Geriatric Fellowship Rotations

Inpatient Geriatric Medicine

Duration: 12 weeks

Fellows serve as one of the multiple team members in the geriatric inpatient service. At the beginning of the year, the focus is on developing skills in geriatric patient care and effective patient and family communication. Fellows will gain further experience with discharge planning and develop a deeper understanding of issues that arise at transitions of care. As the academic year progresses, fellows will have graduated responsibilities for oversight and supervision of the service with a role in teaching and providing feedback to residents and students.

Palliative Care

Duration: 6 weeks

Fellows should develop the ability to use hospice and palliative care services to provide geriatric patients with quality, patient-centered care. Fellows should be comfortable leading goals conversations with patients and families and managing symptoms at end of life. Several weeks are spent with the St. Margaret Palliative care team, and several weeks are spent with the Palliative care team at UPMC Presbyterian, Shadyside, or Magee. 

Hospice (Inpatient and Outpatient)

Duration: 2 weeks each

Fellows' time is split between the inpatient hospice service in Lawrenceville and spending time doing hospice home visits. This time is spent with the hospice doctors affiliated with UPMC/Family Hospice.  

Neurology

Duration: 3 weeks

Fellows spend time with the neurology specialists at the Pittsburgh Veterans hospital. Outpatient time is spent with the movement disorder specialist. Inpatient consults are performed along with neurology residents. Fellows also spend time with the Alzheimer’s Disease Research Center.

Geriatric Psychiatry

Duration: 4 weeks

Fellows should develop an understanding of the unique presentation of psychiatric illness in the geriatric population. They spend 2 weeks at UPMC Western Psychiatric Hospital in the geriatric ward, and 2 weeks working with the geriatric psychiatrists at UPMC St. Margaret Geriatric Care Center.

Rehabilitation

Duration: 3 weeks

Fellows should recognize the impact of physical function on the health of geriatric patients and be able to complete a functional assessment. One week is spent at St. Margaret with the rehab doctors, and 2 weeks are spent at the Mercy stroke unit.

Rheumatology

Duration: 1 week

Fellows should be able to distinguish characteristics of common rheumatologic conditions in the elderly. They work with our rheumatology specialists at St. Margaret.

Wound Care

Duration: 4 weeks

Fellows should have a framework for the assessment, diagnosis, and management of chronic wounds. They work for 2 weeks with our plastics surgeons in the nursing homes and 2 weeks with the inpatient wound team.

Pain Management

Duration: 2 weeks

Fellows learn the impact of pain on the health of geriatric patients, the nonopioid and opioid management of pain, and the interventional management of pain. The fellows work with pain management specialists at St. Margaret.

Urology

Duration: 2 weeks

Fellows should gain comfort in the common urologic conditions that impact geriatric patients, such as urinary incontinence. Fellows spend 1 week with urology at St. Margaret, and 1 week with the urogynecology specialists at UPMC Presbyterian hospital.

Geriatric Consults

Duration: 2 weeks

Fellows round with geriatricians at Presbyterian hospital completing geriatric medicine consults on the trauma service for 2 weeks. The focus is on developing a skill set in providing consultant services.

Scholarly Activity

Duration: 2 weeks

The goal is to permit fellows to have ample time to prepare projects. Common projects include posters for the American Geriatrics Society Annual Scientific Conference, working on QI projects that are then presented at St. Margaret’s Fellowship Day, or medical education work that can be presented at UPMC Medical Education Day.

Elective

Duration: 2 weeks

Multiple electives are available through the many resources available in the UPMC system. Commonly pursued is the geriatrics consult elective at UPMC Presbyterian, or time with community life, the local PACE program.  

Faculty Development Fellowship

Duration: 4 weeks

In August, fellows have the opportunity to work with the faculty development fellows during a 4 week intensive, 8 sessions per week, developing the skill set to become clinician-educators and clinician-leaders. Fellows will attend didactics that range from leading small groups to teach in the inpatient or outpatient settings, giving formal presentations, or undergoing a QI project. This didactics series helps fellows prepare for multiple leadership roles that they will maintain throughout the year.

Community Life/ADRC

Duration: 1 week

The fellows work with the local PACE program, Community Life. Fellows attend the adult day center to get a sense of how the center works. Fellows help lead patient visits with the Community Life team, including doctors, social workers, and nursing staff.

Fellows work with the interdisciplinary team at the ADRC. This group includes researchers, neurologists, psychiatrists, and neuropsychologists, who are evaluating patients with dementia for treatment options.