1. The Reynold’s Geriatrics Experience at Emory Family Medicine Residency Program
Eddie Needham, MD, FAAFP
Assistant Professor/Program Director
Emory Family Medicine Residency Program
Department of Family and Preventive Medicine
Emory University School of Medicine

2. Agenda RRC requirements in Family Medicine
Geriatrics curriculum to date
Emory Reynold’s Resources

3. RRC Requirements – July 2006
“The residents must have clinical supervised experiences dealing with common acute and chronic diseases of aging.”
“Residents must develop competency in assessingand meeting the healthcare needs of declining elders, episodic, illness-related care, delivery of healthcare in the home, FMC, hospital, and long-term facility, and end-of-life care.”

4. Where we were in 2003…

5. 2003 Geriatrics Curriculum in Family Medicine
There were multiple facets to this curriculum:
Inpatient rotations caring for the older adult.
A four week Geriatrics rotation in the PGY 2 year.
Home visits.
Dedicated Geriatrics didactics during our residency lecture series.
Continuity care clinics over three years

6. 2003 Geriatrics Curriculum in Family Medicine
Inpatient rotations
Residents rotate on internal medicine, family medicine, cardiology, and psychiatry.
A large portion of these patients are older adults, thus allowing residents to incorporate the principles of geriatrics into the medical care they render.

7. 2003 Geriatrics Curriculum in Family Medicine
We desired to solidify our geriatrics rotation in the PGY 2 year.
Rotating through the geriatrics division was an excellent educational opportunity for our residents.
We needed a dedicated nursing home experience.

8. 2003 Geriatrics Curriculum in Family Medicine
We desired to establish a site where we could send and care for our own patients who needed nursing home care.

9. Where we are April 2006…

10. Geriatrics at EFMRP Continuity care clinic (FMC)
Dedicated geriatrics rotation in the PGY 2 year
Nursing home experience in PGY 2 and PGY 3 years
Residency didactics once a week
Reynold’s involvement

11. Current Geriatrics Curriculum in Family Medicine
Continuity Care Clinics
Residents are in clinic with the same patients over the three year residency.
This fosters an excellent physician patient relationship.
Residents are able to assess and care for the organic, psychosocial, and spiritual aspects of their patients.
Access to the Emory’s geriatrics web site for ready access to clinical tools

12. Prior Geriatrics Curriculum in Family Medicine (pre-2003)
The Geriatrics rotation
In the past, this consisted of the following:
3 half days per week at Sunrise Assisted Living of Decatur
2 half days per week in geriatrics clinic in the family medicine clinics
Geriatric inpatient consults
2 half days with the ostomy/wound care nurse at Crawford Long Hospital
2 half days at the Wesley Woods Health Center
3 half days at Peachtree Hospice

13. Current PGY 2 Geriatrics rotation
Occurs at the Atlanta VAMC with Emory Geriatrics faculty
Inpatient nursing home experience
Wound care clinic
Home visits
Geriatrics clinic
Excellent learning environment from resident feedback

14. PGY 2 Geriatrics rotation
Of note, each resident does a presentation while in the geriatrics rotation.
One resident won 2nd place at the GAFP poster presentation 2005 for a poster on osteoporosis in men.
One resident is going to the AGS meeting to present on geriatric patients and the use of call buttons.
Excellent scholarly output from this rotation!

15. Nursing Home Experience
Beverly Northside Nursing Home
Once a month, PGY 2 and PGY 3 residents visits their patients at the nursing home.
They round with a geriatrics attending and then share a didactics topic from our geriatrics nursing home curriculum.

16. Residency Didactics Residents have required didactics every week.
Lecture topics are covered on a regular basis.
EFMRP didactics calendar on-line

17. Current Geriatrics Curriculum in Family Medicine
Geriatrics lecture topics
There are dedicated geriatric lecture topics that are covered every months so that a topic is given at least twice during a three residency (36 months).

18. Emory Reynold’s Involvement
The Reynold’s Foundation Grant has opened doors for EFMRP to have access to superior educational resources
Atlanta VAMC geriatrics rotation
Beverly Northside Nursing Home
Web Resources at:

29. How have you measured this?
Ah yes, the continual JCAHO/RRC/ “pick an acronym” question…
Glad you asked 

30. Geriatrics ITE Scores Geriatrics % for program 2002 52 2003 57 2004 50
2005 64
Average 53

31. Resident Feedback This site is “A credit to our residency!”
“Dr. House is an excellent educator.”
“I liked this rotation because I was involved in different outpatient clinics.”

32. Other Benefits
One faculty member has been funded for a Reynold’s Faculty Scholarship.
Another faculty has received funding as a Core Faculty member – dedicated Geriatrics time
Many networking opportunities as a result of Reynold’s activities
Resident scholarly output

33. Summary Markedly improved PGY 2 geriatrics rotation
Initiation and continued development of a continuity nursing home experience
Improved ITE scores
Excellent web resources

34. The beginning of the end