Geriatric and Palliative Care Education

Geriatric Curriculum

Allegheny County is second in the nation only to Dade County, Florida in its percentage of persons over age 65. In response to meeting the special challenges of this growing population, high priority is placed upon adequately preparing our residents to care for these patients. A strong group of geriatric faculty (that are also core family medicine faculty) are actively involved in teaching, developing new initiatives, and serving on CQI committees for the elderly. One of our goals is to encourage residents to continue following patients in long-term care settings upon completion of their residency program.

Geriatric educational experiences are integrated into all three years of our residency curriculum. During the first year, residents will round on the inpatient geriatric service. This rotation involves rounding with a senior resident, a geriatric fellow, and geriatric faculty on geriatric patients. During rounds, we touch on topics in geriatric medicine such as cognitive impairments, incontinence, osteoporosis, sensory impairment, decubitus ulcers, malnutrition, and elder abuse. The home visit program brings the first-year resident into close contact with community-dwelling, homebound geriatric patients. 

During the second year, residents will be the seniors in the geriatric inpatient service. Residents are learning to lead an inpatient team while under the direction of geriatric faculty. Residents have more dedicated time to their longitudinal nursing home patients. Each resident is responsible for history and physicals, required periodic visits, and management of any acute problems that may arise. A required geriatric outpatient rotation is split into 2 weeks during 2nd year of residency and 2 weeks during 3rd year. This gives residents an opportunity to join the team of geriatric specialists at UPMC St. Margaret's Classic Care, one of the few approved geriatric assessment units in western Pennsylvania.  

Nursing home longitudinal experiences are built directly into the rotational curriculum starting with the intern year, increasing in experience and visit numbers throughout the residency. Residents will rotate through four faculties with various faculty members and one on one teaching. 

Electives can be crafted into the residency curriculum for residents that want to focus on geriatrics and/or palliative care. Often, elective time can help residents to solidify their interests and help them decide if further education will help them meet their career goals. Residents have the option to participate in a geriatric area of concentration. Postgraduate education boasts an accredited geriatric fellowship. Three fellowship positions are available at UPMC St. Margaret. This fellowship works hand in hand with St. Margaret residents on the inpatient geriatric service and is an excellent resource for residents and the community.

Palliative Care Curriculum

In addition to a robust geriatric medicine curriculum, the St. Margaret Family Medicine Residency offers a multitude of experiences aimed at teaching core competencies in the care of seriously ill and dying patients. First-year residents will receive early practical training in communication strategies that will be used to talk to patients and their loved ones about difficult information, prognostication, and advance care planning. Residents will work collaboratively alongside Palliative Care colleagues while caring for seriously ill patients while on hospital-based rotations, with dedicated time rounding with the inpatient Palliative Care service in their second year of training to hone skills in complex symptom management and psychosocial support. Additionally, high-level communication training is provided to 3rd-year residents as they develop expertise in conducting family meetings and facilitating values-based shared decision-making as they prepare for independent practice. For residents seeking additional training, popular electives are also available in palliative medicine and hospice care. These electives include experiences in both inpatient and outpatient care of the seriously ill, and are tailored to the individual interests and goals of each resident.

Some residents may choose to develop further expertise by selecting our Area of Concentration in the field of Hospice and Palliative Medicine. Alongside a dedicated faculty mentor, this program offers longitudinal clinical and academic experiences related to the care of seriously ill and dying patients. Residents that take advantage of these opportunities are well-prepared at graduation to pursue a relevant fellowship, and subsequently obtain a Certificate of Added Qualifications (CAQ) in Hospice and Palliative Medicine through the American Board of Family Medicine.