What are good geriatric fellowship programs?

[elizabeth5863]

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Hello,

I'm planning on applying to geriatric fellowship programs and am trying to find programs that have good/great training but are FP friendly. I heard about the ones in the West Coast, but what about in the Midwest or East Coast? I would appreciate any input. Thanks so much for your time and help! 🙂

 

[Doctor Grim]

Hello,

I'm planning on applying to geriatric fellowship programs and am trying to find programs that have good/great training but are FP friendly. I heard about the ones in the West Coast, but what about in the Midwest or East Coast? I would appreciate any input. Thanks so much for your time and help!

First of all, let's start with program rankings. The top 20 are:

According to US News-
1. UCLA
2. Johns Hopkins
3. Mt. Sainai MC, NY
4. Mass General
5. Duke
6. Yale
7. Mayo, MN
8. U Pitts MC
9. BIDMC
10. U Mich
11. Emory
12. UCSF
13. U Wash
14. Cleveland Clinic
15. UAB
16. NY Presby U Hospital
17. Northwestern
18. Wash U
19. NYU
20. U Penn

I believe all of these programs are based out of IM. So it depends on whether you want to be trained at one of the reputable programs listed above or not.

From my experience, MOST geritaric programs are FM friendly (I was trained at one of the programs listed above). Certainly faculty and teaching should be taken into considerations as well as the different facilities you will be working at (Univ hospital, VA, Univ-affiliated NH and subacute units..etc). Some of these programs are 2 yr programs with a focus in research during the 2nd year which will prepare you better for academics. But you will only need 1 yr of clinical curriculum to be board eligible for a CAQ-G.

I was trained in FM in an urban university setting so I wasn't interested in rural or community based fellowship programs. Our faculty actually comprised of both IM and FM and I did enjoy learning some medicine from internist faculty members.

I did interviewed at one university affiliated geri fellowship based out of a FM dpt 2 hrs away from the metro area but I didn't like it b/c of the light workload and fellow experience-it was a very small program and basically one of the two fellows take turn teaching each other MOST of the time in didactics with a faculty facilitator. In addition, some of the geri fellowhsip within FM would require you to do FM clinic in addition to your geri continuity clinic which I wasn't interested in.

You also want to think about your career plan afterwards. Whether or not you want to remain in academics may influence your decision-university vs. community or IM (more opportunity/research) vs. FM (more clinical).

Hope this helps.

 

[bunnymd]

In addition, some of the geri fellowhsip within FM would require you to do FM clinic in addition to your geri continuity clinic which I wasn't interested in.

I'm curious about this. I'm currently an FM doc doing geriatric fellowship in an IM sponsored program. It is my understanding, after talking with rep's from the ACGME, that all FM docs must do a continuity clinic. My PD and I have been arguing this issue with ACGME and they continue to insist on keeping it in the curriculum. IM fellows don't have an additional clinic requirement like FM fellows. Currently, this extra 1/2 day of clinic in FAMILY MEDICINE is a major pain and I truly loathe that afternoon. Did you not do this requirement? How was that justified?

Interestingly, I will start a palliative care fellowship in july and for some reason it isn't required for FM fellows to have a 1/2 day continuity clinic in that curriculum. So, why is it so impt to keep an FM clinic in geriatrics but not so much in palliative care? The whole thing is ridiculous to me.

Congratulations are in order for not having to deal with that clinic.

 

[Doctor Grim]

I'm curious about this. I'm currently an FM doc doing geriatric fellowship in an IM sponsored program. It is my understanding, after talking with rep's from the ACGME, that all FM docs must do a continuity clinic. My PD and I have been arguing this issue with ACGME and they continue to insist on keeping it in the curriculum. IM fellows don't have an additional clinic requirement like FM fellows. Currently, this extra 1/2 day of clinic in FAMILY MEDICINE is a major pain and I truly loathe that afternoon. Did you not do this requirement? How was that justified?


Congratulations are in order for not having to deal with that clinic.

Interesting. I didn't do anything special or extra to get out of FM continuity clinic. I only knew that if I trained at a IM based geri program then I didn't have to do FM continuity clinic. Most of our current clinical fellows are FM trained and they don't have to do any FM continuity clinic as well. We are a big university program-with a fairly large ger division within the dpt of medicine and the Dpt of M is HUGE. So my guess is that as long as we satisfy the ACGME/RRC requirements for IM then we're fine. I had no prob registering for the board exam offered by ABMS/ABFM.

 

[DrJosephKim]

Do you have any interest in research? Or purely clinical? If you go to a "top-tier" program, expect to get involved in some research and to publish several papers.

 

[elizabeth5863]

Thank you, everyone, for all your responses so far! 🙂 These are some of the most useful advice I have received.

