Medical Residents

PGY 2 Rotation

The four-week geriatrics rotation is required for all second-year internal medicine residents. The inpatient component is based at Greenberg 11SB, the Acute Care of Elders Unit at New York-Presbyterian Hospital. The outpatient week takes place at different venues across the city. 

Each PGY-2 resident is assigned a 4-week geriatric block consisting of:

• 2 weeks managing a panel of patients on the geriatrics inpatient service
• 1 week covering nights on the geriatrics inpatient service
• 1 week in an outpatient module that introduces the resident to the systems of care that help meet the medical and psychosocial needs of community-dwelling older adults.

During the systems-based practice (outpatient) module, residents:

• Visit an inpatient hospice site
• Make geriatric house calls
• Accompany geriatric care managers on client visits
• Tour a nursing home, independent living, and other levels of senior housing
• Visit an elder abuse shelter
• Visit a community-based organization
• Assist with Wright Center walk-ins.

Residents also have opportunities for self-directed learning through readings and online modules and are encouraged to engage with patients/clients, families, and staff across these care settings. The SBP module is not about the physiology or pathophysiology of individuals but of the health care system – how and where health care is currently delivered to older adults. Residents also present one of their own WCIMA patients in the weekly geriatrics team meeting for discussion and advice. An oral exam and debriefing at the end of the week enable the resident to integrate the experiences and put them in context of their inpatient and outpatient responsibilities.

Goals of the geriatrics rotation include:

1. Evaluate and manage falls.
2. Recognize and avoid polypharmacy.
3. Demonstrate appropriate dosing of medications based on geriatric pharmacokinetics.
4. Perform an effective functional assessment.
5. Communicate effectively with patients with cognitive and sensory impairment.
6. Effectively manage pain in elderly patients.
7. Assess, manage, and reduce risk of delirium.
8. Take patient/health care agent wishes into account when developing plans of care. 

Electives

A two-week elective in geriatrics is available for interested medical residents.