Our Geriatric Medicine Fellowship is a 12-month program designed to provide comprehensive training -- preparing participants to become leaders in gerontology academic settings, nursing homes, outpatient centers and hospitals.
Fellows will benefit from the experience of the Geriatric Medicine's interdisciplinary team of physician-educators and other healthcare professionals dedicated to maintaining patients' quality of life as they deal with the chronic – and often interacting – medical conditions, cognitive issues and frailty that can accompany aging.
The Center for Geriatric Medicine has been recognized and ranked among the very best in the United States by such prestigious publications as U.S. News & World Report.
The Center for Geriatric Medicine's programs and services include:
- Geriatric Evaluation and Management (GEM) assessments
- Inpatient Geriatric Consults
- Center for Brain Health
- Falls Clinic
- Geriatrics Dementia Shared Medical Appointments (SMA)
Two, 12-month geriatric fellowship positions are available each year. The Geriatric Medicine Program participates in the Electronic Residency Application Service (ERAS) developed by the Association of Medical Colleges (AAMC). Therefore, we only accept applications submitted electronically through ERAS:
The 12-month fellowship in Geriatric Medicine is offered by Cleveland Clinic Health System. At the completion of the fellowship, the fellow is eligible to sit for the Certificate of Added Qualification exam.
Throughout the fellowship, participants spend two half-days per week in a longitudinal geriatric clinic, where they follow a panel of patients under staff supervision and one-half day per week in the nursing home Fairfax Place.
The Fellowship Program:
- Focuses on core competency in patient care, medical knowledge (including geropharmacology), practice-based learning and improvement, interpersonal and communication skills, systems-based practice, and professionalism.
- Enables fellows to achieve expertise in the physiology of aging, the pathophysiology of common diseases, geriatric neurology and geriatric psychiatry. Fellows learn to evaluate and treat patients with geriatric syndromes and psychosocial needs in hospital, community and institutional settings. Interdisciplinary assessment and management are emphasized.
- Prepares fellows for positions of clinical and educational leadership in the field of Geriatric Medicine, including medical directorships of long-term care facilities, acute care for elders (ACE) units, and outpatient assessment programs.
Fellows participate in 12 one-month rotations, based at either Cleveland Clinic (Cleveland) or in the following areas:
Outpatient Geriatric Evaluation and Management (GEM)
To prepare physicians for leadership in the interdisciplinary assessment and ongoing management of frail elderly patients with common geriatric syndromes and medical problems.
Inpatient Consult Service
- To enable Geriatric Medicine fellows to achieve expertise in hospital-based consultations on medical and surgical patients.
- To provide opportunities for fellows to develop skills as educators of medical residents and students and other medical personnel in the assessment, management, evaluation and treatment of elderly patients in the acute care setting.
Long-term Care/Nursing Home (Fairfax Nursing Home)
- To prepare Geriatric Medicine fellows to assume leadership in the care of patients in long-term care institutional settings.
- To prepare physicians to meet the physical, medical and preventive care needs of elderly patients in long-term care settings.
- To achieve expertise in the management of patients in long-term care settings, including knowledge of the administration of long-term institutions and the continuum from short-term to long-term care.
Geropsychiatry (Lutheran Hospital)
To prepare Geriatric Medicine fellows to gain expertise in the diagnosis, evaluation and management of common affective disorders and behavioral disturbances occurring in elderly patients.
- To prepare Geriatric Medicine fellows to gain expertise in the evaluation, diagnosis and treatment of elderly patients with common neurologic problems, including cognitive dysfunction, post-stroke disorders, seizure disorders, movement disorders and neuropathies.
- To gain expertise in the evaluation of dementia, treatments for dementia, and the interpretation of neuro-imaging studies.
Acute Care for Elderly (ACE) Unit (Summa Hospital)
- To enable Geriatric Medicine fellows to become experts in the administrative, clinical and consultative roles of a medical director for an Acute Care for Elders (ACE) Unit for hospitalized older adults, as well as leaders of the inpatient interdisciplinary team of health professionals.
- To gain expertise as geriatricians in methods to improve the hospital care of older adults.
