Internal Medicine Division of Geriatrics

Geriatric Medicine Fellowship

Hennepin County Medical Center offers one-year fellowship positions in Geriatric Medicine for both internists and family physicians. At our most recent ACGME-RRC review we received accreditation “with commendation”!

The Geriatric Medicine Fellowship year is structured around a carefully designed clinical and didactic schedule providing broad experiences in the care of elderly patients in a variety of settings. Fellows learn about the theoretical and practical aspects of caring for healthy elderly, those who are frail or functionally impaired, those with cognitive impairment and those at the end of life. Clinical sites for care include comprehensive geriatric primary care and consultative clinics, nursing facilities incorporating long term care, sub-acute and rehabilitation care, specialty clinics including dementia, stroke, Parkinson’ s disease, and bone and mineral metabolism, acute inpatient rehabi-litation, geriatric psychiatry and acute general hospital inpatient consultation services. Trainees can elect additional experience in a broad range of clinical services.

Fellows follow an assigned panel of patients longitudinally throughout the year in ambulatory geriatric clinics, home care and nursing home settings. Trainees provide consultation advice to in-patient physicians when their primary care patients are hospitalized and advance their learning in specialty areas by seeing patients in consultation and specialty clinics. All patients seen by trainees are seen or discussed with faculty. While fellows have no specific supervisory responsibility for other resident trainees, they participate with faculty in resident and medical student teaching. Fellows participate in multidisciplinary team discussions in hospice and palliative care, home care service agency, vulnerable adult protective service, nursing home quality improvement programs, and other clinical settings. They serve as members of HCMC’s Biomedical Ethics Committee.

Fellows attend weekly Geriatric Grand Rounds / Journal Club discussions and present at least four of these conferences. They participate in additional “core curriculum” conferences and weekly multi-disciplinary clinical case presentation conferences. They attend Department of Medicine Grand Rounds, CPC/Mortality conferences and participate in monthly meetings of the HCMC Biomedical Ethics Committee for case and didactic discussion. Fellows participate in weekly conferences in Geriatric Psychiatry, have additional didactic sessions in research study design, statistical analysis and critical review of medical literature. They participate in ongoing Quality Improvement initiatives in the Geriatric Medicine Division.

Fellows are expected to participate in scholarly activities and are strongly encouraged to develop a project for presentation at a national or regional scientific meeting or for publication. To date each fellow completing the program has met this requirement. There are many broad areas for fellow participation in research including epidemiology of dementia and delirium, educational and clinical outcomes of consultative initiatives in adult protective services for vulnerable adults (elder abuse and neglect), palliative care clinical outcomes, and diabetic management in long term care settings, among others.

Major Teaching Staff:

• Lawrence J. Kerzner, MD FACP, AGSF, Assistant Professor, Program Director and preceptor for ambulatory clinic, inpatient geriatric consultation, home care and vulnerable adult/protective services, biomedical ethics.
• Anne Murray, MD, MSc, Assistant Professor, Associate Program Director for Research. Preceptor for ambulatory clinic.
• Martha McCusker, MD FACP Assistant Professor, Preceptor for long term care and hospice/palliative care, biomedical ethics.
• Roberta Meyers, MD, MPH, CMD Assistant Professor, Preceptor for ambulatory clinic care, long- term care and sub-acute rehabilitation
• Riley McCarten, MD Assistant Professor, Preceptor for Dementia Clinic
• Susan Czapiewski, MD Assistant Professor, Preceptor for Geriatric Psychiatry
• Charles Smith, MD. Associate Professor, Preceptor for Bone and Mineral Metabolism
• Martha Nance, MD Assistant Professor, Preceptor in Parkinson’s Disease and Movement Disorders
• Scott Bundlie, MD Assistant Professor, Preceptor in Stroke Clinic
• John, Bowar, MD Assistant Professor, Preceptor in Rehabilitation Medicine
• Steven Hillson, MD, MS Associate Professor, Preceptor in statistical analysis, research study design, and critical review of medical literature.

Faculty evaluate trainees’ competency in specific goals and objectives developed for each major component of the program. Trainee performance is evaluated in the six ACGME core competency areas of patient care, medical knowledge, practice based learning and improvement, professionalism, interpersonal and communication skills, and systems based practice. Patient interactions directly observed by faculty, 360 degree evaluations by nurses and social workers, peer and self assessments, portfolios of teaching and practice based learning and quality management, and performance on specifically developed multiple choice examinations are included in the assessment of educational performance. Quantitative and qualitative data from these evaluation tools is shared with the fellow in formative and summative formats.