CLINICAL CURRICULUM AND RESPONSIBILITIES
The clinical aspect of our training program features a variety of rotations representative of clinical opportunities for geriatricians. Settings include the Veterans Administration (VA) medical center; the University of Utah hospital and clinics; an integrated residential facility with rehabilitation, long-term care, and assisted living; and Intermountain Healthcare, an aggressive community provider.
The core of the fellowship curriculum is based on longitudinal clinical experiences that last at least the full first year. Each fellow has a continuity clinic at the VA. Dr. Jonathan Nebeker, the Geriatric Fellowship Program Director, and Dr. Laurence Meyer, one of the most popular teaching attending's at the University, supervise this clinic. This clinic provides fairly equal exposure to general-care in older patients, demented patients, and consults for dementia and other neurological or psychiatric problems associated with aging. Fellows follow a panel of patients at the nursing home where the focus is on rehabilitation but also includes long-term care and hospice. The fellow also participates in administrative meetings. Dr. Sara Jane Andersen, the Associate Fellowship Director, supervises this experience. The final, longitudinal clinical experience is in Home Based Primary Care at the VA where fellows work with a good-humored team of nurse practitioners, social workers, and occupational therapists to care for homebound veterans. The fellow may customize this experience to make more or fewer home visits, according to the fellows' preference. Dr. Phil Kithas, the VA Geriatric Section Chief, supervises this rotation.
There are three required six-month rotations for fellows. These include rotations through the University Geriatric Primary Care and Consultation Clinics with Dr. Mark Supiano, Division Chief, and Dr. Gerald Rothstein. Fellows also rotate through the Gero-med-psychiatric Clinic at the VA, which is supervised by Dr. Byron Bair, one of the nation's few certified geriatric psychiatrists.
In addition to their continuity and consult experiences, first year fellows can choose to rotate through a variety of specialty clinics relevant to the practice of geriatrics. Clinics which have proven popular are geriatric gynecology and incontinence, movement disorders, geriatric rheumatology, neurology's cognitive disorders clinic, palliative care, and general urology.
All fellows take night and weekend call every other week. The burden of call is highly variable but usually less than five a week. It is not unusual to go a whole week without a call. The majority of all calls can usually be handled over the telephone.
Didactic sessions are also provided by and for fellows. We review the geriatric literature and the American Geriatrics Society (AGS) Geriatric Review Syllabus once a month. The fellow attends a weekly clinical conference at which he/she presents every other month. The fellow also delivers core lectures to medical interns weekly.
