Click each rotation below to view its description and objectives.
Description of Rotation and Educational ExperienceFellows will gain experience in patient safety, quality improvement (QI), and administrative aspects of the practice of medicine. Fellows will shadow various clinical specialists in QI and participate in QI activities. Fellows will have the opportunity to meet one-on-one with senior management and leadership to learn about the administrative aspects of medical practice.
Rotation ActivitiesThe fellow will gain knowledge in quality management (QM) by learning alongside specialists in medical administration, risk management, utilization and peer review, and patient safety. The fellow will meet with the Community Living Center (CLC - the VA nursing home) medical director to discuss curricular topics including nursing home and long-term care regulations and requirements, the Minimum Data Set, quality and safety indicators, and risk management. The fellow will participate in quality assurance activities with an infection control nurse, a falls coordinator, and systems redesign coordinator. They will learn about the administrative aspects of medicine by attending operational meetings with CLC leadership.
Description of Rotation and Educational ExperienceDuring the Geriatric Psychiatry rotation the geriatric medicine fellow will learn about the role of mental health care professionals in providing comprehensive care for older adults, along with the diagnosis and treatment of specific geropsychiatric syndromes. The fellow will interact with other professionals (psychologists, social workers, psychiatric nurses) in the context of an interprofessional team. Patient care experiences on this rotation will include inpatient consultations on an acute care medical unit, and care and follow up of patients on an acute care psychiatry unit and mental health care in the outpatient setting.
Rotation ActivitiesDuring the rotation, the fellow will care for a panel of patients over age 60 admitted to the inpatient psychiatry service, complete assigned mental health consultations in the hospital, and will attend weekly outpatient psychiatry clinics. The fellow will be responsible for:
During this rotation the fellow will have the following experiences:
Description of Rotation and Educational ExperienceThe home care rotation consists of a varying schedule in the care of homebound older adult veterans along with structured scholarly activities. The fellows’ schedule will be unique in order to accommodate their continuity clinic schedule, and to accommodate the schedules of teaching faculty for home visits. This rotation will be based at the Home-Based Primary Care (HBPC) at VA Medical Center, West Palm Beach. The fellow will make home visits with the HBPC staff and participate in interdisciplinary team meetings.
Rotation ActivitiesDuring the rotation, the geriatric medicine fellow will perform the following activities:
Description of Rotation and Educational ExperienceDuring the Hospice and Palliative Care rotation, the geriatric medicine fellow will learn about comprehensive care for older adults with serious illness and limited life expectancy. The fellow will interact with other professionals (psychologists, social workers, nurses and chaplains) in the context of an interprofessional team. Patient care experiences on this rotation will include inpatient consultations on an acute care medical unit, outpatient consults and care of patients admitted to an inpatient Hospice unit.
During the rotation, the fellow, as assigned by attending, will care for a panel of patients who are admitted to the VAMC WPB Valor Way hospice unit including:
The fellow, as assigned by and in consultation with attending, will complete palliative care consults in the hospital and will attend weekly palliative care clinics. During this rotation the fellow will:
Description of Rotation and Educational ExperienceThe Geriatric Medicine Fellow will gain experience and knowledge in all aspects of geriatrics in acute hospital settings including:
ObjectivesThe objectives of this rotation, concordant with the ACGME requirements and the AGS/ADGAP curricular milestones for geriatrics fellowship programs, are to train fellows to:
Rotation ActivitiesThe fellow will be part of the Geriatrics inpatient consultation team. Under the direction of geriatrics faculty they will complete inpatient consult on acute care medical and surgical units. The fellow will also be part of the inpatient internal medicine teaching rounds 3 days a week and provide input to the teaching team in the management of Geriatric Syndromes and other illness seen typically in the hospitalized older adult. The fellow will attend the utilization management rounds and will facilitate appropriate placement or discharge of hospitalized patients.
Description of Rotation and Educational ExperienceThis rotation will take place in the West Palm VA Medical Center Military Manor Community Living Center (CLC), which cares for both long-term care (LTC) and post-acute care (PAC) patients. These two components of the curriculum are therefore integrated in two 4-week blocks.
Rotation ActivitiesDuring the rotation the fellow will be involved in the following activities:
Description of Rotation and Educational ExperienceThe Geriatric Medicine Fellow will participate in longitudinal and outpatient geriatric care at the VA West Palm Beach Medical Centers Primary Care clinics. This rotation will be both block (4 weeks) and longitudinal (1/2 day per week throughout the year) with an assigned panel of patients. The block rotation will consist of primary care experiences with scheduled and walk-in patients. The longitudinal portion will consist of experiences with a cohort of primary care patients where the fellow will assume the role of primary care physician. The clinic attending or Chief of Geriatrics will supervise the fellow’s care of the assigned cohort of patients for longitudinal primary care.
Outpatient Care - GeneralThe objectives of this rotation, concordant with the ACGME requirements and the AGS/ADGAP curricular milestones for geriatrics fellowship programs, are to train fellows to:
Audiology/Speech and Language Pathology
Teaching MethodsThe principal approach is direct care involvement. The fellow will provide and coordinate care for assigned patients assuming the role of the primary physician and coordinator of care of the patient. The fellow will be expected to review pertinent texts and journals and retrieve evidence-based literature for specific patient issues. Clinical teaching will occur during outpatient visits with the teaching attending. In addition to review of assessments and plans for each patient, selected patients may be the focus of more formal presentations and discussion by the fellow during educational conferences.
Description of Rotation and Educational ExperienceThe geriatric medicine fellow will learn to apply the principles of PM&R to the special functional needs of the geriatric population. The fellow will participate in PM&R outpatient services at VAMC at West Palm Beach and will learn about the role of the physiatrist, what services are provided by the Medical Rehab team, when to refer, how to prescribe various therapies and assistive devices, and inpatient vs outpatient/subacute rehabilitation settings.
Rotation ActivitiesThe geriatric medicine fellow will learn about the principles of PM&R in the outpatient setting. The fellow will participate in the evaluation of older adults with conditions such as arthritis, Parkinson’s, amputation, and deconditioning working alongside attendings, physical therapists and occupational therapists. The fellow will spend one half day in the prosthetics clinic.