Geriatric Medical School Teaching at the University of Michigan
Several educational experiences in Geriatric Physiology and Clinical Medicine are standard components of the medical school curriculum at the University of Michigan. Geriatric content is taught across the four years of medical school to allow students to have a comprehensive experience rather than isolated, infrequent blocks of teaching. Content and skills taught in the pre-clinical years are used as a foundation to build on and reinforce clinical activities in the M3 and M4 year that focus on assessment of function in the inpatient and outpatient setting.
Students are introduced to communication and assessment of older adults in their first week of medical school, in a teaching block (“Talking to Patients in a Diverse Society: Introduction to the Older Patient”) that highlights communication in conventional and alternative medical settings. Students visit clinics to observe clinical interactions between patients and caregivers, and meet in focus groups to analyze the interactions. Later in the M1 year, students participate in small group sessions that introduce physical examination skills required to perform a Geriatric Functional Assessment.
In the M2 year, students practice clinical examination of the older patient using a Geriatric Functional Assessment Standardized Patient Instructor (GFA SPI) for formative feedback, or role-playing sessions in small groups. The skills taught in this session are re-enforced in the M3 year in the outpatient Geriatrics Center Clinics and inpatient rotations on Internal Medicine at the Ann Arbor VA and the University Hospital. A required write-up of a geriatric patient allows students to practice documentation skills, and get feedback from faculty. A comprehensive review of the unique aspects of geriatric assessment and management of complex patients is given in an M3 lecture.
During the M4 year, three month-long electives in geriatrics allow some students to have a more intensive experience in Geriatric Medicine or Geriatric Education in a variety of venues. Students can participate in interdisciplinary care of geriatric patients as part of the Geriatric Inpatient Consult Team (GICT) at the University of Michigan Health System, or can obtain experience in caring for patients in sub-acute care in the Ann Arbor VA as part of a sub-internship in Geriatric Medicine. Students in the VA elective also have the opportunity to round with the Geriatric Consult Team and the Palliative Care Team, and care for a variety of patients with chronic disease, rehabilitation needs, and some admitted to inpatient hospice. An elective in Geriatric Medicine education research offers an opportunity to develop curriculum modules that highlight geriatric issues. Two new M4 electives in Long Term Care and geriatric anatomic pathology are under development.
Students that graduate from the University of Michigan have a comprehensive grounding in the skills required to care for older patients, and are able to interact directly with the majority of the clinical faculty in the Division of Geriatric Medicine in both the inpatient and outpatient settings.
The wide variety of research interests of the Geriatric Medicine faculty have allowed some students to perform advanced research during their medical training, as part of the MSTAR program. The American Geriatrics Society (AGS) Student Chapter is one of the oldest geriatric medical interest groups, having been in continuous existence since 1993. Students in the M1 and M2 years organize a variety of clinical experiences and volunteer activities that enhance their understanding of the challenges faced by older adults in today’s society, and allow students to make a difference in the life of an older adult.