Rotations

Clinical Continuity

Outpatient Primary Care: The outpatient primary care experience will allow fellows to learn skills in both preventative and acute ambulatory care of older adults. Fellows will manage their own panel of patients under the guidance of trained geriatric physicians. Home Visits with geriatric teaching faculty are also expected as part of this rotation.

Assisted Living: Fellows will also be the primary care provider to a panel of patients at an area assisted-living. By seeing these patients in their “home,” fellows will experience the challenges and rewards of working in this setting.  

Nursing Home and Skilled Care: This is particular strength of our fellowship. Fellows carry their own panel of long-term care and skilled nursing facility patients. In addition to learning to care for this vulnerable population, fellows will be exposed to the role of a Medical Director and be an integral member of the quality improvement team.

Consultative Care

Outpatient Geriatric Assessment: One of the key longitudinal experiences, this clinical allows fellows to practice interdisciplinary evaluation and care of patients, mostly with dementia and other complex geriatric syndromes. Falls Clinics occur once monthly and will also be included as part of this rotation.

Inpatient Geriatric Consultation: The Geriatric Consult Service provides consults to acutely ill hospitalized patients at Maine Medical Center, a 637-bed, tertiary medical center in Portland, ME. All consults will be performed under the supervision of a geriatrician. Each patient consult will be reviewed with the faculty member and the care plan will be reviewed on the day the patient is seen.

Featured Subspecialty Exposures

Rural Geriatrics: Fellows will gain experience caring for older adults in rural areas and navigating rural health care systems. They will learn to identify and address barriers to health care for rural older adults such as: isolation, lack of transportation and decreased access to specialized health services.

Administration and Quality Improvement: Fellows will also have dedicated time to learn about common Geriatric models/systems of care (including financing and coverage of care) and to complete Institute for Healthcare Improvement learning modules on patient safety and quality of care. They will shadow Geriatric Medicine physicians in their administrative roles to observe and practice their newfound knowledge through involvement in quality improvement experiences.

New England Rehabilitation Hospital: This experience exposes the Fellow to acute rehabilitation. Fellows follow patients who are recovering from conditions such as strokes, amputations, spinal cord injury, multiple trauma, and brain injury among other things. The Fellow will admit and manage patients as a member of the rehabilitation team under the direction of psychiatrists at New England Rehabilitation Hospital of Portland.

Inpatient Gero-psychiatry: Fellows will spend time on the inpatient geriatric psychiatry service both evaluating and treating elderly patients hospitalized with acute psychiatric illnesses under the supervision of a geriatric psychiatrist. An outpatient geriatric psychiatry rotation is also available for additional training. Geriatric psychiatrists will supervise the Fellow in all sites.

Neurology: This office based experience will expose fellows to common neurological complaints in the elderly, including memory and movement disorders.

Ambulatory Electives: Electives available to fellows include: Sports Medicine, Geriatric Gynecology and Uro-gynecology and Rheumatology.

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