Mobile Acute Care for the Elderly (MACE) Unit
Visiting physicians gain experience in the interdisciplinary management of acutely ill elderly in a hospital unit oriented to their unique needs. The physician participates in daily admission and management rounds with the medical team, and in interdisciplinary rounds with nursing, social work, nutrition, and therapy professionals. He or she interacts with housestaff during clinical rounds and in didactic sessions concerning geriatric syndromes and complications of hospitalization in the elderly.
The Martha Stewart Center for Living Practice (Ambulatory Geriatrics)
This experience prepares visiting physicians to manage the many challenges in ambulatory geriatrics. It provides clinical experience in recognizing and treating common medical problems and geriatric syndromes encountered in ambulatory care, in the practice of regular health maintenance, and in the use of common assessment tools. The physician gains an appreciation of the comprehensive team approach to the psychosocial and economic factors affecting the aging patient and the patient's family.
Consult Service Rotation
Visiting physicians gain experience in the role of the consultant geriatrician by following inpatients with the Consult Service, which provides care for elderly inpatients hospitalized on non-internal medicine services.
Palliative Care Service Rotation
Visiting physicians participate in providing care for seriously ill hospitalized patients as members of the Palliative Care Service at Mount Sinai Hospital. The Palliative Care Service focuses on symptom management, enhancement of function, physical comfort, quality of life, psychosocial support, and communication about goals of medical care with patients and their families.
Visiting physicians participate in providing home care with the Mount Sinai Visiting Doctors Program, one of the largest physician home visit programs in the country. He or she gains proficiency in the art and science of house calls, learns to assess patients for appropriateness for house calls, and becomes more confident in providing care in the home. He or she also acquires an understanding of the financial, legal, and safety issues involved with house calls. The visiting physician collaborates in team rounds with members of the Visiting Doctors interdisciplinary staff, and in didactic sessions offered for fellows and housestaff.
Geriatric Rehabilitation Medicine Rotation
The Jewish Home and Hospital (JHH) Rehabilitation rotation involves the medical care and rehabilitation of patients admitted to a thirty-eight bed Sub-acute Care Unit devoted mainly to geriatric rehabilitation. Visiting physicians learn how to distinguish between preventative, maintenance, and restorative rehabilitation, how to discuss evaluation, treatment objectives, methods, devices, and modalities of physical and occupational therapy, and how to manage many other aspects of geriatric rehabilitation.
Visiting physicians focus specifically on the psychiatric issues of geriatric patients, acting in the capacity of the consulting psychiatrist under the supervision of the Director of Psychiatry at the Jewish Home and Hospital (JHH). These visiting physicians also provide diagnostic assessment, and medication and behavioral treatment plans for nursing home residents. Didactic sessions focus on:
- The approach to interviewing and performance of a mental status evaluation
- Prescription of each of the major classes of psychotropic medications
- The management of behavioral disturbances in dementia
Icahn School of Medicine (MSSM) Teaching Rotations
This experience provides both didactic information and skills for teaching geriatric medicine at the residency and medical student level. Visiting physicians have the opportunity to participate in developing and teaching sessions concerning common geriatric syndromes and the appropriate care of elderly patients in multiple settings, including ambulatory morning report and precepting sessions for students on the inpatient geriatrics/medicine rotations.