 Medical
Student Education
The Donald W. Reynolds Department of Geriatrics is vigorously
committed to educating medical students in the unique skills
required in the care of older persons. All medical students
at UAMS must complete a mandatory Geriatrics Clerkship during
their junior year of medical school. The goal of the Geriatrics
Clerkship is two-fold: To assist the student in developing
a knowledge base in Geriatric Medicine with an emphasis on
common geriatric syndromes and diseases as well as the normal
aging process and to introduce the student to the interdisciplinary
approach of comprehensive assessment, management, and prevention
techniques in the elderly. This four-week course exposes students
to elderly patients in four of five different care settings:
primary care outpatient clinics, transitional care unit, inpatient
service, nursing homes, and hospice. By arranging the clerkship
in this manner, students are introduced to the continuum of
care for elderly patients and the resources associated with
each area. In addition, students attend both weekly didactic
sessions and Geriatric Grand Rounds.
Students attend ambulatory clinics, either at the UAMS Senior
Health Center or the North Little Rock VA Primary Care Geriatric
Clinic. In each of these settings, students see a wide variety
of elderly patients with multiple chronic diseases and geriatric
syndromes. Students spend six half-days per week in this setting
where their skills are honed to perform specialized exams
for elderly patients. The clinic experience plays a vital
role in teaching students the importance of health promotion
and appropriate disease prevention.
In addition, students spend six half-days per week in either
the Transitional Care Unit (TCU) at the North Little Rock
VA or the Geriatric Inpatient Service at the University Hospital.
In the TCU setting, students observe common rehabilitative
and restorative techniques used with elderly patients. In
the inpatient setting, students become familiar with the atypical
presentation of diseases in the elderly and treat the acute
exacerbations of chronic disease for which elderly patients
are frequently hospitalized.
The third experience provides students with one half-day
per week in a nursing home. In the nursing home, the issues
of frailty, loss of independence and privacy, polypharmacy,
chronic pain, and end-of-life decision making are addressed
as well as the importance of non-physician healthcare providers
to overall patient care.
The fourth experience consists of one half-day per week in
hospice care. This combines home visits to terminally ill
patients and didactic sessions that focus on symptom relief
and the importance of interdisciplinary healthcare teams.
At the end of the rotation, students take an Objective Structured
Clinical Examination (OSCE). This takes place in the state-of-the-art
Clinical Skills Center at UAMS. The students interview and
/ or examine three standardized patients representing typical
geriatric syndromes or problems. Trained observers, via unobtrusive
video cameras, score the students. Each standardized patient
encounter is followed by a computerized Post-Encounter examination
consisting of five multiple-choice questions relating back
to the patient case.
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