Geriatric Medicine Los Angeles Medical Center - Curriculum
Goals and Objectives
Our one-year educational program provides a superior geriatric medicine experience within Kaiser Permanente’s unique not-for-profit, vertically aligned, managed care setting. As a fellow, you will gain the competencies to manage the entire range of geriatric conditions and serve as a consultant to other medical physicians. Our program’s specific areas of focus include:
- Training fellows who are well-prepared for all care-settings: clinic, custodial and skilled nursing facilities, subacute facilities (ventilator management), home-based care, hospital)
- Training fellows in the care of palliative and hospice patients: symptom management, pain-management expertise, goals of care discussions, shared-decision making
- Training fellows in the habits of self-care, resiliency, introspection, and empathy
- Training fellows to engage in scholarly inquiry as front-line clinicians: quality / process improvement
Our fellows are well-trained and highly desired by prospective employers. Our graduates provide consistent feedback about being well-prepared for their future careers. All our previous geriatric medicine fellows have passed their board examinations on their first attempt.
The Kaiser Permanente Los Angeles curriculum is designed to help learners acquire and master medical knowledge through a variety of methods including group didactic sessions, critical thinking and appraisal of literature, focused discussion rounds with the program director, and fellow-led lectures to other learners such as medical students and residents. In addition, there is a strong focus on scholarly inquiry through protected academic time, quality improvement workshops, and collaborating with faculty on department studies. Learning is further supplemented by the program’s support of fellows attending regional and national conferences.
Because Kaiser Permanente LAMC is home to numerous residency and fellowship programs, it has a long history of academic excellence. We leverage our robust didactics and research foundation to enhance our patient-centered care with cutting-edge evidence-driven medicine. Fellows will also learn to care for patients with different socioeconomical and cultural backgrounds through their rotation at the Kaiser Permanente West Los Angeles (WLA) campus, our sister medical center.
Our fellowship program boasts a high faculty to fellow ratio. With more than 20 board-certified faculty across both the LAMC and WLA campuses, there is a deep well of diverse strengths from which fellows can draw. We value individualized attention, and our entire department is devoted to the successful maturation of our fellows into well-rounded and skillful geriatricians. Technology is an integral part of our learning. The majority of our curriculum is available remotely so that access to lectures, videos, and current journal articles is only a few clicks away from your desktops, laptops, tablets, and smartphones. Lastly, we embed teaching into Health Connect, Kaiser Permanente LAMC’s EPIC-based electronic medical system.
|Core Geriatric Lecture Series / Journal Club||Weekly|
|Geri-Pal Noon Lectures with FM/IM Residencies||Monthly|
|SNF Grand Rounds||Quarterly|
|West Coast Geriatrics Fellows’ Most Difficult Case Conference (MDCC)||Monthly|
|Program Director Rounds||Weekly|
|Quality Improvement Rounds||Monthly|
|Simulation/Standardized Patient Curriculum||Quarterly|
|CV/Interview Skills Workshop||Annually|
|Quality Improvement Workshop||Annually|
|EMR,Coding, and Practice Management Workshop||Semi-Annually|
|Fellows as Teachers Workshop||Annually|
|iRISE(Introspection, Resiliency, Self-Care, and Empathy)|
Initiative (Psychospiritual Skills Training and Balint Group)
|Kaiser Permanente Hospice & Palliative Medicine Symposium||Biannually|
Rotation Schedule and Call
Our geriatric medicine fellowship program spans both the LA and WLA medical centers, providing fellows with a patient population that is diverse in its racial, ethnic, health-literacy, and socioeconomic backgrounds. The clinical rotation schedule in our program is a blend of longitudinal care experiences with key block rotations. We feel this is the best way to prepare fellows for any possible setting or combination of settings in their careers as Geriatricians. The block rotations allow for intensive training in topic-specific fields while the longitudinal approach provides a year-long foundation in the “bread and butter” of geriatrics. This reduces the attrition of skills over the fellowship year that may occur within block systems. We are always trying to enrich our program. To that end, we have added a community-based rotation with the Los Angeles LGBT Center, partnered with the LA County / USC Elder Abuse Forensic Center, created a Simulation program, and expanded our wellness curriculum. The call schedule for the fellowship involves taking home-call 2 weeknights a month from 5pm-11pm. Additionally, fellows take 4-5 weekend home-calls a year, from Friday 5pm-11pm through Saturday 8am-11pm. Sunday is call-free.
|Skilled Nursing Home (includes Subacute SNFs)||Blocks (5 months)|
|Custodial Nursing Home||Longitudinal (12 months)|
|Memory Assessment Clinic||Longitudinal (12 months), one half-day/week|
|Primary Care/Geriatric Consult Clinic||Longitudinal (12 months), two half-days/month|
|Outpatient Geriatrics Assessment Clinic||Block (4-6 weeks)|
|Outpatient Geriatric Psychiatric Clinic||Block (4 weeks)|
|Inpatient Geriatric Consultations||Longitudinal (12 months)|
|Hospice & Palliative Medicine (Home-Care)||Longitudinal (12 months)|
|Home-based Geriatric Care||Longitudinal (12 months)|
|Academic Time||Longitudinal (one half-day/week)|
Physical Medicine and Rehabilitation
Inpatient Palliative Care
|Block (4 weeks)|
|Transitional Care Center||Block (4-6 weeks)|
|Pain Management||Longitudinal (12 months)|
|Elective Time||Block (8 weeks)|
|Equity, Inclusion, Diversity Curriculum: LGBT Center||Block (1 week)|
|USC Center on Elder Mistreatment||Quarterly|
Scholarly Activity and Research
We require our fellows to complete an academic project for the year. In the past, fellows have written review articles and case-studies, or implemented quality improvement processes within the department and even the medical center at large. The Graduate Medical Center has full-time research staff to assist fellows in academic projects. Additionally, faculty mentors collaborate with the fellows to guide the research process.