Three sites in Gainesville will be used. One student will go for four days to each of the sites. The sites are the Geriatric Evaluation and Management Unit at the VA Medical Center; the Shands Rehabilitation Hospital; and Hospice of North Florida. In Jacksonville, the students at the University Medical Center will go to the River Garden Nursing Home. This will be coordinated with Drs. George Wilson and Frank Genuardi.
The patients on the GEM Unit are typically men over age 65 with multiple medical problems and in need of rehabilitation. The staff include an attending physician (Dr. Meuleman, Dr. Lowenthal, Dr. Bender, Dr. Hoffman), PGY2 medical residents, geriatric fellow, geriatric nurse clinician, pharmacist, psychologist, social worker, PT and OT personnel. The time to be spent in the GEM Unit would include evaluating an assigned number of patients, rounds, teaching conferences, reading, use of CD-ROM based geriatric materials, and observation of their patients in PT and OT. On one of the days, Wednesday, is a one-hour multi-disciplinary team conference wherein each patient is discussed by individual members of the health care team. The evaluator of the student would be the attending who is assigned to the GEM Unit for the month.
Shands Rehabilitation Hospital offers rehabilitation in stroke, orthopedic, and spinal cord problems. Students have been going for an afternoon, while on the medicine clerkship, for the past two years to Shands Rehabilitation Hospital and have gained a substantial amount of knowledge concerning rehabilitation. Their mentor has been Jesse Lipnick, MD. Dr. Lipnick is board-certified in physical medicine and rehabilitation as well as in electrodiagnostic studies related to stroke and spinal cord disease. The student would spend each morning making rounds with him and then working with the physical therapist, occupational therapist, speech therapist at the rehab center. More than 5(0) percent of the patients are over age 65 so that there are ample numbers of patients for a student to be in a geriatric rehab experience. The student will also participate in the multi-disciplinary team conference held weekly. Dr. Lipnick would serve as the evaluator.
The Hospice Center of North Florida is located near the Shands Rehabilitation Hospital. This is an 18-bed unit wherein greater than 50 percent of the patients are over age 65. Dr. Robert McCollough is the director of the center and he already has been mentoring residents in family medicine from the University of Florida. Dr. McCollough will be making rounds at least once daily if not twice and would be providing teaching along with the multi-disciplinary health care team regarding the end-of-life issues and problems. The student will spend four days at the center. Dr. McCollough will serve as the evaluator for the student.
All of these centers have in common the issues of geriatric patients--multi-disciplinary care and chronic illness. In two of the centers there is the hope of rehabilitation and restoration of function, a lesson to be learned by each student. At the third center is the equally valuable exposure to dealing with end-of-life issues wherein the patient is helped to function comfortably and compassionately in his (her) waning days.
Textbook Material:
Syllabus of the American Geriatric Society. Textbook of Geriatric Medicine - Cassel, C., et al
Journals:
Journal of the American Geriatric Society Journal of Gerontology - Medical Sciences American Journal of Hospice and Palliative Care
Goals:
Objectives:
Lectures:
MAGNA Lecture Series - UF and UMC during Medicine-Pediatrics.
Geriatric Lectures: Case-oriented based on a review of syndromes studied in year two.
Competencies expected by the end of the third-year rotation in geriatric medicine - All those remaining from the list derived by the Curriculum Committee and include by category: