Description of Geriatrics Training Grants Approved in April 2001

Cornell University, New York, NY - $2,000,000

Cornell’s Joan & Sanford Weill Medical College is among the country’s most prestigious academic health centers. It strengthed the training in geriatrics of its approximately 440 medical students and 129 medical residents, employing problem-based cases and the use of older adults and their caregivers. All medical students were introduced to a multi-year curriculum in geriatric medicine. All medical residents were required to take a one-month rotation in geriatric medicine. An enhanced psychosocial curriculum and novel courses in environmental design for frail elders and geriatric psychiatry were introduced. Special geriatric courses also were offered to the network of 14,000 practicing physicians in the New York Presbyterian Health System. 

Medical College of Wisconsin, Milwaukee, WI - $1,999,990

The Medical College of Wisconsin is a private, freestanding medical and graduate school originally associated with Marquette University. The Medical College launched a three-part initiative in geriatric education in which approximately 800 medical students received a comprehensive curriculum in geriatrics, featuring the use of "virtual patients" in CD Rom format and the opportunity to participate in community-based programs focused on geriatric health. A new residency program was launched combining geriatrics and general internal medicine along with a geriatric fellowship program focused on preparing geriatric clinician educators. The initiative was led by the Chairman of the Department of Medicine.

University of Hawaii, Honolulu, HI - $2,000,000

Though smaller than most mainland institutions, with only 248 medical students, the University of Hawaii’s School of Medicine is highly regarded for its strong geriatrics fellowship and research programs. It developed and implemented a required curriculum in geriatrics for all four years of medical school and to institute geriatrics training in all three years of its medicine and family practice residency programs. In addition, it developed and implemented new geriatrics content for residency programs in obstetrics/gynecology, psychiatry, and general and orthopedic surgery. It also developed an innovative continuing medical education program in geriatrics for faculty and clinicians in Hawaii. During the course of the grant, Hawaii established the country’s fourth department of geriatrics.

University of Iowa, Iowa City, IA - $2,000,000 

Iowa has the nation’s highest proportion of citizens over the age of 85. As the state’s only allopathic medical school, the University of Iowa committed itself to preparing its 663 medical students and 98 internal medicine and family medicine residents to care more effectively for the state’s growing population of frail elderly. The principal focus of the program was on strengthening the infrastructure for geriatric education in primary care disciplines. The school drew on its widely acclaimed "virtual hospital" to develop a "geriatric virtual hospital," offering web-based teaching modules on ten common geriatric syndromes and digitized lectures on 40 core geriatric topics. In addition, a one-year "mini-fellowship" program offered a combination of intensive clinical training and distance learning to help train community-based practitioners in the principles of geriatric management.

University of Michigan, Ann Arbor, MI - $1,999,161

The University of Michigan’s goal was that every graduating medical student and every physician who completes residency or fellowship training have a meaningful educational experience in geriatrics. It benefited from one of the country’s outstanding geriatric fellowship and research programs in pursuing its goal. In addition to developing and establishing new mandatory clinical experiences, Michigan requires each student and resident to complete a web-based geriatrics portfolio to gain and demonstrate geriatric competence. Faculty was trained to develop new geriatrics training programs in such medical and surgical specialties as obstetrics/gynecology, emergency medicine and urology. All 671 of Michigan’s medical students and at least 140 of its residents participated in the project.

University of Nebraska, Omaha, NE - $1,997,188

The University of Nebraska’s Medical Center integrated geriatrics into its programs to train 480 medical students, 263 residents and 420 practicing physicians annually. Particular emphasis was placed on improving the amount and quality of geriatric education received by internal medicine and family practice residents and on training faculty in geriatrics. An intranet web site was developed to facilitate this training. An effort also was made to expand geriatrics training for surgery and anesthesiology residents. The project to train practicing physicians focused on providing better care at the end of life. The training of residents and of practicing physicians was decentralized to cover the entire state.

University of Rochester, Rochester, NY - $1,999,346

The University of Rochester’s new "double helix" curriculum intertwines basic science and clinical experiences in a highly innovative, problem-based learning approach. One of its goals was to expose all 400 of its medical students to the practice and science of geriatrics in a comprehensive and continuous curriculum. The new curriculum serves as a national model. Rochester also introduced a special aging curricular pathway to interest medical students in pursuing geriatrics in greater depth. Another initiative trained community-based physicians to serve as mentors in geriatrics. Medical residents were involved in a home-to-hospital program that allowed them to visit an older patient at home after a hospitalization in the hopes of improving the residents’ skills and attitudes about discharging patients. Rochester was already known for its strong geriatrics fellowship and medical residency training programs and for its aging-related research. The project also strengthened geriatrics in four to five surgical residency programs.

University of South Carolina, Columbia, SC - $2,000,000 

The School of Medicine at the University of South Carolina is a relatively small school, enrolling approximately 300 students, but it plays a central role in training the state’s primary care physicians, as evidenced by the fact that 76% of its graduates practice in South Carolina. The highest priority in the project was to strengthen the faculty’s knowledge of geriatrics, as the first step in improving the geriatrics training of the school’s medical students and residents. Fifteen key faculty members, in gynecology, surgery, emergency medicine, internal medicine, family medicine and psychiatry, gained protected time to develop geriatrics expertise in their respective areas. They then were able to apply that expertise in developing medical student and resident education modules in geriatrics. An effort also was made to train community-based physicians, particularly in rural areas, using distance education techniques. 

Virginia Commonwealth University, Richmond, VA - $1,839,961

Advanced informatics and distance learning techniques were employed by VCU’s School of Medicine to improve the training of faculty, medical students, residents and community physicians in geriatrics. CD Roms now provide interactive instruction. A web site offers practical advice on common problems through "Geriatric Quick Consult" plus hundreds of archived seminars. The school’s 688 medical students experienced a major increase in hours devoted to geriatric topics using new curricular materials, including a series of interconnected cases. Internal medicine residents doubled their required involvement in geriatrics. Training for other specialties, including orthopedics, neurology, psychiatry, emergency medicine, and general surgery, were enhanced by focusing on acute geriatric care. A new medical education effort in geriatrics targeted 500 practicing physicians each year who are also community instructors for the school. 

Yale University, New Haven, CT - $2,000,000

Yale’s goal in this project was to integrate into the education of all medical trainees a model of care that reflects the complex nature of the needs of the aging population and is scientifically informed, culturally sensitive and ethically appropriate. The 400 medical students, 250 internal medicine residents and over 300 residents and fellows in the subspecialties were trained to recognize the multi-factorial nature of illness in the elderly, to elicit patient preferences and goals and to integrate these into an appropriate plan of care. Building from its strong base in aging research and existing resident and fellow training in geriatrics, Yale developed a case-based curriculum with multiple levels of complexity that integrated these concepts into medical education from the basic sciences to continuing medical education for practicing physicians. A web-based version of the curriculum was developed for use at Yale and other institutions. The Yale-Reynolds Project also utilized a train-the-trainer model of faculty development to further assure the integration of these concepts into practice.