Geriatric Medicine Fellowship

Here’s what you can expect: Ambulatory geriatric care training combines primary care geriatrics

with exposure to relevant complementary ambulatory training experiences. Fellows spend one morning each week performing comprehensive cognitive assessments in our outpatient office in Monroe, NJ, where they also maintain a weekly continuity ambulatory clinic in their core discipline (Family Medicine or Internal Medicine) by seeing a broader age range of patients. Fellows provide outpatient care to residents of Parker at Stonegate (assisted living) and participants in two of Parker’s adult day programs. Additional outpatient experiences are gained through several of the core and elective rotations, which include participation in specialty clinics.

Long-term care training is based within three local Parker Homes, which embrace the Eden Alternative model, a person-directed approach that fosters an enriched environment aiming to reduce loneliness, boredom, and helplessness. Fellows provide primary geriatrics care for a panel of patients at these homes under the direct supervision and guidance of faculty geriatricians. Fellows gain administrative skills, medical directorship experience, and familiarity with population health during this time. Additionally, they’re frequently able to maintain continuity with individual patients, for example, by following and caring for them through transitions from assisted living, to post-acute and then LTC.

Inpatient geriatric medicine rotations in acute and consultative geriatric hospital care at the Robert Wood Johnson University Hospital in New Brunswick, NJ, offer ample opportunities for learning within an Age-Friendly Health System. With a medical staff of 1,300 physicians and as the core teaching hospital for the Robert Wood Johnson Medical School, fellows interact with over 300+ residents and fellows from other graduate medical education fields. Fellows work closely with the Family Medicine inpatient service and faculty from the Department of Family Medicine, Department of Medicine, Cancer Institute of New Jersey, and hospital social work, discharge planning, outcomes, pharmacy, and complementary medicine teams. Fellows provide geriatric consultative care for hospitalized aging individuals and gain hands-on experience in delirium assessments, palliative care consultation and management, decision-making capacity evaluations, and level-of-care determinations.

Fellows participate in weekly didactics sessions with learners from Rutgers-New Jersey Medical School in Newark, and CentraState in Freehold, as well as medical students, residents, and pharmacy students from Rutgers New Brunswick. Typically, these sessions include a varied combination of expert speakers, case presentations, journal club, M&M, grand rounds, and formal board review.  Additionally, fellows participate in eight half-day didactics sessions through a collaborative with all the Geriatrics Fellowship programs in New Jersey, offering an excellent networking opportunity to fosters collegiality. Fellows are also encouraged to participate in the rich educational offerings available to them as members of the greater Rutgers community.

The fellowship curriculum includes a dedicated time for “selective” and “elective” experiences to select areas of clinical interest, explore the state of the art, and develop clinically derived research questions. Time for scholarly activity is woven into fellows’ schedules, allowing them protected time to generate a required scholarly product such as a literature review, abstract, poster, paper or formal presentation. The Research Division of the Department of Family Medicine supports fellows in these activities. In past years fellows have presented posters at national meetings of the American Medical Directors Association and the American Geriatrics Society. Others have co-authored a book chapter or journal article. At the culmination of the fellowship, fellows share their scholarship in a presentation to colleagues and the Parker Health Group community.

Fellows are evaluated by fellowship faculty, non-physician staff, and professionals from other disciplines outside of medicine (360 degree evaluations). In turn, fellows provide direct feedback to faculty to improve their learning experiences. We perform milestones evaluations in the middle and at the end of fellowships in accordance with ACGME guidelines. Fellows document their learning with a portfolio of clinical experiences, quality improvement activities, and scholarly products to aid in their future careers.