Maine Medical Center
Dr. Kabaeva treating a geriatric patient

Curriculum | Internal Medicine - Geriatrics Residency & Fellowship

Continuity Experiences in General/Geriatric Primary Care

In addition to their internal medicine teaching primary care clinic, IM-Ger residents will also have a longitudinal nursing home experience which continues through all four years of training.

Teaching Conferences

IM-Ger PGY 1-3 residents will have access to two hours each week of geriatric medicine interprofessional conferences while on their ambulatory blocks. PGY-4 fellows will have access to weekly geriatric medicine didactics including:

  • Case conferences (including M&M)
  • Core conferences
  • QI and research meetings
  • Journal clubs

All sessions are structured for interactive and interprofessional learning and are presented in an online/hybrid fashion to maximize participation.

IM-Ger residents in PGY1-3 will also attend intern report, morning report, Department of Medicine Grand Rounds, and the IM academic half-day conference with their IM resident peers. 

Scholarly Activity

IM-Ger residents will be required to complete a scholarly project during their residency in addition to being involved in departmental QI. Residents will have two hours per week during their ambulatory blocks for PGY 1-3 and weekly during PGY 4. IM-Ger residents are encouraged to present at, and attend, at least one national conference during their four years. There are also ample opportunities to attend local geriatric medicine and internal medicine conferences, including the Dirigo-Maine Geriatrics Society (affiliate of AGS); the Maine Gerontological Society meetings and the annual Maine ACP chapter meeting. 

Rural Experiences

Through our partnerships with the rural health networks including VA Maine, MaineHealth system hospitals and the Consortium for Healthcare Education and Training (Programs & Initiatives - CHET Maine | Training, Partnerships & Healthcare Workforce Development) IM-Ger residents have opportunities to explore rural geriatric care. They will also complete a dedicated fourth year rotation in rural geriatric medicine. 

Curriculum Structure 

For the first three years, our curriculum is organized in a “4+2” block scheduling format similar to the IM categorical program. This features alternating blocks of 4 weeks (IM categorical blocks with predominately inpatient service, night float, consult rotations, and electives) and 2 weeks (predominately continuity clinics, administrative time and vacation). The fourth year (fellowship) curriculum is organized as four-week rotations.

PGY 1-3 

Categorical Blocks (4 weeks)

Vacation: 4 weeks per year (divided between +4 and +2 weeks)

Rotation TitleR1 (total weeks)R2 (total weeks)R3 (total weeks)
General Medicine Inpatient888
Medicine Night Float444
Critical Care Medicine444
Inpatient Cardiology/CICU 444
Inpatient Hematology/Oncology200
Inpatient Nephrology Transplant200
Other (2–4-week blocks)
  • Emergency Medicine 
  • Geriatrics
  • Outpatient Neurology 
  • Rural Medicine
  • Rheumatology
  • Outpatient Nephrology
  • Inpatient Infectious Diseases
  • Outpatient Heart Failure Clinic
  • Urology
  • VA Medical Specialties
Electives268

Ambulatory (2 weeks)

 MondayTuesdayWednesdayThursday Friday
7:30-8:30 AMBoard ReviewMorning Report 

Geriatric Didactics 

(8-10 am)

 
MorningContinuity ClinicLong-term Care Continuity ClinicIndependent StudyLong-term Care
Afternoon

Continuity

Clinic

Intern Conference or Administrative

Continuity

Clinic

Senior Conference or AdministrativeAdministrative

PGY-4

Geriatric Medicine Fellowship 

Vacation is scheduled during the fellowship year on an as-requested basis.

Rotation Title

Total Weeks

Fellow Experience

Inpatient Consultation

12

Provide consultation to acutely ill hospitalized patients at MaineHealth Maine Medical Center Portland, a 700-bed tertiary care center
Acute Rehabilitation 

6

Admit and manage patients recovering from conditions such as strokes, amputations, spinal cord injury, multiple trauma and brain injury at New England Rehabilitation Hospital of Portland in partnership with physiatry faculty
Inpatient Geriatric Psychiatry

8

Admit and manage older adults in acute psychiatric crises as part of the inpatient geriatric psychiatric team
Ambulatory Skills 

6

Rapid exposure to a variety of specialties essential to geriatric medicine, including sports medicine, integrative medicine, rheumatology, uro-gynecology and more
Outpatient Geriatric Psychiatry

4

Follow outpatient geriatric psychiatrists as they manage older adults with chronic psychiatric conditions
Elective 

8+

Since geriatric medicine training is embedded earlier – more time for individualized learning 
Rural Geriatric Medicine 

4

  • Caring for older adults in rural areas, often in their own homes
  • Learning to navigate rural health care systems and identify/address barriers to health care such as isolation, lack of transportation and decreased access to specialized health services

Other

  • Palliative Care
  • Post-acute Care & Administration 
  • Scholarly & Process Improvement 

2 weeks each

The Scholarly & Process Improvement rotation provides fellows with foundational training in patient safety, quality improvement and health care disparities while allowing dedicated time to use this knowledge to develop a scholarly project. During the post-acute care rotation, fellows experience working in a high-volume skilled nursing facility and are introduced to the role of the Medical Director.

PGY-4 Continuity Experiences

Half-day and full-day continuity experiences at VA Maine Primary Care, area assisted living/nursing homes and the MHMMC Geriatric Assessment Center will be integrated into each rotation and continue throughout the training year.

Dedicated Time for Learning and Wellness

The fellowship has dedicated time for didactics and independent/wellness activities study every Thursday morning. Our lecture series includes case conferences, core content lectures, board review sessions, journal club and research conferences. Grand Rounds occurs once a month on Thursday mornings. All sessions are structured for interactive and interprofessional learning and are presented in an online/hybrid fashion to maximize participation.