During your 12-month training program, you will participate in teams that work both with elderly patients and their families. You will assess individual needs through the spectrum of life keeping the elderly patient at his or her best functional level, while supporting them medically, socially and spiritually as they reach the end of their life.

Curriculum

• 2 weeks: Research Principles  (Bryan Larson, Ph.D.)  – A research project will be created that will be worked on throughout the clinical year with research time available. The project will be presented as a poster at a national geriatric conference, presented to the Family Medicine residents and considered for publication.

• 2 weeks: Epidemiology at the Iowa State Department of Health (Patricia Quinlisk, M.D.) – The state department of Public Health is in Des Moines, providing an opportunity to participate on teams researching public health issues at the state level in coordination with the  Centers for Disease Control (CDC).

•  6 weeks: Geriatric Psychiatry – The fellow will learn both pharmacologic and behavior therapy in management of psychiatric disorders in the elderly.

  • 1 week – Geriatric Pharmacology (Denise Nichols, PharmD)

  • 5 weeks with Geriatric Psychiatrist (Jerry Greenfield, M.D.)

• 6 weeks: Neurology – The fellow will:

  • Be exposed to radiologic procedures that are most frequently used to aid diagnosis and treatment of geriatric neurologic disorders.

  • Participate in neuropsychological testing and interpretation in the workup of elderly patients with cognitive issues.

  • Work-up and participate in the management acute and chronic geriatric neurologic disorders.

  • 1 week Neuro-imaging (William Young, M. D.)
  • 1 week with Neuropsychologist (Dee Nerum, Psy.D.)
  • 4 weeks with Neurologist (Michael Jacoby, M. D.)

• 2 weeks: Wound care center (Ravi Vermuri, M. D.) – The fellow will work on the wound care team in the wound care center, the hospital and on home visits to assess and manage acute and chronic wounds.

  
  

Concurrent Longitudinal Blocks (over 22 weeks)

• Long term Care (Roy Overton, D.O., Robert Conner, D.O.) – The fellow will participate in care of the nursing home resident in facilities that provide care at assisted living, skilled, intermediate care and progressive levels of dementia care in a longitudinal experience.

• Subacute Care (Roy Overton, D.O., Robert Conner, D.O.) – The fellow will evaluate and manage elderly patients as they move from inpatient setting to Subacute care to increase their functional status, or get treatment as a step-down from the hospital.

• Home Care (Ben Collins, D.O.) – The fellow will have a unique experience working with a faculty who assesses and manages elderly patients in their homes and when they are admitted to the hospital.

• Home Hospice (Roy Molina, M.D.) – The fellow will have an opportunity to participate on the teams that care for patients and their families in the home setting at the end of life. Home visits will be made with the team and the fellow will participate in the twice-weekly coordination of care meetings with the medical director and staff.

• Geriatric Consults (Rob McKinney, D.O.) – The fellow will do consults of inpatient elderly to evaluate, treat geriatric syndrome and make discharge and palliative care recommendations.

• Palliative Care (Stephen Berry, M.D.) – The fellow will work on the inpatient palliative care team to assess the individual needs of the elderly patient and their family in the palliation of chronic debilitating medical conditions. Palliation will include the medical, social and spiritual assessment and recommendations for quality of life issues.

• 2 weeks: Hospice Care at Hospice facility (Martin Mortens, D.O.) – Time will be spent at the inpatient hospice facility working with the hospice team in the day-to-day management of end of life issues and in the twice-weekly care meetings with the medical director and staff.

• 6 weeks: Physical Medicine and Rehabilitation (Kurt Smith, D.O.) – Evaluations and management of elderly patients requiring intensive rehabilitation services will be done initially in the inpatient setting, followed by the rehabilitation unit and outpatient care.

• 2 weeks: Elective

Other

• Geriatric Assessment Clinic- at Mercy Family Medicine and out reach to Storm Lake, Iowa (1/2 day per month combined) 

• Continuity Clinic- ½ day per week

• Research Development-approx. ½ day per month

• Educational afternoon: ½ day 2 x a month

  • Journal Club

  • Board Review

  • Lecture topic

• Geriatric Morning Report (once a month with the Family medicine residents)

• Committees: Palliative Care, Ethics Committee

• Community Medicine (8 half days)

• Specialty Clinics (6 half days)

• Nursing Home Rounds with Family Medicine Residents (7:30-9:30 a.m. once a month)

• 1 week: American Medical Directors Annual Meeting

• 1 week: American Geriatrics Society Annual Meeting