Geriatrics
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Program Curriculum

Rotations

Full or Part-time Track

    VA Community Living Center is an in‐hospital nursing home specializing in rehab, skilled care and hospice care. Long term care veterans tend to be more complex than typical nursing home residents. The goal is for the fellow to learn screening of residents for admission, transitional care, skilled care, rehab principals, hospice care, nursing home regulations, and to function with the IDT.

    Fellows will spend 4 weeks each at Sanford Health and Avera Dougherty Hospice House. The fellow works with the Sanford Health hospice team on
    inpatient consults and follow‐up palliative care visits. At the Avera Dougherty Hospice House, the fellow spends time in outpatient palliative
    care and in acute in‐house hospice.

    HBPC takes care directly to the veteran’s home. The fellow accompanies the team for provider visits, nurse, and social work visits, and works with the IDT.

    This is a traditional inpatient teaching service at Sanford Health under the direction of a geriatrician who receives consultations from the other hospitalists on complex geriatric patients. There are younger learners on this rotation also. The goal is to become proficient at inpatient and transitional care.

    The goal of this rotation is to learn neurologic conditions of elders at the Sanford Health Neurology clinic. Some inpatient consultations are also seen.

    The fellow learns treatment of urogenital problems on urology and urogyn adds the treatment of incontinence.

    The fellow learns inpatient acute rehab and outpatient rehab from a physiatrist at Avera McKennan Hospital.

    The fellow follows elders at the Avera Behavioral Health Gero‐psych inpatient nursing home and the outpatient clinic.

    The fellow works with the wound care team.

    The fellow works with the Avera Hospital‐At‐Home team, seeing elders in their homes and will spend time with the skilled and non‐skilled home care.

    This may be done in Sioux Falls or an away rotation. The fellowship can design a rotation suited for the fellow’s interests.

  • Community Living Center

    8 weeks ?

  • Hospice Care

    8 weeks ?

  • VA Home Based Primary Care

    4 weeks ?

  • Inpatient Care

    4 weeks ?

  • Neurology

    4 weeks ?

  • Urology/UroGyn

    4 weeks ?

  • Rehabilitation

    4 weeks ?

  • Geriatric Psychiatry

    4 weeks ?

  • Wound Care

    4 weeks ?

  • Hospital at Home

    4 weeks ?

  • Electives

    4 weeks ?

Rotation Blocks

There are thirteen four-week block rotations.  Twelve are required with 1 elective. Depending on career goals we can add more electives. The inpatient core will be primarily based at the long-term care facilities with 1 month on hospital inpatient wards.

The longitudinal component includes an ambulatory and long-term care experience.  The fellow will have one half-day session in a primary care clinic seeing geriatric patients. The conference schedule will include two weekly conferences of one hour with members of the faculty.  Lectures will be didactic lectures from the GRS teaching slides and board review conferences as well as specialty lectures, case conferences, IHI modules, journal club, research discussions, and business meetings.

The long-term care rotation includes experiences in SNF and LTC. The fellow will also have a nursing home panel of LTC residents for their fellowship that are visited monthly.

Required Rotations

  1. VA Community Living Center
  2. Hospice
  3. Home-Based Primary Care
  4. Inpatient Service
  5. Urology/Urogynecology
  6. Neurology
  7. Rehabilitation
  8. Gero-Psych
  9. Wound Care
  10. Hospital at Home

Electives

  1. Podiatry
  2. Urology
  3. Avera Palliative Care and Hospice
  4. Research/Writing/Independent Study

Continuity Experiences

  1. Geriatrics Outpatient Clinic Panel: year-long, but can be divided into six-month blocks
  2. Nursing Home Panel: year-long
  3. Certified Medical Director (CMD) Training: year-long nursing home administration
  4. GEM (Geriatric Evaluation and Management) Clinic at the VA.
  5. Nursing Home Participation in Medicare Team Review of SNF Patients: ( on SNF)
  6. Noon Conferences: year-long twice weekly

Other

  1. Attendance at the Annual Meeting of AMDA, Dedicated to Long Term Care, Futures Program
  2. Attendance at the Annual Meeting of the American Geriatrics Society
  3. Attendance with a presentation at the Annual Meeting of the South Dakota Medical Directors Meeting