Geriatric Rehabilitation (MacGregor Nursing Home)
- To enable Geriatric Medicine fellows to achieve expertise in the principles of geriatric rehabilitation.
- To prepare Geriatric Medicine fellows to assume leadership of a team of health professionals in the management of common medical diagnoses in the older adult, with an emphasis on chronic care issues and practices.
- To prepare Geriatric Medicine fellows to assess and manage chronically ill, elderly patients who suffer from progressive and incurable diseases and who are approaching the end of life.
- To provide fellows with the knowledge, skills and expertise in terminal illness, pain management and end-of-life issues needed to evaluate and treat patients with terminal illnesses.
In-Patient GEM Rotation (VA Medical Center)
To gain expertise in the evaluation and management of frail veterans who require multidimensional assessment and restorative interventions in a hospital setting.
Additional Clinical Experiences
Outpatient Assessment and Management
(Euclid Hospital Geriatric Assessment Program) and Lakewood Hospital Geriatric Assessment Program.
- To enable Geriatric Medicine fellows to achieve competence in the outpatient evaluation, diagnosis and management of common geriatric syndromes.
- To enable fellows to achieve expertise as a leader of the interdisciplinary team that provides a consultative service to physicians and assists in the education of families and caregivers.
Longitudinal (Fairfax Place Nursing Home) Experience
- To provide fellows an opportunity to achieve and maintain skills in long-term care practice.
Elective Two- or Four-week Rotations
In addition to the one-month rotations, fellows may select elective rotations in:
To gain expertise in the application of ethical principles germane to the practice of geriatric medicine, including patient autonomy, justice, confidentiality, competence and beneficence.
To prepare Geriatric Medicine fellows to attain expertise in the acute, chronic and rehabilitative needs of patients in the home setting.
To prepare Geriatric Medicine fellows to gain expertise in the diagnostic evaluation, differential diagnosis and therapy of common movement disorders in elderly patients.
To enable Geriatric Medicine fellows to gain expertise needed in the diagnostic evaluation and rehabilitation of elderly patients who suffer major strokes.
To enable Geriatric Medicine fellows to gain the skills necessary to provide diagnostic evaluation of patients with syncope or autonomic dysfunction.
Urinary Incontinence/Voiding Dysfunction
To attain expertise in the clinical presentation, pathophysiology, diagnostic evaluation and therapy of patients with urinary incontinence and/or voiding dysfunction.
- To gain expertise in the diagnosis, evaluation and therapy of patients with peripheral vascular disease and venous disease.
- To gain the skills needed in the non-invasive evaluation of vascular diseases.
Lectures, Journal Clubs, and Conferences
From July to September, fellows are required to attend multicampus tutorial lectures on basic topics in geriatric medicine. In addition, fellows are expected to participate in and present at weekly interdisciplinary team conferences and geriatric fellows' conferences. Geriatric fellows' conferences include an evidence-based monthly journal club, monthly topic reviews conducted by fellows, quarterly geriatric faculty conferences, and citywide journal clubs in conjunction with the other Cleveland programs.
Fellows are encouraged to attend either the American Geriatrics Society (AGS), American Medical Director's Association (AMDA), or Gerontological Society of America (GSA) annual meeting. Opportunities exist to attend other national meetings.
Fellows are required to participate in resident and medical student teaching/training in both outpatient and inpatient settings; and to give lectures at General Internal Medicine Grand Rounds. In addition, fellows are asked to give presentations to community groups (including the lay public).
Fellows are expected to take call from home - weeknight and weekend coverage - 12 weeks during the year at Fairfax Place, a long-term care facility affiliated with Cleveland Clinic's Geriatric Fellowship Program.
Fellows have ample opportunity to purse scholarly activities and to publish manuscripts.
More than 2,400 clinical research trials currently are under way at Cleveland Clinic. Many are focused on diseases associated with aging, including cerebrovascular disease and movement disorders.
Fellows are responsible for completing their master schedule of rotations in consultation with Geriatric Fellowship Program Director Dr. Ronan Factora.
Fellows share responsibility for scheduling teaching conferences and giving presentations at the conferences. (A monthly schedule of teaching conferences is posted on the program bulletin board and distributed by e-mail.)
