SOM Elective Brochure

Electives Type:  Clinical

Elective Title
Geriatrics in the Community
Course Number
Prerequisites: Successful completion of Year 2 
      Additional Requirements:
Responsible Faculty Director:
Erin Hommel, MD
Other Faculty:
Vinod Kaushik, MD, Maria Hughes, MD, Mukaila Raji, MD Anna Rotkiewicz, MD Olusola Onoviran, MD Rafael Samper-Ternent, MD PHD
Location to Report on First Day
Rebecca Sealy, Rm. 6.608 (Christian Mikobi) at 8:30am on first day of elective. Phone 409-266-9635
Periods Offered
NOT including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment

 1. To discover the available care options for the community dwelling older adult through experiences at various clinical sites 2. To develop an understanding of comprehensive geriatric assessment focusing on complex medical disease , geriatric syndromes, preventative health and goals of care. 3. To enhance communication skills with the older adult with an enhanced sensitivity to gender, age, ethnicitiy, and socioeconomic status as relates to medical care.

 1. Perform a comprehensive history and physical on a community dwelling older adult with attention to presence of geriatric syndromes 2. Create a comprehensive assessment and plan for a community dwelling older adult with multiple comorbidities and geriatric syndromes taking into account patient expressed goals of care 3. Describe the benefits and limitations of care options for the debilitated older adult including skilled nursing, long term nursing home, hospice, home care, and assisted living

Description of course activities
 1. The student will accompany a faculty member and geriatric fellows in the ambulatory geriatric clinic, skilled nursing facility/nursing home, and in home visits. 2. The student will participate in geriatric didactic noon conferences and internal medicine grand rounds. 3. The student will participate in older adult health prevention and promotion in the community as opportunity affords.

Type of students who would benefit from the course
 Knowledge and experience gained will benefit: those pursuing a career in primary care or as a hospitalist, those pursuing adult surgical specialties or adult medical specialties, those with aging loved ones

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
  Day of Week AM PM
  Monday PCP Geriatric Clinic PCP Geriatric Clinic
  Tuesday League City Geriatric Clinic Skilled Nursing Facility
  Wednesday Skilled Nursing Facility House Call
  Thursday Specialty Experiences Specialty Experiences
  Friday League City Geriatric Clinic League City Geriatric Clinic
  Average number of patients seen per week: 25  
  Call Schedule:   none  

  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, 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 living functions, psycho-social issues and common geriatric syndromes
  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)?
    Single comprehensive H&P submitted during rotation, Daily progress notes at discretion of faculty physician
  B. Format - What guidelines are set for the student's written work?
    Standard UTMB Internal Medicine format with addition of details specific to geriatric assessment including psychosocial aspects of care, geriatric syndromes, and goals of care
  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?
    However, pertinent literature review is expected to show depth of understanding of covered differential diagnosis and care needs.
  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 as well as Thursday noon Internal Medicine Grand Rounds (time permitting).

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.