CURRICULUM

Year 1

1. Ambulatory geriatrics clinics and home care (VA Connecticut Health Care System and University Hospital)
2. Teaching nursing home: long-term care (Hebrew Home and Hospital)
3. Teaching nursing home: sub-acute care, hospice and adult day care (St. Francis Hospital & Medical Center)
4. Rehabilitation hospital (Hospital for Special Care)
5. Geropsychiatry in-patient and out-patient care (Masonic Home and Hospital)
6. Inpatient Geriatrics Service (University Hospital)
7. Academic Leadership and Research Skills Course

Year 2

1. Inpatient Geriatrics Service (University Hospital)
2. Ambulatory geriatrics and home care (VA Connecticut Health Care System)
3. Teaching skills development
4. Independent Project
5. Electives

All fellows spend 1/2 day weekly for two years providing primary care for a panel of elderly out- patients in the university-based Geriatrics Associates, P.C.  When these patients require hospital care, they are admitted to the Geriatrics Service at the university hospital (JDH).  Fellows are encouraged to select a second clinic site for longitudinal care in Year 2.

All fellows follow a small panel of nursing home patients at the Hebrew Home and Hospital in their second year for longitudinal care.

Year 1 is approximately 80% clinical work and 20% leadership skills development.  Each fellow undertakes a scholarly project in years 1 and 2.  The balance between research, teaching, and administrative training emphasis in year 2 is determined after discussion with individual fellows about career goals.  For fellows pursuing research-intensive careers, a third year of training is encouraged.

In both years, family practice fellows devote 10 percent of time to working with family practice residents and faculty, to improve family practice skills.

Research

All fellows take the Year 1 Academic Leadership and Research Skills course and participate in a personal project in Year 2, whether headed for teaching-, research-, or administrative-intensive careers.  The ability to critically appraise new information is essential for leadership after fellowship.

Methods for valid studies in aging are taught during Year 1 to the fellows through a year-long, didactic course in aging research. The course covers epidemiology, statistics, research design, biometry, computer use, evidence-based medicine and clinical trials, all related to aging. Fellows have access to computers for the duration of training.  Fellows acquire a firm base in theoretical and practical aspects of research in aging, which greatly enhances their ability to critically evaluate
the research of others.

During the Year 1 Academic Leadership and Research Skills course, fellows identify an area of special interest and choose a project mentor from The University of Connecticut faculty.  They receive group and individual assistance from the faculty in shaping their fellow projects. Clinically relevant studies in the biology and physiology of aging, health care delivery, geriatric syndromes, education, epidemiology, ethics and health policy are prominent among research opportunities at the University.  Program flexibility allows concentration on administrative and teaching skills rather than research during Year 2.  Fellows spend more than 60% of the time in Year 2 conducting their independent projects; funding is available to support fellow projects.  Close collaboration is encouraged with the Claude Pepper Older Americans Independence Center.

Teaching

Teaching-intensive careers are equally emphasized as a goal of fellowship training.  Learning to teach and exposure to academic administration are viewed as vital to fellowship training. From 1988-1994, the UCA was funded as a Center of Excellence by the John A. Hartford Foundation to train faculty for academic careers in geriatrics.  In 1994, a new 3-year award was made (one of 7 nationally) to develop national models for training internal medicine and family practice residents in geriatrics.  In 2000, the AAMC funded UCA and the School of Medicine to develop models of comprehensive, integrated geriatrics education for four years of medical school.

Teaching skills (learner-centered techniques, small groups, precepting, feedback, role play, and curriculum development) are taught in the Year 1 Academic Leadership and Research Skills course.  In addition:

1.    Academic skills development sessions are held monthly with the program director.

2.   At the weekly fellows conference, fellows present didactic talks to fellows, faculty and house staff. Constructive feedback is provided by the program director immediately following the conference and by other faculty.

3.   Teaching is a focus of the VA rotation in Year 2. Fellows serve as junior attendings and teaching techniques are discussed throughout the rotation.

4.   Geriatrics fellows have the usual bedside and clinical rounds with other trainees.  Teaching responsibilities of fellows include:  medical students on clinical clerkships and house staff in acute hospital, teaching nursing home, clinics, and home care settings.

5.   Formal and informal conferences by fellows are given during their rotations at the clinical sites in both Year 1 and Year 2.

Administration

Administration skills and knowledge are taught through tutorials and seminars, and the Year 1 Academic Leadership and Research Skills course. Fellows learn about the organization and management of health care facilities, including nursing homes, home care agencies and ambulatory care.  At the conclusion of the program, fellows are able to analyze training and clinical care settings to provide rational administrative consultation concerning central issues in geriatric program
development.

Faculty

The division of Geriatrics in the Department of Medicine has 28 full-time internist-geriatricians who teach the fellows.  Another 2 full-time faculty in Family Medicine, 2 in psychiatry, 2 in Community Medicine and 1 in Neurology are clinical teachers for the Fellowship program.  All 31 faculty eligible (IM, FM) for the Certificate of Added Qualifications (CAQ) in Geriatric Medicine have the CAQ.