Department of Medicine - Division of Gerontology
Professor and Head
Andrew P. Goldberg, MD
The educational programs in the Division of Gerontology, Department of Medicine at the University of Maryland School of Medicine are designed to teach students and house staff the principles of gerontology and geriatric medicine, and to train fellows and junior faculty for academic careers in aging research and clinical geriatric medicine. The program emphasizes research in the biology of aging, the prevention of cardiovascular disease and the rehabilitation of disabled older people in clinical trials which examine the physiological and functional effects of exercise training, rehabilitation and nutritional interventions. Educational activities in the division are enhanced by campus-wide geriatric and gerontology collaborations coordinated by the Geriatrics and Gerontology Education and Research Program (GGEAR), and the University of Maryland Medical Center for Research on Aging. This enriched academic environment allows trainees to learn skills of clinical geriatrics and basic research for careers in gerontology and geriatric medicine.
Research fellowships during the summer (10 weeks), and during the academic year, are offered in conjunction with the University of Maryland School of Medicine Office of Student Research for students interested in intensive basic and/or clinical research in aging. Students are matched with a faculty member based on their research interests. Students receive didactic teaching in geriatric medicine and gerontology, exercise physiology, biostatistics and epidemiology, laboratory techniques, and participate in weekly grand rounds, clinical conferences, research seminars and journal and data presentation sessions. There are also lectures and short-term rotations in geriatric clinics and research laboratories for medical students and housestaff.
Geriatric Medicine Elective
There is a wide spectrum of research, clinical and educational programs for students, house staff, fellows and physicians interested in clinical training and research in gerontology and geriatric medicine. There are opportunities for research training in: 1) exercise physiology and nutrition in the management of cardiovascular disease risk factors in high-risk older patients; 2) rehabilitation and longitudinal management of the elderly to maintain functional independence and exercise capacity to prevent institutionalization; and 3) basic mechanisms of age-related declines in cardiovascular, metabolic and musculoskeletal function. Trainees work closely with faculty members in a research curriculum that provides mentored training in clinical and basic scientific investigation and in the conduct of clinical trials. A Geriatric Research Education and Clinical Center (GRECC) and the Claude C. Pepper Older Americans Independence Center provide resources for training in basic research, clinical medicine and health services research focused in prevention and rehabilitation of older patients with risk factors of complications of cardiovascular diseases. Academic programs in these centers seek to increase the basic knowledge of the aging process and prevent disability from cardiovascular disease through clinical trials of aggressive risk factor and rehabilitation interventions. Knowledge gained from these studies is imparted to health care providers, students and trainees through system-wide educational programs.
The clinical programs teach the principles and applications of the treatment and management of older patients with a wide spectrum of acute and chronic medical diseases and preventive geriatric medicine. Instruction is provided in primary, consultative and long-term care of patients in various clinical facilities of the University of Maryland Medical System. Trainees learn the physiology of aging and principles of geriatric assessment, preventive maintenance and the treatment and care of the older patients in ambulatory medical practices, acute in-patient services, geriatric rehabilitation units and in a comprehensive home care program for frail, homebound patients. There is clinical training in geropsychiatry to learn counseling, psychopharmacologic and ethical issues in the management of older patients with mental illness. This approach provides wide clinical exposure and training in relevant skills for an academic career or clinical practice in geriatric medicine.
Clinical Geriatric Medicine Rotation (Students and Residents)
Two week and one month rotations are available for house officers and students. The purpose of this rotation is for trainees to gain an in-depth understanding of the assessment and care of complex frail older patients. Residents customize this clinical rotation to match their interests. Clinical training sites include the Baltimore VA Medical Center Geriatric Evaluation and Management Unit, inpatient consultation service, Baltimore VA Medical Center Hospital Based Home Care Program, and Geriatric Assessment Clinic, and the Baltimore Rehabilitation and Extended Care Center. Experiences in geriatric assessment and long-term care are enhanced through rotations at Union Memorial Hospital, Franklin Square Hospital and Franklin Woods. There are weekly clinical and research conferences, and monthly geriatric grand rounds in conjunction with Union Memorial and Franklin Square. Residents also have the opportunity to become engaged in basic or clinical research.
Postgraduate Fellowship Training in Aging and Exercise Physiology
The division has an accredited fellowship training program for MDs and PhDs funded by the National Institute on Aging. Research focuses on the effects of exercise and nutritional interventions on the metabolic syndrome, pathophysiology of type 2 diabetes, hypertension, hyperlipidemia and changes in body composition with aging. Post-graduate training emphasizes basic and clinical research in the pathophysiology of aging-related diseases, adipocyte regulation, gene and protein expression in muscle, and the mechanisms by which exercise and dietary interventions prevent cardiovascular disease and disability in at-risk older people. Collaborative research projects can be pursued with investigators in the Division of Endocrinology, Diabetes and Nutrition in the Department of Medicine and in the Department of Kinesiology, University of Maryland College Park.
Postgraduate Fellowship Training
The division has an ACGME accredited clinical fellowship training program in gerontology. The geriatric medicine fellowship focuses on the assessment and care of complex frail older patients, preventive medicine and rehabilitation in the elderly, and provision of care and longitudinal management of the frail elderly to maintain independence and prevent institutionalization. Geriatric medicine fellows learn clinical skills during rotations at the Baltimore VA Medical Center Geriatric Evaluation and Management Unit, inpatient consultation service, Baltimore VA Medical Center Hospital Based Home Care Program, and Geriatric Assessment Clinic. Multidisciplinary teams comprised of geriatricians, nurse practitioners, psychiatrists, Pharm D’s, social workers, physical therapists, occupational therapists, and other health care providers manage these patients, and provide an enriched educational milieu for trainees. Training in rehabilitation, geropsychiatry and long-term care is provided at the Baltimore VA Rehabilitation and Extended Care Center. Experiences in geriatric assessment and long-term care are enhanced through rotations at Union Memorial Hospital, Franklin Square Hospital and Franklin Woods. There are weekly clinical and research conferences, and monthly geriatric grand rounds in conjunction with Union Memorial and Franklin Square. All fellows spend one day/week in the Geriatric Assessment and Continuity of Care Clinic, where they evaluate new patients and develop a patient population for longitudinal clinical management. The clinical fellowship is one year in duration, with the opportunity to add a second year research fellowship. Fellows completing the one year clinical program are eligible for the Certification Examination in Geriatric Medicine.