Educating the Next Generation: Equipping Students in Geriatric Health Care

Jon Parham

ecognizing the complexity often encountered in treating older patients, UAMS students are equipped with a more in-depth and increasingly interprofessional exposure to geriatric health care than many of their peers elsewhere.

Students draw on the nationally known resources of the UAMS Donald W. Reynolds Institute on Aging and the Donald W. Reynolds Department of Geriatrics in the UAMS College of Medicine. It’s the kind of expertise that ranks the educational program regularly among the best in the country in U.S. News & World Report. 

Fourth-year medical students serve a required month-long clerkship in geriatrics where they see patients in outpatient clinics, inpatient settings and long-term care facilities. In addition to honing their clinical skills, students learn the roles of pharmacists, nurses, social workers, physical therapists and other members of the health care team in caring for elderly patients. 

The month-long student rotation in geriatrics and the fact it is required for all 165 UAMS senior medical students is uncommon nationally. Credit the presence of the Institute on Aging, alongside the state’s aging population, said Paula Podrazik, M.D., an associate professor who works with the medical students and resident physicians and is the geriatrics fellowship program director.

“We can offer our students more depth and breadth of focus around the skills for taking care of older, more medically complex patients,” Podrazik said. “Older adults may be dealing with lots of chronic problems, whether it’s diabetes or high blood pressure, at the same time they are becoming frail and have declining systems.”

The four-week rotation allows students to see patients with different conditions and in different settings. Faculty members are able to spend more time with the students, including one-on-one, bedside teaching moments.

But it’s not just about medical students. Internal medicine and family medicine interns and some internal medicine residents rotate in geriatrics for two weeks to a month. In addition, a geriatric pharmacy rotation is available for upper-level College of Pharmacy students. 

“We can offer our students more depth and breadth of focus for taking care of older, more medically complex patients.”
“Almost anywhere a pharmacist practices, the majority of patients they will see will be elderly,” said Lisa Hutchison, Pharm.D., M.P.H., a  professor in the Colleges of Pharmacy and Medicine who works with students in clinical rotations.

Nursing students and those in other programs also have opportunities to work with older patients. The first students in the physician assistant program of the College of Health Professions just began required clinical rotations in geriatrics. 

The Department of Geriatrics also offers an accredited 12-month Geriatrics Fellowship Program that allows practicing physicians to return for more specialization and increased skills in geriatrics. Upon completion, the physician may take the exam to become board certified in geriatrics.

“This program focuses on growing our specialty and keeping these fellowship-trained physicians in our state,” Podrazik said. 

The medical, nursing, and pharmacy students along with the interns, residents and fellows, have many opportunities to work and learn together and to discuss cases in weekly clinical case conferences, the monthly neuropsychological case conferences, and weekly geriatrics grand rounds.

“Interprofessional education is an increasing focus in academic health care. It’s hard to provide the best care if you don’t know how to function as part of a health care team,” Hutchison said. “Interprofessional experiences let students learn what the other professions do and understand the expertise each brings to delivering patient- and family-centered care.”