Curriculum

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

You attend weekly case conferences, journal club, courses in clinician educator and geriatric research, and mini-seminars. 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. You attend Grand Rounds in geriatrics and palliative care as well as a monthly departmental morbidity and mortality conference.

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 geriatric and palliative care patients. You have some required rotations and some electives.

As a geriatrics fellow, you can participate in a teaching rotation educating medical students, older adults at the 92nd Street Y, and lead community talks to residents at the Linkage House, an assisted living residence. You can prepare and deliver formal, large and small group teaching materials for residents and students. You provide hands-on supervision of third year medical students as they rotate in the Ambulatory Care Clerkship.

You also teach and supervise geriatric nurse practitioner students and other trainees through the Consortium of New York Geriatric Education Centers and elsewhere.

 

Outpatient Care

At the Coffey Geriatrics Practice at the Martha Stewart Center for Living, we work as a team. You learn to evaluate patients and consider the psychosocial and economic factors, as well as the medical components, to working with 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. You may also work at the James J. Peters VA Medical Center. 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.

Home Visits

An increasingly common part of geriatric 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 Visiting Doctors 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 them requires follow-up inquiry, repeated exams, and considerable assessment and analysis. You work with other caregivers and 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 work in an interdisciplinary team with 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 getting more training in palliative medicine, you can spend an additional year in clinical, educational, research, and administrative aspects of palliative care.

Concurrent Service

We provide care for Martha Stewart Center For Living patients and Mount Sinai Visiting Doctors patients who are hospitalized on a subspecialty service or an intensive care unit in order to act as liaison among specialists, patient, and family.

Psychiatry Rotation

You spend a month on the Consultative Liaison Psychiatry Service focusing specifically on psychiatric issues among elderly patients. You perform psychiatric evaluations, diagnostic assessments, and develop medication and behavioral treatment plans for inpatients. 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.

Consult Service

We provide consultative services to geriatrics hospitalized patients for acute delirium, dementia with behavioral issues, family communication/goals of care, discharge/transition planning, and comprehensive geriatric assessment. 

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

4

ISSMS

Concurrent/Consult

8-12

ISMMS

Co-management

4

ISMMS

Post Acute Care

8

NJH

Long Term Care

8

NJH

Palliative Care

4

ISMMS

Home Care

4

ISMMS

MACT

4

ISMMS

Scholarly activity/research

4

ISMMS

Neurology

4

ISMMS

Martha Stewart Center for Living

48

ISMMS/MSBI

Second Year

Rotation

Duration

Site

MACE Unit

8-12

ISMMS

Research

24

ISMMS, VA, NJH

Urgents

8-10

ISMMS

Martha Stewart Center for Living

Two sessions in the first 6 months/one session in the last 6 months 

ISMMS

Teaching

4

ISMMS