Montefiore North Division Geriatric Medicine Fellowship Program

Sponsored by New York Medical College

Sponsored by New York Medical College, the Geriatric Medicine Fellowship Program at the North Division of Montefiore Medical Center emphasizes the development of strong clinical and teaching skills, while also providing opportunities for research.  Acute, ambulatory and long-term care settings provide continuity of care for geriatric patients within a solid physician faculty framework.

This fully accredited fellowship program, one of the largest programs in the country, offers a complement of eight fellows. Fellows are offered a wide range of experience, serving a heterogeneous geriatric population comprised of individuals of many ethnic groups, in multiple settings. The faculty-fellow ratio is quite favorable, with core faculty members in geriatrics and related specialties who hold teaching appointments at New York Medical College. The program received a five year accreditation in September 2008.

Fellows are responsible for regular admission and follow-up of patients, both for primary care and for consultations. Every case is discussed with the attending physician, on or off rounds, on at least a daily basis. Patients are admitted through the emergency room or direct referrals, and originate from both the community and nursing homes.  If patients are transferred to critical care units, follow-up care is continued by the fellows.

Cases are also followed in the ambulatory care clinics (presently conducted four times a week) by fellows under direct attending geriatrician supervision. In the nursing homes, each fellow provides care to a panel of residents at one or more units, also under direct faculty supervision. Among the three sites, fellows gain a broad spectrum of clinical experience, from healthy adult to a wide range of chronic diseases and acute illness. Cases are followed by fellows from admission to discharge and post discharge, allowing continuity of care between community, hospital and nursing home settings.

The Geriatric Medicine Faculty

Board-certified faculty physicians are responsible for providing clinical, basic science and research experience to the fellows.  They are available on a 24-hour basis, including weekends. All faculty members are board certified in internal medicine and geriatric medicine, and some in additional areas. The faculty members work closely with the fellows and participate in most of the didactic conferences offered as teaching experiences.

Education and Research

A major strength of the program is its teaching component. Extensive teaching is provided at bedside rounds, didactic conferences and case discussions, in addition to Grand Rounds and monthly journal clubs.  A Board Review in Geriatric Medicine is offered annually at the end of the academic year (from April through June) to help fellows prepare for the certification examination. Trainees are provided the opportunity to develop their teaching skills by receiving instruction through critical appraisal of their presentations. A monthly Grand Rounds in Geriatric Medicine is part of the educational process. Additionally, didactic conferences in geriatric medicine are conducted three times weekly (twelve a month); sessions in geriatric psychiatry are provided three times a month, and a fellows teaching conference takes place three times a week (twelve a month). The total number of conferences is approximately 25 each month, and every attempt is made to avoid repetition of topics (see conference schedule).

The near 100% board pass rate achieved by fellows graduating from this program since its inception in 1993 is a testimony to the program's strong educational component. Ample opportunity is available for clinical research. Several clinical and basic science research projects have been the basis for publications and abstracts presented in national and international meetings. The program has been the source of numerous publications in peer-reviewed journals and books over the years. An easy-to-comprehend textbook, Clinical Geriatrics, published in 2003, was the product of several faculty members and fellows from this program.

Conference and Clinic Schedule