Geriatric Medicine Training and Practice in the United States at the ...

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Appendix H. Residency Review Committees' Recommendations for Geriatrics in Selected Allopathic Specialties with Effective Date, continued Specialty Internal Medicine (Requirements for all sub specialties) July, 1999 ACGME Requirements Facilities and Resources – A sufficient number of new and follow-up patients, including the geriatric age groups, and patients of both sexes must be available to ensure adequate inpatient and ambulatory experience for each subspecialty resident. Specific Program Content – Patient Care Experience: Such experience should include sufficient opportunities in the management of the complex physical, social, and psychological problems prevalent in elderly patients. General Internal Medicine July, 2001 Specific Program Content – End-of-Life Care: 1. Each resident should receive instruction in the principles of palliative care for terminally ill patients, including the role of the health-care team. Instruction should include psychosocial, cultural, and religious issues related to death and dying. 2. It is desirable that residents participate in hospice and home care. Introduction – Definition and Scope of Specialty: Internal medicine is the discipline encompassing the study and practice of health promotion, disease prevention, diagnosis, and treatment of men and women from adolescence to old age, during times of health and through all stages of acute and chronic illness. Facilities and Resources – Patient Population: There must be patients of both sexes, with a broad range of age from adolescent to geriatric patients. Educational Program – Specific Patient Care Experiences – Geriatric medicine: 1. Residents must have formal instruction and regular, supervised clinical experience in geriatric medicine. 2. The written curriculum must include experiences in the care of a broad range of elderly patients. 3. Geriatric clinical experiences must be offered. They may occur at one or more specifically designated geriatric inpatient units, geriatric consultation services, longterm care facilities, geriatric ambulatory clinics, and/or in home-care settings. Educational Program – Special Educational Requirements – End-of-life care: 1. Each resident should receive instruction in the principles of palliative care for terminally ill patients, including the role of the healthcare team. Instruction should include psychosocial, cultural, and religious issues related to death and dying. 2. It is desirable that residents participate in hospice and home care. Internal Medicine, Hematology July 2001 Nephrology July, 2001 Neurology Pain Management June, 2000 Obstetrics and Gynecology July, 2001 Oncology July, 1999 Pain Management Educational Program – Special Educational Requirements – Violence: It is desirable that all residents receive instruction in the principles of recognition and management of domestic violence and of sexual, family, and elder abuse. Specific Program Content – Care and management of geriatric patients with hematologic disorders. Specific Program Content – Residents must have formal instruction, clinical experience, and opportunities to acquire expertise in the prevention, evaluation, and management of the following disorders: Geriatric aspects of nephrology, including disorders of the aging kidney and urinary tract. Specific Program Content – Formal Instruction – Specific content areas that must be included in the formal program (lectures, conferences, seminars, and journal clubs) include the following: Geriatric medicine, including: 1. physiology and pathology of the aging kidney and 2. drug dosing and renal toxicity in elderly patients. Educational Program – Didactic Components – The pain management curriculum must include the following topics in lectures and reading: Management of pain in the elderly. Educational Program – General – Organization and Structure: In addition to rotations in obstetricsgynecology, general medical management experience may also be obtained during rotations in geriatric medicine. Residents must have an experience in menopausal health care and geriatric medicine that is the equivalent of at least one month of a block rotation. Educational Program – Specific Educational Experiences – Primary and Preventive Care: Ambulatory primary care problems of the geriatric patient. Specific Program Content: The residents must have formal instruction, clinical experience, opportunities to acquire knowledge in the following: Care and management of the geriatric patient with malignancy. Educational Program – Didactic Components – The pain management curriculum must include the following 110
Appendix H. Residency Review Committees' Recommendations for Geriatrics in Selected Allopathic Specialties with Effective Date, continued Specialty Physical Medicine and Rehabilitation July, 2001 ACGME Requirements Facilities and Resources: Equipment must be suitable for all age groups, with special attention to modified equipment for the … geriatric patient. Educational Program – Clinical Components – The clinical curriculum must be written and implemented for the comprehensive development of measurable competencies for each resident in the following areas: geriatric rehabilitation and end of life care. Educational Program – Clinical Components – The resident must have opportunities for progressive responsibility in diagnosing, assessing, and managing the conditions commonly encountered by the physiatrist in the rehabilitative management of patients of all ages of at least the following: diseases, impairments and functional limitations seen in the geriatric population. Physical Medicine