I would love to go into academics at some point and would prefer to go to an IM program if I can get into a good one. I am mostly interested in clinical but I also want to do some research. The thing though, besides the U.S. rankings, I am not too familiar with what each individual program is like since I don't personally know anyone in those programs.

I am also concerned about my preparedness compared to other IM applicants interested in geriatrics. Obviously, IM applicants receive intensive training in older adults while FP residency training involves a wide spectrum of age groups including peds, young adult, and OB. I am trying to do all my electives in geriatrics and in rotations that would be useful for geriatric fellowship.

For those of you who did FM residency, did you find yourself at a steep learning curve compared to IM trained fellows?


I know that geriatrics fellowship isn't as competitive compared to other fellowships but the top programs are fairly competitive I think. I want to train at a good program with great role models and mentors, but I also want an FP friendly faculty.

Doctor Grim and bunnymd, if you don't mind sharing which programs you go to, then please PM me. Thank you so much!

 

[Doctor Grim]

Do you have any interest in research? Or purely clinical? If you go to a "top-tier" program, expect to get involved in some research and to publish several papers.

Yes and no as each program is unique with different emphasis. UCLA is no doubt the best program in geriatrics with its leadership under Dr. David Reuben. But it is only a one year clinical program. There are opportunities to do research through different funding mechanisms for 1-2 more years after the clinical curriculum if one desires. University of Washington is also a great program but it is a two year program requiring research during the second year.

If you're only doing a one year clinical geri training, you're not required to do research or publish any papers-although an abstract for AGS or AMDA or other scholarly activities are highly encouraged.

 

[Doctor Grim]

Thank you, everyone, for all your responses so far! 🙂 These are some of the most useful advice I have received.

I would love to go into academics at some point and would prefer to go to an IM program if I can get into a good one. I am mostly interested in clinical but I also want to do some research. The thing though, besides the U.S. rankings, I am not too familiar with what each individual program is like since I don't personally know anyone in those programs.

I am also concerned about my preparedness compared to other IM applicants interested in geriatrics. Obviously, IM applicants receive intensive training in older adults while FP residency training involves a wide spectrum of age groups including peds, young adult, and OB. I am trying to do all my electives in geriatrics and in rotations that would be useful for geriatric fellowship.

For those of you who did FM residency, did you find yourself at a steep learning curve compared to IM trained fellows?


I know that geriatrics fellowship isn't as competitive compared to other fellowships but the top programs are fairly competitive I think. I want to train at a good program with great role models and mentors, but I also want an FP friendly faculty.

Doctor Grim and bunnymd, if you don't mind sharing which programs you go to, then please PM me. Thank you so much!

On the contrary, in my opinion, FM docs are very suitable for additional geri training b/c geriatrics is an extension of FM. What is special about geriatrics trained docs is that you are able to take care of the most frail and oldest of the old (>80 yo) who are very complicated with their geriatric syndromes.

In addition, I found that my geriatric training during FM (which is required) was very good. It started out as a one month geri block at the beginning of our PGY2 and then we were assigned 2 NH patients who we have to follow until graduation on a monthly basis. Furthermore, FM docs are more experienced with beeper calls-screening over the phone and make some medical decisions and it will help when it comes to covering for nursing home patients. My IM classmates didn't really have that experience as most of their training was hospital based where they just went and evaluate the patients in their rooms.

At the beginning of your geri training, you will learn about comprehensive geriatric assessment. I found it easy to grasp b/c I was doing similar things already during my FM training with each of my patient minus some of the unique geri aspects.

So I think you don't have to worry about not being up to par with your fellow IM classmates in an IM based program.

 

[elizabeth5863]

On the contrary, in my opinion, FM docs are very suitable for additional geri training b/c geriatrics is an extension of FM. What is special about geriatrics trained docs is that you are able to take care of the most frail and oldest of the old (>80 yo) who are very complicated with their geriatric syndromes.

In addition, I found that my geriatric training during FM (which is required) was very good. It started out as a one month geri block at the beginning of our PGY2 and then we were assigned 2 NH patients who we have to follow until graduation on a monthly basis. Furthermore, FM docs are more experienced with beeper calls-screening over the phone and make some medical decisions and it will help when it comes to covering for nursing home patients. My IM classmates didn't really have that experience as most of their training was hospital based where they just went and evaluate the patients in their rooms.

At the beginning of your geri training, you will learn about comprehensive geriatric assessment. I found it easy to grasp b/c I was doing similar things already during my FM training with each of my patient minus some of the unique geri aspects.

So I think you don't have to worry about not being up to par with your fellow IM classmates in an IM based program.

Thank you so much for your perspective and encouragement! 🙂