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Overview

The Care of the Elderly Training Program has been officially recognized by the College of Family Physicians of Canada since 1989. It represents elective, supplementary training in care of the elderly of 6 or 12 months鈥� duration, available after the two-year core Family Medicine Residency. The 91社区 program has existed since 1990 and is fully accredited by the CFPC and the CMQ.

The Department of Family Medicine and the Division of Geriatric Medicine jointly organize the content of our comprehensive Enhanced Skills Program in Care of the Elderly.

The Care of the Elderly Training Program provides in-depth training for Family Physicians seeking any or all of the following:

• to enhance their knowledge and skills in elder care;
• to enhance their knowledge and management skills of the special needs of the frail elderly;
• to act as resource persons in care of the elderly in the community, urban or rural;
• to pursue an academic career in geriatric medicine;
• to take on leadership roles including program development in settings such as Long-Term Care, Geriatric Assessment/Rehabilitation Units, or Home Care.

The 91社区 Care of the Elderly Training Program is of six- or twelve-month duration. The six-month program focuses on clinical skills. Those trainees interested in pursuing an academic or administrative focus are encouraged to apply for the twelve-month program.

The rotations done in the six and twelve months programs are outlined in Appendix III 鈥�Care of the Elderly Rotations Structure.鈥� Below is a brief description of each rotation.

Longitudinal Schedules

• Identical for both six- and twelve-month streams
• 0.5 day per week of longitudinal family medicine clinic
• 0.5 day per week of geriatrics clinics divided between:
  • Geriatrics Assessment Clinic (1 per period)
  • Memory Clinic (1 per period)
  • Home Care (2 per period)

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Home Care

The trainee will participate in the evaluation and treatment of patients in the home care program. They will also learn about community resources, as well as the application process for placement in long-term care institutions.

The trainee will be the primary care physician for a number of homebound patients. To facilitate continuity of care, the trainee will have approximately two half days per month for the duration of their training program to care for those patients. This will involve regular and emergency home visits, as well as being available to respond to questions and problems which arise.

Out-patient Geriatric Clinic & Specialty Clinics (i.e. Memory Clinic, Pain Clinic, Incontinence Clinic)

The trainee will participate in multi-disciplinary outpatient geriatric assessment clinics, which respond to referrals coming from physicians in the community or in the hospital. Our residents have the opportunity to join any other specialty clinic according to their interests.

Geriatric Day Hospital

The trainee is involved in the initial assessment and ongoing evaluation of the patients in the geriatric day hospital. The focus is on rehabilitation of the frail, community-based elderly; co-management of patients with primary-care physicians; and learning about community resources. A special focus of this rotation focuses on the dynamics of interdisciplinary team-work.

Acute Geriatric/Rehabilitation Ward

The trainee will be actively involved in the care and responsibility of patients on the ward, including the discharge planning process. Conducting daily rounds together with the staff physician, the trainee will be involved in the teaching of the family medicine residents and medical students rotating on the ward. Multidisciplinary management is emphasized.

Long-Term Care Ward

The trainee will jointly round with the attending physician in charge of a long-term care ward, and actively participate in patient care. The particular focus is on management of ethical issues, competency, and managing complex issues in a 鈥渃are rather than cure鈥� mode.

Geriatric Consultation (ER and Ward)

As a member of a multi-disciplinary team, the trainee will be involved in the evaluation of geriatric patients referred from the emergency room, and from medical, surgical, and psychiatric wards. The trainee will be involved in decisions concerning admission and discharge from the emergency room or hospital.

Continuity of Care Clinics

Residents will have a longitudinal component of two half days per week to participate in continuity of care in both a family practice and a geriatrics setting.

Geriatric Psychiatry

The trainee will participate in the evaluation of new problems and the ongoing treatment of patients, on both the geriatric psychiatry ward and the outpatient clinic or home setting.

Electives

Clinical electives help the trainee achieve their particular goals in Care of the Elderly. Commonly chosen electives include palliative care, rheumatology, and neurology. Electives in teaching, research, and administration can be tailored to suit individual needs.

Each trainee will be assigned an academic advisor to review their academic progress throughout the training and to allow for further mentoring when needed.

Curriculum and Training

Core Rotations:
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Oral, Written, and Interactive Sessions (if any):
Describe the structure and purpose of oral, written, and interactive sessions, including frequency and evaluation methods.

Core Rounds and Teaching Sessions (if any):
Provide details about core rounds, including the topics covered, frequency, and any specific requirements for participation.

Trainees actively participate in a Care of the Elderly Trainee Seminar Series, held approximately once a month, depending on the number of trainees in the program at one time.

Trainees are often involved in teaching activities (sometimes to family medicine residents and students, and members of the multidisciplinary team). They may be invited to give talks to community audiences.
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Evaluations:
The evaluation process is the same as the process followed during the family medicine residency program. Daily field-notes are used to collect feedback. There is a mid-term evaluation during each period (informally with the supervisor of that rotation) and a final evaluation at the end of each period (via ONE-45 system).

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Application Process

Contact Information

For more information, please contact听vladimir.khanassov [at] mcgill.ca (Dr. Vladimir Khanassov)
Director, Care of the Elderly Program

For information regarding the application process:
postgrad.fammed [at] mcgill.ca (Ms. Alana Walsh-Ferland)
Enhanced Skills Coordinator
Tel: (514) 399-9126