Goals and Objectives

The one-year geriatric residency educational program is organized to provide a superior educational experience in geriatric care in a managed care setting. As a fellow, you will gain the competencies to manage the entire gamut of geriatric care and serve as a consultant to other medical providers. Fellows are provided with the knowledge and skills necessary to sit for the CAQ in Geriatrics. All of our previous geriatric fellows have passed the CAQ on the first attempt.

The training program also assists fellows with acquiring the communicative skills needed to discuss and educate their patients and families on issues such as quality of life, chronic disease progression, and palliative care.

Teaching Program

The Kaiser Permanente Los Angeles curriculum is designed to help learners acquire and master clinical information through a variety of methods including: group didactic sessions, critical thinking and appraisal of literature, focused discussion rounds with the program director, leadership development with the chief of service, and scheduled lectures and presentations given by fellows to other learners (residents, medical students).  In addition, there is also a strong focus on process / quality improvement through activities such as Quality Improvement rounds and QI projects.  Learning is further supplemented by the programs support of fellows attending regional and national conferences.

Los Angeles Medical Center is a unique place to learn within Kaiser Permanente because it is home to over 20 residency and fellowship programs.  This synergism combines the patient-oriented clinical care of a community hospital with the robust didactic and research foundation of a major academic center. Fellows will also rotate through the West Los Angeles (WLA) campus of our fellowship program.  There, fellows have an opportunity to care for patients with socioeconomically and culturally unique backgrounds.  Additionally, some core rotations are specific to the WLA campus, including a Geriatrics Clinic and a Geriatric Psychiatry experience.

Our fellowship program also boasts a very high faculty to fellow ratio.  With more than 15 board-certified geriatricians (across both the LAMC and WLA campuses, from both Family Medicine and Internal Medicine), there is a deep well of diverse strengths from which fellows can draw.  We value individualized attention and the entire department is devoted to the successful maturation of our fellows into well-rounded and competent geriatricians.  Technology is an integral part of our learning.  The majority of our curriculum is available remotely so that access to didactic lectures, videos, current articles, etc is only a few clicks away from your desktops, laptops, tablets, and smartphones.  Lastly, we leverage the versatility of Epic to embed teaching into the Kaiser Permanente Los Angeles Medical Center’s EMR.
ConferenceFrequency
Geriatric Lecture SeriesWeekly
Custodial Nursing Home Lecture SeriesEvery 4 weeks
Family Medicine Geriatric Case ConferenceEvery 4 weeks
Program Director RoundsWeekly
Quality Improvement RoundsMonthly
Chief RoundsBimonthly
Geriatric Journal Club/Article ReviewMonthly
UCLA Multi-Campus Family Medicine Research SymposiumAnnually
Kaiser Permanente Hospice/Palliative Care SymposiumBiannually

Rotation Schedule and Call

Our geriatrics department serves both the Los Angeles and West Los Angeles medical centers, providing fellows with a patient population that is diverse in its racial, ethnic, and socioeconomic backgrounds.  The clinical rotation schedule at Kaiser Permanente Los Angeles is a blend of longitudinal care experiences with key block rotations.  We feel this is the best way to prepare fellows for easily engaging the “real world” once they are done with their fellowship.  The block rotations allow for intensive training in topic-specific fields while the longitudinal approach allows for year-long improvement in the “bread and butter” work of geriatrics. This reduces the attrition of skills over the year-long fellowship that may occur if an area of learning is only covered early in the year. The Home Primary Care and Community Medicine rotation is a wonderful block for fellows to focus on healthy aging and community-dwelling elder patients.  It is a fun time to be creative and innovative in building relationships with community partners to meet community needs as well as provide extra-services to our patients.  The call schedule for the fellowship has been revamped and involves taking home-call 24 weeknights a year, from 5pm-11pm.  Additionally, fellows take 4-5 weekend home-calls a year, from Friday 5pm-11pm through Saturday 8am-11pm.

RotationLength
Skilled Nursing Home (includes SNF’s with Subacute Beds)Longitudinally (6-8 months)
Custodial Nursing HomeLongitudinally (12 months)
Neurology/Physical Medicine/Pain Management4 weeks
Geriatric Psychiatry4 weeks
Memory Assessment ClinicOne half-day/week, Longitudinally (12 months)
Primary Care ClinicOne half-day/week, Longitudinally (12 months)
Home Primary Care & Community Medicine(Outpatient Healthy Aging Curriculum)4 weeks
Inpatient Geriatric ConsultationsLongitudinally (12 months)
Hospice & Palliative Medicine (Home-Care)Longitudinally (12 months)
Academic TimeOne 1/2 day/week
Elective Time4 weeks
Outpatient Geriatrics Clinic4 weeks
Vacation4 weeks

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.