Geriatrics Fellowship Curriculum
Page Hierarchy
Each rotation will last a minimum of four weeks and take place at the following locations: Lehigh Valley Health Network–One City Center, Lehigh Valley Hospital–Cedar Crest, Lehigh Valley Hospital–17th Street, Fleming Memory Center, LVPG Family Medicine–Hamburg and Cedarbrook Senior Care and Rehab.
Outpatient Care
During this six-week rotation at LVPG Family Medicine–Hamburg, you will learn to evaluate patients considering psychosocial and economic factors, as well as medical components, to gain a more complete understanding of aging patients and their families. You will assume the role of primary care physician for a panel of patients, attend team meetings, participate in ambulatory sessions and supervise medical students and family medicine residents. You will also be involved in quality improvement projects.
Nursing Home Care
Working at Cedarbrook Senior Care and Rehab will allow you to see that nursing home care involves more than doing rounds and attending to the daily medical needs of patients. During two four-week blocks, you will care for patients who have multiple organ system complications requiring follow-up inquiry, repeated exams and considerable assessment and analysis. You will work with patient caregivers and family members. You will also attend conferences and seminars.
Palliative Care/Hospice
During this four-week rotation, you will aid in the provision of patient-centered care for seriously ill hospitalized and ambulatory patients. Working as part of an interdisciplinary team, which includes palliative care fellows and advanced practice clinicians, you will become more confident in providing care to terminally ill/end-of-life patients, learn to lead family meetings focused on end-of-life care goals, and gain familiarity with state law as it relates to end-of-life decisions.
Psychiatry Service
The Consultative Liaison Psychiatry Service will focus specifically on psychiatric issues among elderly patients. During this four-week rotation, you will perform psychiatric evaluations and diagnostic assessments and develop medication and behavioral treatment plans for inpatients. Didactic sessions will focus on the psychiatric interview, performing a mental status evaluation, managing the behavioral disturbances of dimension and learning about the major classes of psychotropic medication.
Consult Service
During two four-week blocks, you will care for patients who have multiple organ system complications requiring follow-up inquiry, repeated exams and considerable assessment and analysis.
Block Diagram
PG-4 Year – all blocks are 1 month in duration
Block | Site | Rotation Name | % Outpatient* |
---|---|---|---|
1 | 1 | Orientation and Geriatric Immersion | 100% |
2 | 1 | Physical Medicine and Rehabilitation | 100% |
3 | 2, 3 | Long-Term Care and Post-Acute Care | 100% |
4 | 1 | Inpatient Consult | 14% |
5 | 1 | Hospice and Palliative Care | 14% |
6 | 1 | Geriatric Psychiatry | 14% |
7 | Varies | Elective | 100%** |
8 | 1 | Inpatient Consult | 14% |
9 | 2, 3 | Long-Term Care and Sub-Acute Rehab | 100% |
10 | Varies | Elective | 100%** |
11 | 4 | Neurology | 14% |
12 | Varies | Elective | 100%** |
Fellows have 15 days of paid time off and 5 days CME, both of which can be taken anytime.
*% outpatient calculation is the percent of time during the listed rotations spent in their longitudinal experience.
**Elective experiences listed here are primarily outpatient, but this calculation may change based on what the fellow chooses.
Sites
- Site 1 = Lehigh Valley Hospital (LVH)–Cedar Crest, which also includes: LVH–17th Street, LVPG Family Medicine–Hamburg and LVPG Musculoskeletal Center–Hausman Road
- Site 2 = Cedarbrook Skilled Nursing and Rehabilitation Center
- Site 3 = ProMedica Skilled Nursing and Rehabilitation
- Site 4 = LVH–Muhlenberg
- Site 5 = Luther Crest Senior Living Community (optional site; may be used for elective time)
Longitudinal Experiences in PGY-4
Geriatric Primary Care – half-day sessions weekly
- Fellow will see patients referred from family medicine residents and attendings for geriatric consults
- Fellow will also see adults over the age of 65 for acute needs and chronic care follow-up
- Fellow will complete home visits at least monthly with family medicine residents and geriatric faculty member
- Fellow will complete pre-operative risk assessment for adults over age 65
- Fellow has access to a multidisciplinary team including behavioral health, nurse care manager, pharmacy and social work
- Home visits scheduled monthly
Outpatient Consult – two half-day sessions monthly
- Fellow will see a panel of patients with geriatric faculty member at Fleming Memory Center
- Multidisciplinary team on-site
Long-Term Care Continuity – half-day sessions monthly
- Fellow will be assigned to follow a panel of continuity patients at a local nursing home (Site 2)
- Fellow will be scheduled to see their empaneled patients once per month
Didactics
- Second, fourth and fifth Wednesday afternoons monthly
- Also as assigned with other departments
- Geri-A-Float https://sites.google.com/view/geriafloat/home
Electives
Elective experiences are available within our fellowship in the following areas:
- Cardiology
- Ear, nose and throat
- Endocrinology, gastroenterology and gynecology
- Geriatric psychiatry
- Hematology oncology
- Infectious disease
- Inpatient consult service
- Medical directorship/long-term care
- Nephrology
- Neurology
- Ophthalmology
- Orthopedics
- Pain management
- Primary care
- Pulmonary
- Rheumatology
- Sports medicine
- Surgery
- Urogynecology
- Urology
- Wound care