SOM Elective Brochure

Electives Type:  Clinical

Elective Title
Geriatric in the Community
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
A genuine interest in the healthcare of elderly patients.
Responsible Faculty Director:
Erin Hommel, MD
Other Faculty:
Vinod Kaushik, MD, Maria Camacho, MD, Mukaila Raji, MD Liliana Andrade, MD
Location to Report on First Day
Rebecca Sealy, Rm. 6.608 (Christian Mikobi) at 8:30am on first day of elective. Phone 409-772-1987
Periods Offered
including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment

 1. To provide the student with an experience in Geriatric Medicine: off-campus/hospital setting. 2. To learn the role of a primary care physician.

 1. Be able to evaluate and manage elderly patients in a non-hospital based Skilled Nursing Facility. 2. Be able to evaluate and manage elderly patients in a nursing home facility. 3. Be able to evaluate and manage home-bound elderly patients in their homes. 4. Be able to evaluate and manage elderly patients in community-based outpatient clinics.

Description of course activities
 1. The student will accompany a faculty member and geriatric Fellows in the skilled nursing facility, nursing home, and patient's home. 2. The student will participate in health prevention and promotion in geriatric community based programs. 3. The student will be accompanied by a physician, geriatric fellow, geriatric nurse practitioner and other health care team members to assess patients in their homes. wellbutrin online cozaar advil zithromax phentermine online purchase phentermine order soma online naproxen generic zyrtec buy ultram generic lipitor phentermine online generic wellbutrin generic xanax buy soma diflucan order cialis prevacid viagra online allegra wellbutrin online hoodia online norvasc lorazepam ambien online purchase viagra soma buy phentermine generic prevacid cheap adipex phentermine online cetirizine lasix viagra generic phentermine famvir imovane augmentin order valium online celecoxib zestril generic prozac buy xenical order phentermine cheap alprazolam purchase valium zyrtec tylenol cheap viagra online buy ultram online generic cialis buy propecia order soma viagra online buy hydrocodone metformin

Type of students who would benefit from the course
 This course would be particularly important for a student planning a career in primary care.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
  Day of Week AM PM
  Monday Didactics Skilled Nursing facility
  Tuesday League City Geriatric Clinic Skilled Nursing Facility
  Wednesday Geriatric Clinic Skilled Nursing Facility
  Thursday Community Hospice Libbie's Day Care for Seniors
  Friday Nursing Home House Call
  Average number of patients seen per week: 10-15  
  Call Schedule:    

  Research Activities (please insert estimated schedule here)
  Activity Hours per Week
  Faculty contact time

  Self-directed study

  Data collection/analysis


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily at nursing homes, skilled nursing facilities, clinics and patients' homes when on house call duty, always with a geriatric fellow or a geriatric faculty.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Attending physicians and geriatric fellows
  B. Frequency / duration of presentation(s)?
    Daily Presentations of patients seen in House Call, Clinics and Nursing Home/Skilled Nursing facility
  C. Format - What guidelines are set for the student's presentation?
    Standard UTMB Internal Medicine oral format containing all components of H and P and care plans, with emphasis on activities of daily livinig functions, psychosocial issues and common geriatric syndromes such as dementia, depression and delirium, among others
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily progress notes and H&P from Monday to Friday
  B. Format - What guidelines are set for the student's written work?
    Subjective, Objective, followed by Assessment and Plans (SOAP) of care with emphacy on functional outcome and quality of life
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    For indepth discussion of pathophysiology and management, among others, as they relate to patients being cared for.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Cases under discussion and assigned topics by attendings
  F. Audience - Who assesses the studentís written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    The students will attend Tuesday and Wednesday noon geriatric conferences and grand rounds, Thursday medicine grand rounds at noon, house call meetings and didactic lectures given by the nursing home and skilled nursing facility attendings. Students will do the written assignments of the case-based analysis of the polypharmacy in the elderly. The case-based analysis is a one-time task completed in the last week of the course. Knowledge of geriatric pharmacology is evaluated by short answers to 5 questions on appropriate drug use in the elderly.

6.  Other Modes of Evaluation
  Please explain below.
    Observation by faculty. Fellow report on the student's clinical skills and professionalism. Attendings will fill the evaluation forms sent from the Dept of Internal Medicine
7.  If this course is an Acting Internship, please complete the following:
  A. Specify how the student will be given formative feedback on their clinical skills.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
  E. How will this course help prepare a student enter an internship in this field or a related field?
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.