Indiana University School of Medicine (IUSM) is the largest medical school in the country and we are nationally recognized for our undergraduate medical education program. IUSM has recently undergone an extensive curriculum reform process which places an emphasis on early clinical exposure and uniformity of the curriculum across all nine of our campuses. The training at IUSM is unparalleled and allows students to rotate through a variety of hospital systems including Eskenazi Health System (EH), IU Health System (IU), the Roudebush Veterans Affairs Medical Center (VA) and others. Thus, our graduates have the tools to succeed beyond IUSM in graduate medical education as well as in their long term careers.
Geriatric Education is taken seriously at IUSM. Why? IUSM recognizes the importance of educating our learners on how to care for older adults both now and in the future. Statistics and projections show the U.S. population is aging as indicated both in graphic and textual formats below.
- Between 2010 and 2050, the U.S. population is projected to grow from 310 million to 439 million, an increase of 42 percent
- The older population (65+) is projected to nearly double, growing from 43 million in 2012 to 84 million in 2050.
- By 2030, one in five Americans will be 65 years or older.
- From 2010 to 2050 the population 85+ will increase from 14% to more than 21%
Geriatrics education begins in year one at IUSM and by the end of their undergraduate medical education experience, medical students are prepared to care for older adults regardless of selected specialty or subspecialty. The required and elective courses where geriatrics is offered are listed below.
- Foundations of Clinical Practice I (Required)
- Foundations of Clinical Practice II (Required)
- MS3 Geriatrics Workshop (Selective)
- MS3 Clinical Sessions (Selective)
- Begun as part of the “Indiana University Geriatrics Workforce Enhancement Program (GWEP)” an initiative funded by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services
- Sessions focus on key geriatrics issues: dementia, depression, falls, and medication management
- Sessions occur in primary care geriatrics outpatient settings with interprofessional teams
- Fourth Year Electives where students rotate across the continuum of care with geriatricians to provide care to frail older adults at the Indianapolis Campus
- Acute Care for Elders inpatient consultative service (EH, IU-Methodist, and VA)
- Outpatient consultative settings (IU-Methodist)
- Outpatient primary care settings (EH and VA)
- Indianapolis extended care facilities with both subacute rehabilitation and long term care options
- House calls for Seniors (EH)
IU Geriatrics has a Geriatrics Student Interest Group (GSIG). GSIG is designed to provide medical students from all levels of undergraduate medical education opportunities to learn about the care of older adults regardless of career path or specialty or subspecialty interests. For students who are interested in pursuing a career in geriatric medicine, involvement in GSIG provides early experience to the field and health care providers. GSIG is supported in part by the American Geriatrics Society.
The Indiana University Department of Medicine (DOM) has a 20-year history of recognizing the importance of educating residents on how to provide care to older adults. In 1997 the DOM began a mandatory one month geriatrics rotation. This rotation, which we call the “Core Geriatrics Rotation,” has undergone continuous quality improvement throughout its existence. Feedback from geriatricians, interdisciplinary team members and residents have resulted in the Rotation being ranked as the sixth most enjoyed by the residents out of more than 100 rotations! Most residents take the rotation during their intern year and, upon completion, can successfully perform the following:
- Recognize aging-related physiological changes and clinical syndromes in older adults and account for these syndromes in treatment plans
- Identify patients at risk for functional decline and/or reduced quality of life
- Utilize treatment options that will help patient avoid functional decline and/or reduced quality of life
- Identify complex patients who have multiple medical and psychosocial comorbidities and refer them to geriatricians
- Review patient’s medications, simplifying medication regimens and discontinuing potentially harmful ones
- Collaborate with patient’s families and caregivers and acknowledge patient wishes in goals of care
- Confidently interact with other disciplines (social workers, advanced practice nurses, registered nurses, pharmacists, rehabilitation therapists) to formulate best plans of care for their older patients.
- As part of our GWEP, residents have begun attending a Geriatrics Resources for Assessment and Care of Elders (GRACE) Team Meeting
- The GRACE Meeting they attend introduces them to this unique model of care for frail older adults as well as provides them with another opportunity to interact with an interprofessional team
- Know and be able to communicate about the continuum of care where older adults receive care (home, hospital, clinic, nursing home)
In addition to the required Core Geriatrics Rotation, a resident may elect an additional month of geriatrics, the “Advanced Geriatrics Rotation”. Each Advanced Geriatrics Rotation is customized to the individual goals of the resident electing the month. A resident may choose to spend additional time in one of the clinical venues or may choose to focus on a particular geriatric condition. A resident might also spend the elective month doing research mentored by one of the internationally and nationally renowned researchers in the IU Center for Aging Research. We have hosted residents on the Advanced Geriatrics Elective who have come from the IU Department of Medicine, IU Department of Family Medicine, as well as other local, regional, and even national postgraduate education programs. For more information on available opportunities please see the contact information below.
Glenda R. Westmoreland, MD, MPH
Director, IU Geriatrics Education
Residency Coordinator for IU Geriatrics Education