Geriatrics

Geriatric fellowship rotations

Inpatient and geriatric consult team and interdisciplinary geriatric program unit – Fellows will become part of the interdisciplinary team with a geriatrician, advanced practice geriatric nurse, social worker, physical therapist, occupational therapist, pharmacist and chaplain, in the provision of consultative care. In an effort to maintain and maximize function of older adults, fellows will be exposed to the full spectrum of geriatric syndromes. Such syndromes include dementia, delirium, falls, immobility, depression, polypharmacy, end-of-life issues and functional assessment.

Outpatient Geriatric Assessment

Fellows will be part of the interdisciplinary geriatric team, providing geriatric consultative services to a variety of referral services. The goal of this rotation is to help fellows become experts in assessing geriatric syndromes that imprint on function in older adults as well as interfacing with a variety of professional referral sources.

Geriatric Continuity Experience

Under the auspices of the Hospital of Saint Raphael’s ElderCare program, fellows will provide ongoing primary care for a group of frail older adults. The goal of this experience is to enable fellows to learn to manage older adults with multiple chronic conditions. The ElderCare Program is a series of primary care sites throughout the Greater New Haven area that provide older adults living in a variety of senior housing sites comprehensive, ongoing primary care at each patient’s site of residence. Currently, the Hospital of Saint Raphael, in concert with the Greater New Haven Housing Authority, operates eight such sites. Fellows will also have the opportunity to complete home visits with physician assistants and local home care agencies as needed as part of their continuity experience.

Geriatric Rehabilitation

Working under the direct supervision of a board-certified physiatrist, fellows will have contact with older adults undergoing rehabilitation under the auspices of the outpatient rehabilitation program. Fellows will participate in the interdisciplinary management of older adults with stroke, traumatic brain injury and musculoskeletal disorders.

The Sister Anne Virginie Grimes Health Center

Fellows, under the direct supervision of the fellowship program director and geriatricians at the facility, will follow patients over a set period of time. Direct observation of case presentations, chart audits, clinical and teaching skills provide information for feedback and instruction. Fellows will also attend the weekly program director rounds at the facility.

Saint Raphael’s program provides ongoing opportunities for the fellow to develop presentation and teaching skills. In addition to attending weekly didactic conferences on a variety of geriatric topics and monthly geriatric journal club, fellows are expected to present four to six conferences per year to a variety of hospital and professional audiences. The geriatric fellow also has multiple responsibilities and interactions in terms of teaching and supervising the Internal Medicine residents while they complete their geriatric rotations under the general direction of the geriatric fellow and the faculty. This process is structured to enable the geriatric fellows to develop teaching skills while completing bedside teaching rounds with the residents, reviewing the direct application of geriatric principles to individual patients, and specifically instructing residents on the management of multiple geriatric syndromes. The fellows also direct the interdisciplinary team meetings under the supervision of the attending physician.