Clinical Fellowship

• Outpatient geriatric assessment center focuses on cognition, mood, mobility, and maintaining independence in the community
• Interdisciplinary, case-management model integrating physicians, case managers, and family members in care planning
• Fellows participate in comprehensive assessments and individualized care plans with direct attending supervision

• Inpatient general medicine unit for hospitalized patients 65 years and older, emphasizing restoration of function and cognition during acute illness
• Team-based care grounded in Age-Friendly Health System principles (4Ms of Age-Friendly Care: What Matters, Mentation, Mobility, Medications)
• Fellows function as junior attendings and leaders within a multidisciplinary care team

• 4M-based inpatient comprehensive geriatric assessments
• Consultations addressing geriatric syndromes (e.g., cognitive disorders, behavioral disturbances, delirium, falls, polypharmacy), home safety, goals of care, complex decision-making, and perioperative care
• Fellows develop skills in triage, interdisciplinary collaboration, and participation in family and team meetings

• Immersive experience in sub-acute and long-term care, including clinical and administrative aspects
• Exposure to rehabilitation services, quality assurance, utilization review, and systems-based care in the post-acute care setting
• Close supervision by the Medical Director

• Interprofessional care in a skilled nursing and post-acute care-environment for veterans
• Broad clinical exposure including rehabilitation, hospice, and complex medical care
• Strong emphasis on team-based care and patient-centered decision-making

• 4M-based inpatient and outpatient comprehensive geriatric assessments
• Consultations addressing geriatric syndromes (e.g., cognitive disorders, behavioral disturbances, delirium, falls, polypharmacy), home safety, goals of care, complex decision-making, and perioperative care
• Fellows develop skills in triage, interdisciplinary teaching and collaboration, and participation in family and team meetings

• Geriatric primary care delivered by a multi-disciplinary patient-centered home visit team, including nursing, social work, nutrition, rehabilitation, mental health, and pharmacy clinicians
• Fellows develop an appreciation for the unique field of home care medicine, characteristics of the homebound patient population, impact of social determinants of health, and the available community resources to support patients to age in place
• Fellows experience home visits with each HBPC discipline, participate in interdisciplinary team meetings, and perform medical home visits for new patients, routine follow-ups, urgent visits, and post-hospital discharge visits

• Consultative palliative care across inpatient units and outpatient specialty clinics
• Focus on symptom management, goals of care, and serious illness communication
• Fellows manage consult panels with close interdisciplinary supervision

• Outpatient geriatric psychiatry clinic with exposure to mood, cognitive, and behavioral disorders
• Supervised evaluation and management of new and follow-up patients
• Opportunities to observe electroconvulsive therapy, neuropsychological assessments, and groups

• Year-long responsibility for a panel of nursing home residents
• Focus on chronic disease management, acute changes in condition, and end-of-life care
• Fellows serve as primary providers with attending support

• Continuity primary care or consultative care experience managing a panel of older adults over the full year
• Emphasis on priority-aligned care, cognitive disorders, mobility assessment, deprescribing, chronic disease management, and patient/family counseling
• Supervised outpatient care across VA and Yale-affiliated clinical settings

• Year-long experience as primary care physician for a panel of homebound, medically complex older adults in their home environment
• Patients are introduced to the fellow with preceptor during the HBPC block, then followed for routine and urgent care needs during longitudinal time
• Primary learning objectives are to appreciate the changes in cognition and function over time, revisit goals of care as clinical condition changes, and augment support in the home to age in place

• Flexible elective time
• Broad range of options; see Customizing Education
• Off-site rotations as approved by Program Leadership

Scheduled weekend call involves close collaboration with teaching attendings to provide care across affiliated skilled nursing facilities and outpatient primary care settings. Includes weeknight telephone call coverage for the VA Community Living Center.

Evaluation Process

Clinical Fellows are evaluated by the supervising attending employing the ACGME Geriatric Medicine Milestones. Fellows receive both verbal and written feedback throughout the rotation, and attendings complete an evaluation through MedHub at the end of each rotation.

Fellows will meet with the program director and associate program director at the sixth and twelfth month of training to provide a comprehensive assessment of performance based on ACGME Geriatric Medicine Milestones.

Twice a year, the geriatric medicine faculty will conduct a Clinical Competency Meeting to review the fellow’s MedHub evaluations and assess the following:

• Clinical knowledge
• Knowledge of Geriatric Medicine
• Clinical management and consultation skills
• Teaching skills
• Commitment to Geriatric Medicine

Application Requirements

Applications should include: Three (3) letters of recommendation (Program Director, Clinical Mentor, and a Geriatrician), complete CV, one-page personal statement, and USMLE or COMPLEX Test Results (1-3).

How do I apply?

Applications are accepted through eRAS when it opens for subspecialties in July. We participate 100% in the National Residency Match Program (NRMP).