The core of the 12 month fellowship is advanced geriatric clinical training in office, hospital, home based and long term care settings. The program utilizes the strengths of two well developed health systems, the Philadelphia VA and Penn Medicine.
- Hospital Care – Fellows rotate on the Acute Care for the Elderly (ACE) Unit at Penn Presbyterian Medical Center (PPMC). Fellows are tightly integrated into an interprofessional team and serve the role of a junior attending. Fellows are responsible for teaching geriatrics to medical students and residents utilizing bedside teaching skills and small group learning. Hospital consults are done at both the VA and PPMC.
- Outpatient Care – Fellows have a longitudinal clinic at the VA and a block rotation at the Penn Medicine outpatient clinic, Ralston Penn Geriatrics. This provides a well balanced and diverse older adult population.
- Home based care – Fellows will be a part of Penn’s Independence at Home, a Medicare demonstration project, and the Ralston house call program. On the VA side, fellows will be a part of Home Based Primary Care (HBPC), and an innovative Hospital at Home program.
- Long term and post acute care – Fellows will have a diverse experience that can include a VA nursing home (CLC), Penn Center for Rehab and Care (PCRC), and two privately owned nursing homes (Renaissance Healthcare and Rehabilitation and St Ignatius Nursing Home).
By the end of the year, fellows will have learned best practices in every site of care including forward looking models of care. Upon completion, fellows will be able to walk into any site of care and immediately practice and provide expert leadership.
Other clinical experiences will include spending time at the Penn Memory Center-an NIH Alzheimer’s Disease Center, a block experience in palliative care, geriatric psychiatry, urogynecology, rheumatology, sleep medicine, movement disorders, rehabilitation medicine and oral medicine.
Fellows attend a half day of didactic conferences on Friday morning that includes Geriatric Grand Rounds with faculty, and a fellows conference afterwards. Topics covered include a medical director's curriculum, palliative care, quality improvement, teaching, board review and interprofessional education. Fellows are also invited to attend the Department of Medicine Grand Rounds as well as other subspecialty conferences throughout the school of medicine as time allows such as Palliative Grand Rounds on Tuesday Morning and the Penn Memory Center Consensus Conference on Monday mornings.
During the one year fellowship, fellows will have a curriculum to develop them as educators. Opportunities to grow as educators include the ACE unit, formal small group didactics with both residents and students and teaching clinical skills to medical students. Topics include geriatric assessment and transitions of care.
Fellows will also join the other fellows across the University of Pennsylvania Department of Medicine to be mentored in quality improvement through quarterly meetings and a structure curriculum. Further study in quality improvement can be accomplished during additional one or two year programs.
Fellows often attend conferences as well, including the American Geriatric Society meeting, the American Medical Directors Association meeting and the regional meetings of each group.
Advanced Training Fellowship Tracks
Qualified fellows strongly interested in an academic career will the opportunity to pursue specific interests during a second or third year. There are four tracks that fellows can pursue: medical education, quality improvement and health leadership, research and clinical areas of interests.
- Education Track – Opportunities include a one year certificate program (Measey Fellowship in Education) or a Master’s Program in medical education.
- Quality Improvement and Health Leadership Track – There is a Master of Science in Health Policy and Research with a focus on quality improvement (MSHP) that can be done in conjunction with a mentored practical experience through the CHIPS program.
- Research Track – Opportunities include both certificate and degree programs for fellows in research methods, translational research and epidemiology as well as access to the numerous T32 grants across the university, the Healthy Brain Scholars Program (co directed by Dr. Jason Karlawish), and the National Clinical Scholars Program (formerly known as the Robert Wood Johnson Clinical Scholars Program). The Master of Science in Translational Research is co directed by Dr. Nalaka Gooneratne (Entrepreneurial Track).
- Advanced Clinical Track – A second year would allow for up to 50% protected time to design and pursue interests such as surgical co-management, palliative care, or memory disorders.
Overall, there are nine Master Degree programs in the school of medicine that fellows can pursue during a second and third year. Funding is available to cover most of the cost of tuition and possibly the entire cost of the degree. In addition to the Master Degrees in the school of medicine there are other opportunities across other schools such as Wharton and the School of Education.