Curriculum

In this fellowship, you learn both from the more formal didactic components of the program as well as from clinical training. You also will have the opportunity to hone your teaching skills.

You attend weekly case conferences, journal club, which includes a review of sentinel articles in geriatrics with a focus of honing your skill of literature appraisal, courses in clinician educator and geriatric research, and mini-seminars. Our didactics take place every Thursday afternoon, during which you will have protected academic time. These seminars cover a range of topics including clinical teaching, geriatric pharmacology, clinical research skills, health services research methodology, evidence-based medicine, statistics, ethics, medical interviewing, effective clinical training, teaching geriatrics and palliative care in primary care, and working with challenging patients and families. In addition, you will have specialty lectures as pertaining to geriatrics in several other areas in medicine. You attend Grand Rounds in geriatrics and palliative care as well as a monthly Peer Learning Sessions. This academic curriculum has been carefully planned in accordance with core topics in the field of geriatric medicine to best prepare you to meet your geriatric milestones as per the ACGME and prepare you for the certifying boards.

Our clinical training encompasses several components at multiple locations and in conjunction with a number of organizations. This wide variety of educational opportunities exposes you to a range of types of older adults and seriously ill patients, providing you with a robust educational experience across the many various care models in geriatrics and palliative medicine In addition to required rotations, you will have dedicated elective time to deepen your career interests.

As a geriatrics fellow, you will have ample opportunities teach and learn alongside a diverse group of learners across many levels of clinical education and training. We work closely with the Icahn School of Medicine at Mount Sinai and you will provide hands-on supervision of medical students as they rotate though their ambulatory care and in-patient geriatrics clerkships. On your inpatient rotations you will work directly with internal medicine residents as both a supervisor and a geriatrics educator. You can also teach and supervise a geriatrics nurse practitioner. You can prepare and deliver formal, large and small group teaching materials for residents and students.

Our fellows can also lead various community talks, including older adults at the 92nd Street Y, Naturally Occurring Retirement Communities (NORCs), and to residents at the Linkage House, an assisted living residence.

Outpatient Care

We provide comprehensive clinical care to older adults at three Geriatrics and Palliative Care ambulatory sites: Martha Stewart Center for Living Uptown, Martha Stewart Center for Living at Union Square, and Mount Sinai Morningside Geriatrics. At each in cohesive interdisciplinary teams. As a fellow, you will be assign to one of those three sites and you will learn to evaluate patients, considering the psychosocial and economic factors as well as the medical components to aid aging patients and their families. You assume the role of primary care physician for a panel of patients; attend team meetings; participate in ambulatory sessions; and supervise medical students, medical residents, and nurse practitioners. In addition, you can contribute to the Mobile Acute Care for the Elderly Unit, an interdisciplinary, team-based approach to ensuring continuity of care from hospital to home., an interdisciplinary, team-based approach to ensuring continuity of care from hospital to home.

Home Visits

An increasingly common part of geriatrics and palliative medicine, home visits are an important experience. You work with the Mount Sinai Visiting Doctors Program, a collaboration of the Division of General Internal Medicine and our department to care for patients who are frail, suffer from psychiatric illnesses, have debilitating neuromuscular disease, and are terminally ill. You make home visits four days a week and participate in interdisciplinary meetings and formal didactic sessions. We also teach about the financial, legal, and safety issues involved with house calls. You can choose to spend an additional three months with the program.

Nursing Home Care

Working at The New Jewish Home, you see that nursing home care involves more than doing rounds and attending to daily medical needs. You will likely tend to residents who have multiple organ system complications. Caring for these individuals requires follow-up inquiry, repeated exams, and considerable assessment and analysis. You will work with other caregivers and the patients’ family members. During this rotation, you also attend conferences and seminars.

Palliative Care

During this rotation, you help provide patient-centered care for seriously ill hospitalized and ambulatory patients. You will collaborate with an interdisciplinary team comprised of an attending, nurse practitioner, one or two medical students, a social worker, a chaplain, and a massage therapist. In addition to learning to treat symptoms and how to lead family meetings, you also gain familiarity with New York State law as it relates to end-of-life decisions. If you are interested in more training in palliative medicine, you can spend an additional year in clinical, educational, research, and administrative aspects of palliative care.

Concurrent Service

When our patients from the Martha Stewart Centers for Living and Mount Sinai Visiting Doctors patients are hospitalized on a subspecialty service or an intensive care unit, we act as liaison among specialists, patients, and family members. You will join this aspect of our work, which provides an added layer of support and important continuity of care.

Psychiatry Rotation

You will spend a month on the Consultative Liaison Psychiatry Service at Mount Sinai Beth Israel, focusing specifically on psychiatric issues among older adult patients. You will perform psychiatric evaluations and diagnostic assessments; and you will develop medication and behavioral treatment plans for hospitalized patients. Didactic sessions focus on the psychiatric interview, performing a mental status evaluation, managing the behavioral disturbances of dimension, and learning about the major classes of psychotropic medication. You discuss medico-legal issues and have the opportunity to attend court hearings.

Mobile Acute Care of the Elderly/ Mount Sinai Morningside

We provide care to our hospitalized older adults and collaborate with our interdisciplinary team to provide a holistic approach prioritizing the 5Ms of geriatrics, goals of care conversations, and caregiver support. You will be involved in important aspects of transitions of care including discharge and transition planning. You will also have the opportunity to co-manage the patients’ care with various medical and surgical specialties throughout the Mount Sinai Health System.

Wellness

We recognize the many stressors impacting physician trainees both professionally and personally. Our innovative and comprehensive wellness curriculum uses an evidence-based approach, implementing both individual and system-level interventions to promote wellness, reduce burnout, and elevate professional fulfillment for our fellows, faculty, and staff.

Approximate Schedule

Each rotation lasts at least four weeks. Program locations are Icahn School of Medicine at Mount Sinai, The New Jewish Home (NJH), and Mount Sinai Beth Israel (MSBI).

First Year

Rotation Duration (in weeks) Site

Geropsych/Cognitive health

2

ISMMS

Concurrent/Consult

6-8

ISMMS

Co-management

4

ISMMS

Post Acute Care

4

TNJH

Long Term Care

4

TNJH

Palliative Care

4

ISMMS

Home Care

4

ISMMS

Scholarly activity/research

4

ISMMS

Neurology

2

ISMMS

Ambulatory Care

48

MSH/MSDUS/MSM

Second Year

Rotation Duration (in weeks) Site

MACE Unit

8-12

ISMMS

Research

~16-24

ISMMS, VA, NJH

Urgents

8-10

ISMMS

Teaching

4

ISMMS