will participate year-round in the formal lectures for Geriatric Fellows, and they will be expected to give at least one journal club each year to the Geriatric Medicine faculty. UNC-GO fellows can also participate with the Geriatric Medicine fellows self-directed learning sessions as they feel it is helpful.
Optional Geriatric Medicine Training Opportunities: Trainees will be encouraged to participate in as many of these activities as their time permits. While on a Geriatrics rotation, participation in these activities will be compulsory:
- Weekly Conference of the Division of Geriatric Medicine. These meetings periodically include presentations on special topics pertaining to the treatment and care of older patients, such as: Bronchiectasis – an orphan disease re-adopted; Dementia – lessons from the Oldest-Old and Prevention of Alzheimer’s; Medications for dementia and its complications: are we treating patients or ourselves; High dose monthly vitamin D for prevention of acute respiratory infection in older long-term care residents: RCT; Putting the “active” in Geriatrics: implementing “Exercise is Medicine” at UNC; and Aging effects on the neuromechanics of gait and balance control. These meetings also provide an opportunity for trainees to present their American Geriatrics Society (AGS) posters and journal club discussions.
- Geriatric Fellows Teaching Conferences. These conferences are held weekly (after the Geriatric Division weekly meeting) and cover a variety of topics, including Geriatric syndromes, that are essential to the care of older persons including but not limited to: delirium, cognitive assessment, geriatric assessment, dementia, Medicare, health care financing, falls/gait/fitness, mild cognitive impairment, neuropsychology evaluations, polypharmacy, Parkinson’s Disease and medications, mobility aids, abnormal weight loss, urinary incontinence, constipation and fecal incontinence, and communication with elderly patients and their caregivers.