and Educational Program – Didactic Components – The pain management curriculum must include the following Rehabilitation topics in lectures and reading: management of pain in the elderly Pain Management July 1, 2001 Psychiatry Educational Program – Curriculum – Clinical Experience – Geriatric Psychiatry: One-month FTE supervised January, 2001 clinical management of geriatric patients with a variety of psychiatric disorders, including familiarity with long-term care in a variety of settings. This may be fulfilled as part of the inpatient or outpatient requirement. Psychiatry Educational Program – Didactic Components – The pain management curriculum must include the following Pain Management topics in lectures and reading: management of pain in the elderly. June, 2000 Pulmonary Disease and Key Clinical Faculty – There must be key clinical faculty members in geriatric medicine … who participate Critical Care Medicine in the education of residents. July, 1999 Rheumatology Specific Program Content – Formal Instruction – In the study of rheumatic diseases, musculoskeletal July, 1999 disorders, metabolic diseases of bone, osteoporosis, and acute and chronic musculoskeletal pain, the following specific content areas as a minimum, must be included in the formal program (lectures, conferences, and seminary): geriatric and aging influences. Surgical Critical Care Introduction – Objectives – This advanced body of knowledge and level of skill must include the mastery of July, 1997 the use of advanced technology and instrumentation to monitor the physiologic status of … adults of … advanced years. Source: ACGME Program Requirements, 2002 (http://www.acgme.org/req). Compiled by IHPHSR ADGAP Database Project, 2002. 111
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The Association of Directors of Ger
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The Association of Directors of Ger
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National Oversight Panel M. Brownel
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The American Geriatrics Society . .
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List of Tables and Figures Chapter
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Figure 7.4 Figure 7.5 Figure 7.6 Fi
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the fastest acceleration in 12 year
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esidency review committee provide a
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Project Methodology National Oversi
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Table 2.2 Secondary Data and their
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3 Historical Development of Geriatr
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$195.9 million NIA extramural suppo
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important political decision by the
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4 The Practice Of Geriatric Medicin
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participants. Geriatricians have be
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Table 4.8 Medicaid Recipients and P
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Figure 4.1 Distribution of Certifie
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Figure 4.3 Geriatric Caseload for P
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Table 4.19 Total Annual Compensatio
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panel felt were most important for
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5 Academic Geriatrics Programs in U
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Table 5.1 Academic Geriatric Progra
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Table 5.1 Academic Geriatric Progra
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Figure 5.1 Number of Years as Acade
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Table 5.4 Women and Minority Facult
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Figure 5.6 Physician Faculty Vacanc
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Table 5.7 Sources of Geriatric Prog
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Table 5.9 Allopathic Medical School
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Table 5.11 Allocation of Faculty an
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Table 5.12 Allocation of Faculty an
Page 61 and 62: Table 6.1 Geriatric Medicine and Ge
Page 63 and 64: Table 6.4 Sources of Financial Supp
Page 65 and 66: investigators receive $60,000 of su
Page 67 and 68: Table 6.7 Program Directors Reporte
Page 69 and 70: Table 6.10 Program Directors Report
Page 71 and 72: Fellowship Training Activities for
Page 73 and 74: Table 6.16 Fellowship-Trained Geria
Page 75 and 76: 7 Preparing All Physicians To Care
Page 77 and 78: General Internal Medicine The 1999
Page 79 and 80: Trends in GIM Residency Programs Re
Page 81 and 82: Nursing homes and home care experie
Page 83 and 84: Geriatric Education Retreats (GERs)
Page 85 and 86: and GIM programs a mean of 2.8 avai
Page 87 and 88: chapter. The goals of these student
Page 89 and 90: This program awarded 20 two-year, $
Page 91 and 92: Conclusion This report summarizes r
Page 93 and 94: Bureau of Health Professions, HRSA,
Page 95 and 96: U.S. Centers for Medicare & Medicai
Page 97 and 98: APPENDIX A. Research Focus of Curre
Page 99 and 100: APPENDIX C. RESEARCH FOCUS OF NATIO
Page 101 and 102: APPENDIX E. SELECTED GERIATRIC MEDI
Page 103 and 104: Appendix F. Geriatric Medicine and
Page 109 and 110: Helen Hoenig, M.D., M.P.H., Duke Un
Page 111: APPENDIX H. RESIDENCY REVIEW COMMIT
Page 115: Association of Directors of Geriatr
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