geriatric clinical by qLu36Hx

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									                                                                    Dr. R. Madan, M.D., FRCPC
                                                                    Postgraduate Education Coordinator
 Division of Geriatric Psychiatry                                   Tel: 416-785-2500 x 2457  Fax: 416-785-2450
                                                                    Email: : rmadan@baycrest.org



The purpose of senior elective training in geriatric psychiatry is to prepare residents for careers in which they
will devote the major portion of their practice to elderly patients. Such residents may be anticipating
academic careers in which case this rotation will serve as preparation for a fellowship programme. Another
possibility will be residents who anticipate careers as full time geriatric psychiatrists in the community in
which they will assume significant administrative and programme development responsibilities.

1. Previous Training: Must have completed mandatory training in geriatric psychiatry.

2. Time: 6 months for "advanced" training  1 year for "career path" training
   6 months of training is acceptable only for general psychiatry residents who plan/expect to see a lot of
   geriatric patients. True career residents should be doing at least 1 year of senior-elective training.

3. Service: Exposure to at least 2 different clinical settings (example, primary placement might be on a C/L
   service but resident must also be exposed to outpatients or community team assessments).
   Primary setting should be different from the residents' primary setting during mandatory training.
   It is recommended that the primary placement change after 6 months in order to provide the resident with
   the maximum exposure to different settings.
   It is recommended that the resident receive training in consultation and liaison to geriatric medicine and/or
   behaviour neurology. Optimally this should be blended throughout the course of the training year.

4. Supervisor: The primary supervisor for career path trainees will be in all cases a category Full Time
   supervisor. Some supervision may be provided by Part Time supervisors as well.

5. Patient Load: Twenty patient contact hours per week with 2 to 4 new assessments per week (will vary
   depending on primary placement).

6. Supervision: Minimum of 1 hour of individual didactic supervision per week as well as regularly
   scheduled clinical supervision.

7. Formal Teaching: Resident seminar days & Hospital based teaching

8. Academic Requirement: Senior-elective trainees will be required to prepare a scholarly presentation on
   a psychogeriatric topic which is suitable for grand rounds, presentation at research day, or publication.

9. Evaluation: A patient log will be reviewed by the supervisor on a monthly basis to ensure criteria 5 is
   met.
   The supervisor will directly observe a minimum of 6 interviews per year.
   A formal evaluation on each resident will be completed by the primary supervisor as part of the
   Department of Psychiatry's standard bi-annual evaluation.




                                                                                   Division of Geriatric Psychiatry - Page 1 of 2
Curriculum for Geriatric Psychiatry
The Curriculum for Career Path Training in Geriatric Psychiatry was developed in order to guide supervisors
and trainees in designing a teaching program to prepare residents for a career in geriatric psychiatry.
Adapted from a number of sources, (1) this curriculum is intended to compliment the training requirements
already described. By the end of their training, trainees should demonstrate competence in the following
skills and knowledge related to geriatric psychiatry.

SKILLS                                                   3. Psychological
1. Assessment                                                personality and developmental theories and
    Interviewing                                             aging
    mental status examination (including                    age-related changes in cognitive function
     detailed neuropsychiatry assessment)                    psychological reactions to aging and illness
    competency exam                                         psychological reactions to death and dying
    functional assessment                                   role changes and aging
    family/caregiver assessment                             psychological reactions to retirement
    medical/neurological exam                               marriage, relationships with caregivers
    appropriate use of laboratory investigations,           bereavement and grief
     imaging, EEG, etc.
    appropriate use of referrals to medical, para-      4. Social
     medical, and social consultants                         attitudes and beliefs about aging
                                                             ageism
2. Management                                                competence and guardianship
    psychopharmacology                                      economic issues
    ECT                                                     social agencies
    psychotherapy                                           home/community support systems
    social and milieu therapy                               long-term care system
    home maintenance and supports                           elder abuse
    placement/discharge planning                            caregiver stress/issues
    principles of hospitalization and
     institutionalization                                Psychopathology of Later Life

3. Other                                                 Knowledge of
    depending on career focus, the trainee will            epidemiology
     demonstrate competence in teaching,                    presentation
     research, and/or administrative skills                 etiology
                                                            diagnosis
KNOWLEDGE                                                   treatment
Normal Aging                                                prognosis

1. Demographics                                          Related to the following disorders
                                                           1. affective disorders and suicide
2. Biological                                              2. dementia
    biological theories of aging                          3. delirium
    age-related changes in organ systems                  4. schizophrenia
    age-related changes in sensory systems                5. paranoid/delusional disorders
    age-related changes in sexuality                      6. anxiety disorders
    pharmacokinetics and pharmacodynamics of              7. substance abuse
     psychotropic and non-psychotropic                     8. personality disorders
     medications

                                                                               Division of Geriatric Psychiatry - Page 2 of 2

								
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