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Geropsychiatry

  • Rotation length: 1-2 months
  • Location: Northwest Hospital
  • Supervising Faculty: Hisam Goueli, MD
  • Evaluation: written competency-based evaluation.

Practical Details:

Monday Tuesday Wednesday Thursday Friday
AM Geropsych Geropsych Geropsych Geropsych Clinic (9:30am start)
PM Geropsych Geropsych Kline Galland Geropsych WA Care Center

Rotation Goals and Objectives:

Patient Care

  • Become proficient in the inpatient and outpatient management of common psychiatric problems of the elderly, including dementia, depression, bipolar disorder and delirium.
  • Perform initial assessments of decompensated elderly patients, including evaluation of neuropsychiatric symptoms, cognitive and functional abilities, and medical comorbidity.
  • Diagnose and understand special aspects of anxiety and depression presenting in elderly patients with complex medical or situational problems.
  • Observe electroconvulsive therapy and understand indications, risks, and benefits
  • Generate initial treatment plans, including appropriate first-line treatment modalities and management strategies.

Medical knowledge

  • Develop expertise in the diagnostic criteria for dementia; understand the most common types, and how to differentiate them.
  • Understand the available nonpharmacologic and pharmacologic treatments for dementia and depression, and the evidence behind them.
  • Become facile with the use of pharmacologic and nonpharmacologic treatments for the Behavioral and Psychiatric Symptoms of dementia (BPSD).

Practice-based learning and improvement

  • Recognize the criteria for referral to a geropsychiatry inpatient unit.
  • Recognize the criteria for referral to a geropsychiatry outpatient consult.
  • Locate and critically appraise scientific literature relevant to patient care and use evidence from the literature in clinical decision making, as appropriate.

Interpersonal and communication skills

  • Create and sustain effective therapeutic relationships with patients, families, and caregivers.
  • Display empathic listening skills.
  • Work effectively with health care professionals (including those from other disciplines), colleagues, and staff to provide patient-focused care.

Professionalism

  • Demonstrate respect for others, compassion.
  • Demonstrate reliable attendance and appropriate professional attire.
  • Demonstrate integrity, accountability, responsible and ethical behavior.
  • Demonstrate "ownership", i.e. attitudes and behaviors consistent with being the patient's physician and taking responsibility to ensure that each patient receives excellent clinical care.
  • Demonstrate understanding of patients and their illnesses in a sociocultural context, including displaying sensitivity to patients' culture, ethnicity, age, gender, socioeconomic status, sexual minority status, and/or disabilities.
  • Demonstrate concise, pertinent, and timely record keeping.

Systems-based practice

  • Understand the role of the attending geropsychiatrist in the health care system, and how to use him/her appropriately as a consultant.
  • Gain knowledge of appropriate long-term placement for patients with dementia and chronic mental illness within our community.
  • Adequately assess the nature and quality of the patient's caregiving network, including primary care physicians, subspecialty physicians, family members, social network, nursing home staff.

Educational Attitudes

  • Display openness to supervision; accept constructive criticism.
  • Seek direction when appropriate; demonstrate eagerness to learn.