Clinical Training – Geriatrics
The University of Chicago offers comprehensive education in clinical geriatrics across a wide range of care settings, conditions, and patients. Our geriatrics faculty are nationally-recognized educators, most of whom have advanced medical education training and all of whom put a primary focus on teaching fellows. Our philosophy is to center fellows’ learning and development as expert geriatricians who are well prepared to be leaders in teaching, research, policy, and/or clinical roles. Our training offers a strong foundation in the essentials of clinical geriatrics with the flexibility for fellows to tailor their experience towards their future career interests. Recent graduates of our program provide excellent examples of the “outcomes” of our fellowship. Among their ranks are NIH-funded academic researchers, clinician educators in medical school leadership positions, entrepreneurs in nursing home leadership and administration, and leaders of innovative clinical programs.
The overall goals of the fellowship program in Geriatrics are to become and expert in:
- The provision of primary and consultative care to older patients in a variety of settings with special attention to those with frailty, multiple co-morbid conditions, dementing and psychiatric illnesses, and those near the end-of-life.
- The changes associated with normal aging as compared with disease from a variety of perspectives including physiologic and psychological.
- The epidemiology of the aging population with emphasis on changes in disease incidence and prevalence.
- The altered presentation of diseases in older patients.
- The geriatric syndromes (delirium, falls, incontinence, etc.).
- The elements of a multi-disciplinary approach in caring for older patients, how to function as a team, and special emphasis on the functional and psycho-social domains of health.
- The approach to the unique ethical issues that arise in caring for elder patients.
Each fellow in the Geriatric Medicine Fellowship Program completes 12 months of intensive clinical training. The program offers an invaluable opportunity to learn about the care of older adults in a variety of settings. Clinical experiences include longitudinal geriatrics primary care in which fellows follow their own panel of geriatric patients weekly under the supervision of Geriatrician preceptors at University of Chicago’s geriatrics clinic, the South Shore Senior Center . At this clinic fellows learn an interprofessional team approach to care of older adults by collaborating with geriatrics-trained social workers, advanced practice nurses, pharmacists, physical therapists, and sub-specialists. Fellows also provide primary care for a longitudinal panel of patients in the skilled nursing facility setting, under the supervision of a Geriatrician preceptor. In addition, fellows spend several months on the Inpatient Geriatrics Consult Service under the direction of a geriatrics attending. Here, they also have the opportunity to work with a physician assistant, and to teach students and residents.
Core rotations are also provided in the following areas for all fellows in the Geriatric training program:
- Hospice and Palliative Care
- SOCARE Clinic (Geriatric Oncology)
- Acute Rehabilitation
- Center for Comprehensive Care and Research on Memory Disorders
- Successful Aging and Frailty Evaluation Clinic
- Incontinence Clinic
- Wound Care
- Geriatric Psychiatry
- Sub-specialty rotations including: dermatology, podiatry, ophthalmology, joint injections, osteoporosis and bone disorders, movement disorders, neuropsych testing
Fellows rotate on the inpatient palliative medicine consult service under supervision of our palliative medicine faculty.
Specialized Oncology Care & Research in the Elderly (SOCARE) Clinic
Fellows complete a rotation in the SOCARE clinic where they work with board-certified physicians with expertise in geriatric medicine, geriatric oncology, and palliative care to understand the benefits, risks, and limitations of treating cancer in older adults.
Obtaining skills involved in the acute rehabilitation setting is another key element in a well-rounded geriatrics-training program. During this rotation fellows learn the key principles of rehabilitation medicine as they apply to the older patient mainly in the settings of acute stroke, joint arthroplasty, and repair of fractured bones.
Center for Comprehensive Care and Research on Memory Disorders
Fellows complete a two-month rotation at the Memory Center evaluating new patients and participating in the multidisciplinary case conference.
Fellows complete a rotation in the Successful Aging and Frailty Evaluation (SAFE) Clinic where they become members of a multi-disciplinary team that systematically evaluates and treats patients who have been screened for moderate to severe frailty.
Fellows learn about incontinence and voiding dysfunction in older people from a geriatric perspective.
Fellows learn about diagnosis, staging, risk factors and management of pressure ulcers and other complex wounds.
Fellows learn to evaluate and treat older patients with psychiatric problems in the outpatient clinic setting.
Fellowship Training Program in Geriatric Oncology
The Department of Medicine and the nationally ranked Section of Geriatrics and Palliative Medicine and Section of Hematology/Oncology are committed to building a center of excellence in geriatric oncology at The University of Chicago, one of only 5 centers to receive American Society of Clinical Oncology support for post-graduate training. Our goal is to train academic leaders in this new and growing sub-discipline. This 3 or 4-year interdisciplinary program satisfies all clinical training requirements for board eligibility in both disciplines. There is a separate application process for the Geriatrics and the Hematology/Oncology fellowships.
A distinguished faculty creates a supportive environment that includes nationally recognized leaders in both fields. The oncology faculty is active in clinical, basic and translational research, with particular strength in pharmacology and therapeutics. The division is actively involved in cooperative group trials of the Cancer and Leukemia Group B that emphasize enrollment of elderly subjects. The University of Chicago offers an extraordinary depth of research mentorship in health care services and outcomes research through the Robert Wood Johnson Clinical Scholars Program and the Department of Health Studies, and in ethics through the MacLean Center for Clinical Medical Ethics and the Section of Geriatrics and Palliative Medicine. Geriatrics research at The University of Chicago, a Hartford Center of Excellence recipient, is marked by broad collaboration, with studies in geriatric health care, clinical and research ethics, health policy and communication.
Both Geriatrics and Hematology/Oncology programs are highly competitive and have established records of successful training of young investigators. The Section of Hematology/Oncology accepts 6 new fellows per year for the 3 year clinical program. The Section of Geriatrics and Palliative Medicine accepts 2-3 first year fellows for the one year clinical program. Fellows are strongly encouraged to pursue an academic track and to obtain support for research training. Trainees are expected to identify research interests and mentors and to pursue competitive applications for research training support, as are all fellows-in-training in both disciplines.
The curriculum in geriatrics oncology integrates training in both disciplines. In general, geriatric oncology fellows will pursue a program that is predominantly geriatrics in the first year, including inpatient, outpatient and long term care experiences but also with oncology continuity clinics. In the second year, geriatric oncology fellows typically will shift to a more traditional oncology program while maintaining an outpatient Specialized Oncology Care and Research in the Elderly (SOCARE) Clinic continuity panel. The research interests of the trainee will be considered for flexible programming.
SOCARE is a unique clinic established for the purposes of training geriatric oncologists and for developing clinical expertise in the multidisciplinary care for elderly cancer patients. Geriatric oncology fellows participate in comprehensive evaluation and continuity care of this diverse clinical population. The trainee is thus able to follow the same patient across levels of care from ambulatory primary care to inpatient oncology, skilled nursing and home.