|The Harvard Medical School Multi-campus Fellowship in Geriatric Medicine provides specialized training for physicians interested in pursuing academic careers in geriatric medicine. Fellows are usually appointed for one year, with the option of staying for a second or third year if funding becomes available. One-year programs are available for physicians interested in making a career shift into geriatrics or for physicians wishing to combine geriatrics and another sub-specialty.
Fellows in the Program may pursue one of two tracks. One track is intended for physicians who wish to pursue a research career in geriatrics. This option provides a clinical year followed by an intensive year of clinical research or research in basic science, epidemiology, health services, or ethics. The second track is designed for those who plan to serve as clinician-educators in an academic geriatric setting. This option allows for clinical work in the first year, which is continued through part of the second year. The remainder of the second year is devoted to a project focusing on the design or evaluation of a program in geriatric education or the administration of geriatric services.
All fellows receive a faculty appointment to Harvard Medical School.
The goal of the Geriatrics Fellowship is to train academic leaders with skills in clinical geriatrics and in gerontologic research, education or administration. Fellows will develop expertise in the following areas:
- Clinical care of elderly patients in the acute hospital, the geriatric assessment unit, the rehabilitation hospital, nursing home, the sub-acute unit, and the home.
- The structure and economics of the health-care delivery system, including long-term care and home care.
- The essentials of clinical geriatric medicine, including the evaluation and treatment of falls, incontinence, delirium and depression.
- The design of a project to investigate a research hypothesis, educational program, or geriatric service.
- Delivering lectures on geriatric topics, based on research data, the medical literature, and clinical cases.
The clinical program
Fellowship training begins on July 1 and takes place at multiple clinical sites. An in-depth exposure to primary care within a long-term care facility is provided at Hebrew Rehabilitation Center. Expertise in interdisciplinary consultation is obtained through rotations at Beth Israel Deaconess Medical Center, VA NE Healthcare System and VA Boston Healthcare System. Fellows provide inpatient care to frail, ill elderly on the Geriatrics Service of Beth Israel Deaconess Medical Center. Fellows are exposed to a sub-acute unit at Youville Hospital and to hospice care at the inpatient hospice unit of Beth Israel Deaconess Medical Center. In addition, a longitudinal primary care experience and outpatient geriatric consultation are offered at a variety of sites. An elective in geriatric psychiatry is available at McLean Hospital.
Fellows will participate in several didactic conferences each week. Case management conferences alternate with journal club and career development seminars in special sessions designed for the fellows and held at the Hebrew Rehabilitation Center. The entire faculty and fellows at all levels of training attend the Geriatrics Grand Rounds at Beth Israel Deaconess Medical Center. Fellows give in-depth presentations on topics of their choice twice a year at Grand Rounds.
Fellows are invited to attend the annual Harvard Geriatric Medicine Continuing Medical Education Course and are given the opportunity to attend one national scientific meeting each year.
Geriatric fellows have teaching responsibilities for medical students on clinical geriatric clerkships and serve as a source of geriatric expertise for house staff in the teaching hospitals during inpatient and consultative rotations. Second- and third-year fellows are involved in teaching the geriatric component of pre-clinical medical school courses and community education programs about aging.
All fellows are expected to acquire a firm knowledge base in theoretical and practical aspects of research in aging, which will permit them to critically evaluate the research of others and to participate in the design and conduct of their own projects. Fellows pursuing the research track identify an area of research and a mentor from the Harvard Geriatric faculty with whom they work closely to formulate a hypothesis and to gather and analyze data. Fellows pursuing the clinician-educator track define a project in geriatric education or administration and work on implementation with a faculty advisor.
Faculty who take part in Harvard's geriatrics fellowship program are known for their strong interests in both clinical geriatrics and research. Faculty research interests include: geriatric cardiology; fluid and electrolyte balance in the elderly; geriatric endocrinology; incontinence; falls and syncope; osteoporosis; ethics; pharmacology; geriatric neurology; metabolism and nutrition; and exercise physiology.