department of geriatrics medical student teaching

MEDICAL STUDENT ELECTIVE IN GERIATRIC MEDICINE:

The 4-week elective in geriatrics has been available to all fourth-year medical students for over 15 years. The diverse clinical training sites include inpatient and outpatient consultative services (Kuakini Medical Center, Queen's Medical Center, VA Outpatient Clinic); HMO (Kaiser), long-term care/nursing home (VA Center for Aging, Kuakini Geriatric Care, other nursing homes); and VA home care experiences. Nursing home and home care experiences are particularly important, since they are not provided anywhere else in the curriculum. In addition, the medical students participate in didactic seminars two half-days per week, and a weekly Geriatrics board review session. The seminars cover core geriatric topics, supplemented by a curriculum handbook containing current literature, guidelines, and test questions and answers.

The primary goals of this elective are: familiarizing students with the differences between normal aging and disease; medical, psychological, social, legal and ethical issues related to the care of the aged; communicating with older adults; working well in interdisciplinary teams; learning the basics of rehabilitation; and palliative and end-of-life care. Students see both frail and well elders with a variety of health issues, and are taught principles of primary and secondary prevention. Cultural sensitivity issues are stressed, in keeping with Hawaii's diverse population.

REQUIRED ROTATION IN GERIATRIC MEDICINE AND END-OF-LIFE CARE:

The Curriculum Committee of the John A. Burns School of Medicine has approved a 4-week required rotation in Geriatric Medicine and End-of-Life Care for either the 3rd or 4th year medical students, to begin in July 2004. The reasons for this decision are many. The AAMC estimates that 75% of current medical students will care for older people as a substantial portion of their practice. Most medical care of older patients is provided by primary care physicians and sub-specialists, most of whom have not been trained to prevent, recognize, assess, and manage the acute and chronic medical problems of the elderly. While only a few will become geriatricians, the majority of students will care for many older people in their practices. There is a large chasm between the health care needs of the aged and the number of physicians who are specially trained to provide their care. For these reasons, the Liaison Committee on Medical Education (LCME), the accrediting body for medical schools, emphasizes the importance of including geriatrics training in medical student education.

MEDICAL STUDENT GERIATRICS SUMMER PROGRAM:

As of 2003, we have had 14 medical students who have won a scholarship from the John A. Hartford Foundation and spent the summer learning about geriatrics. Instruction includes clinical experiences and didactic teaching. These students also receive instruction in research methodology and complete research projects in the field of aging. Several students have presented their research as scientific abstracts at local and national conferences, and as peer-reviewed journal manuscripts. Many students who have not applied for the scholarship have also completed the summer program.

Copyright 2005-06, Department of Geriatric Medicine
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