Fellows share office space on A-91 and have access to a computer that allows them to access the Cleveland Clinic network and necessary software applications.
- Continuity clinics in X-10, two half-days per week
- Longitudinal nursing home practice at Fairfax Place, including weekly rounds on patients and examination of re-admitted patients
- Selection of cases and guest "discussants" at Thursday noon interdisciplinary team conferences
- Topic review each month at Monday Research and Lecture Conference
- Presentations at Journal Club each month, at Monday Lecture Conference and/or at citywide Journal Club
- Weeknight and weekend coverage from home of Fairfax Place
- Presentation of one brief lecture each month to medical residents and students during their geriatrics rotation (later in the academic year)
- One-hour Geriatric Review Syllabus presentation monthly (Thursday or Monday), arranged with Dr. Factora
- One General Internal Medicine Grand Rounds presentation per year
- Attendance at Multicampus Geriatric Conferences, July-September (MetroHealth Medical Center)
- Attendance at Topics in Geriatric Medicine (citywide Grand Rounds) each Friday morning September-May
- Attendance at Cleveland Clinic/GME required lectures (e.g., ethics)
- Attendance at either American Geriatrics Society (AGS), American Medical Director's Association (AMDA), or Gerontological Society of America meeting each year
- Presentation at geriatric faculty conferences (M&M) (off campus)
- Presentation at citywide Journal Club (rotating sites)
- Participation on Fairfax Place committee
- Community lectures to non-health professionals
- Completion of scholarly project, including submission of abstract to national meeting, presentation at Monday research conference and preparation of manuscript
- Presentation at CME programs sponsored by the Section of Geriatric Medicine
- Submission of review article or case reports for publication
Fellow applicants must be board-eligible or board-certified in Internal Medicine or Family Medicine and demonstrate enthusiasm for the medical care of older adults. Prior experience in research or clinical practice is desirable.
Cleveland Clinic Faculty
Affiliated Cleveland Clinic Faculty
Applications are accepted starting July 1 of the year preceding the fellowship. Interviews are conducted from July through November, or until all positions have been filled. The Section of Geriatric Medicine does participate in the match process.
If you have questions about the Cleveland Clinic Fellowship in Geriatric Medicine, contact:
Kenyette Smith, Project Coordinator
The Cleveland Clinic Foundation
10685 Carnegie Avenue, X10
Cleveland, OH 44106
Email: [email protected]
Cleveland, an ethnically diverse mid-sized city located on Lake Erie, features a host of cultural and recreational attractions. Cleveland Clinic is located near the University Circle area, which is the major cultural center in Cleveland. This area also features the Cleveland Orchestra, the Cleveland Museum of Art, several other museums, and Case Western Reserve University. Downtown Cleveland is approximately 2 miles from the Cleveland Clinic campus.
Downtown Cleveland has seen dramatic changes over the past decade. Foremost are the additions of Progressive Field - home of the Cleveland Indians baseball team, Quicken Loans Arena - home of the Cleveland Cavaliers basketball team, and Cleveland Browns Stadium - the home of the Browns football team. Other notable downtown attractions include the Rock and Roll Hall of Fame and Museum and the Great Lakes Science Center, which houses the Cleveland Clinic OMNIMAX Theater. Cultural attractions in the downtown area include Playhouse Square, the second largest theater district in the United States. In addition, the downtown area and surrounding suburbs are home to a diverse and excellent array of restaurants.
Many activities are also available for outdoor enthusiasts. The natural woodland Cleveland Metroparks form an “Emerald Necklace” which surrounds the city and contains picnic areas as well as miles of bicycle, hiking, jogging, and horseback riding trails. Cleveland also offers sailing enthusiasts, boaters, swimmers, and fishermen abundant lakeshore to enjoy. Cedar Point Amusement Park and Cleveland Metroparks Zoo are among the attractions that offer a day of fun for the whole family.
Cleveland has nearly 90 residential communities with many convenient suburbs located just outside the city center. Housing is very affordable throughout the greater Cleveland area.
Cleveland Clinic's Center for Geriatric Medicine is seeking a well-trained, well-rounded geriatrician to join our nationally ranked program.
For more information, or if you have questions, please contact Jennifer Kambies at 216.448.8203.