Course Director: Claudene George, MD, RPh, email@example.com
The Geriatrics Clerkship is a two-week required rotation completed in either the third or fourth year, and is offered at five sites.
Established as a graduation requirement in 1995, the Geriatrics Clerkship provides clinical exposure to the acute, ambulatory, home and long term care settings. Seminars and workshops in, geriatric assessment, medication management, palliative and hospice care, hazards of hospitalization, healthcare finance & community services, and geriatric nutrition are provided as part of the core curriculum.
Goals and Objectives
The purpose of this clerkship is to provide an introduction to the principles of geriatric medicine including broad exposure to the clinical issues that face older adults, including:
- Medication Management
- Cognitive and Behavioral Disorders
- Self-Care Capacity
- Falls-Balance-Gait Disorders
- Healthcare Planning and Promotion
- Atypical Presentation of Disease
- Palliative Care
- Hospital Care for Older Adults
Upon completion of the 2-week Geriatrics Clerkship, the student must be able to:
- Identify medications, including anticholinergic, psychoactive, anticoagulant, analgesic, hypoglycemic, and cardiovascular drugs that should be avoided or used with caution in older adults and explain the problems associated with each.
- Compare and contrast among the clinical presentations of delirium, dementia, and depression
- Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory or function.
- Assess and describe baseline and current functional abilities (instrumental activities of daily living, activities of daily living, and special senses) in an older patient by collecting historical data from multiple sources and performing a confirmatory physical examination.
- Ask all patients over age 65, or their caregivers, about falls in the last year, watch the patient rise from a chair and walk (or transfer), then record and interpret the findings.
- Define and differentiate among types of code status, health care proxies, and advanced directives
- Identify the psychological, social, and spiritual needs of patients with advanced illness and their family members, and link these identified needs with the appropriate interdisciplinary team members.
- Identify potential hazards of hospitalization for all older adult patients (including immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, peri- and post-operative periods, and hospital acquired infections).
- Gain knowledge in and begin to learn to assess and manage common diseases and syndromes in geriatrics. These include but are not limited to depression, dementia, delirium, falls, incontinence, osteoporosis, pressure ulcers, and pain.
Clinical Exposure and Curriculum
Students are exposed to diverse sites of geriatric care, including nursing homes, rehabilitation programs, patients’ homes, day programs, acute care hospital and outpatient settings.
Students participate in the multidisciplinary teams, which provide care in these settings, working directly with geriatrics faculty, nurse practitioners, nurses, social workers, pharmacists, and therapists.
Students attend family meetings and multidisciplinary case conferences to discuss patient care from a variety of perspectives.
All students attend a half day session at an inpatient hospice program at Calvary Hospital in which they are exposed to the philosophy and the methods of hospice care for patients with incurable chronic diseases
All students participate in a lecture series developed specifically for the student geriatrics clerkship:
- A Practical Guide to Healthcare Finance & Community Services
During this informative lecture a case-based approach is used to review the basics of healthcare financing and community services covered by Medicare and Medicaid.
- Hazards of Hospitalization
This lecture reviews the pathophysiology of aging, addresses medical complications that can result when older patients are admitted to an acute care hospital, and describes methods of prevention.
- Geriatrics Assessment
This lecture introduces an approach to geriatric functional and cognitive assessment and highlights important assessment tools used by clinicians.
- Geriatric Nutrition Workshop
An interactive session reviewing basic principles of nutritional assessment for an older adult.
- Beth Israel Medical Center
- King’s Harbor Multicare Center
- Long Island Jewish Medical Center
- Montefiore Medical Center
- St. Barnabas Hospital