Family Medicine Residency

Fellowship faculty are committed to providing time and resources for reading, reflection, and didactic presentations. Each week of the fellowship except for holidays there will be four hours of didactic conferences, two hours on Tuesday afternoons, and two hours on Friday afternoons.

Five times during the year, there will be "cabin days", where didactics will last from 1:00 to 5:00 PM on a Friday afternoon, generally held at the log cabin of the Fellowship Director, Dr. Ackermann. The first of these sessions is devoted to comprehensive geriatrics assessment; the remaining four are held at the end of each quarter and include time for board review and quarterly conferences for each fellow.

Just over 200 hours of didactic sessions are divided into the following categories:

Basic Science of Aging

Anti-aging medicine, natural history & demographics of aging, pharmacology, physiology of aging, theories of aging & longevity

Clinical Geriatrics

Abdominal aortic aneurysm, abdominal conditions, alternative medicine, anemia, aortic stenosis, arthritis, atrial fibrillation, benign prostatic hyperplasia, cancer, cardiology, COPD, congestive heart failure, constipation, CAD, diabetes, driving assessment, female & male hormone replacement, fluids & electrolytes, foot problems, gynecology, hearing impairment, hip fracture, hyperlipidemia, hypertension, immunization, metabolic bone disease, neurologic diseases, oral health, osteoarthritis, osteoporosis, Parkinson's disease, preoperative management, peripheral arterial disease, pneumonia, polymyalgia rheumatica & temporal arteritis, pressure sores & other ulcers, renal disorders, sarcopenia, screening, seizures, sexuality, skin conditions, sleep disorders, stroke, thromboembolism, thyroid disorders, tuberculosis, UTI, visual impairment, vitamin B subscript deficiency

Geriatrics Syndromes

Dizziness & syncope, falls, functional assessment, mobility & exercise, nutrition, urinary incontinence

Geropsychiatry

Anxiety, behavioral complications of dementia, behavioral therapies, caregiver support, cultural aspects of aging, delirium, dementia diagnosis, dementia prevention, dementia treatment, depression, managing a family conference, neurocognitive testing, psychopharmacology, substance abuse

Health Care Systems

Capitation & cost containment, coding & billing, community resources, history of geriatrics, home care, hospital care, Medicaid, medical direction in the nursing home, Medicare, nursing home care, outpatient care, rehabilitation

Palliative Care

Advance directives, artificial hydration & nutrition, communication, goals of care, grief & bereavement, Hospice, last hours/days of life, other symptoms, pain assessment, pain treatment, palliative care - other, physician assisted suicide & palliative sedation, prognosis, spiritual & cultural aspects of dying, withholding and withdrawing Fellows receive an extensive evidence-based collection of journal articles, book chapters, and other geriatrics resources at fellowship orientation. These readings are organized by the six major didactic areas noted above. Fellows read these materials for the appropriate didactic conference, for specific patients, and when on specific rotations. About 75% of the references (required and supplemental) are available in PDF format. Each fellow receives a CD-ROM containing all of these resources. Supplemental readings are also available in hard copy in the Fellowship Director's office. In addition, appropriate CAQ practice test questions are attached to the required reading, and the answers are provided at the didactic session. Finally, where this is a discussion of the topic in the pocket Geriatrics at Your Fingertips, that reference is also noted. Orientation (4 hours) is held on the first day of the fellowship. Fellows who are new to the Medical Center will also need two days of institutional orientation

Journal Club

Journal Club is held monthly, according to a structured format that will be reviewed during the first session. Research methodology is reviewed, as is the evidence-based approach to decision making in geriatrics medicine. Every quarter, each fellow will present one Journal Club, with guidance from faculty.

Case Conferences

Case conferences are held for one - two hours each month. Initially, the case conferences will be presented by faculty. Each fellow is responsible for presenting one case conference per quarter, using a structured format that will be reviewed at the first faculty-led session.

Fellow Participation

Fellows are responsible for presenting one conference per month, or 12 in a year. In each quarter, the fellow will present a Journal Club conference, a case conference, and a didactic conference on a Clinical Geriatrics topic as selected by the fellow and Fellowship Director. In the final quarter of the fellowship, the fellow will present his/her last Clinical Geriatrics topic as a Family Medicine Grand Rounds presentation. Fellows receive explicit instructions in preparation for each of these conferences

Director's Breakfast

Fellows meet with the Fellowship Director, Dr. Ackermann, one morning a week for Director's Breakfast. Fellows are required to attend except when they are on vacation/CME/admin days or on the inpatient geriatrics rotation. Director's Breakfast is one-on-one time between the Fellowship Director and the fellow(s) - no other faculty/learners are present. The time is for sharing information and schedule changes, feedback from the fellows to the director about the day-to-day functioning of the fellowship, updates on important news in geriatrics medicine, follow-up on prior teaching sessions, and for professional development of the fellow.

Professional development topics include preparation of a curriculum vitae, oral presentations, use of PowerPoint, job negotiation skills, physician wellness, publishing, and role of professional societies such as the American Geriatrics Society and the American Medical Director's Association.