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VA Advanced Fellowship in Geriatrics
Purpose
The purpose of the VA Advanced Fellowship in Geriatrics
is to offer post-specialty education to foster the development of leadership in
health care issues of the elderly. The program capitalizes on the international
prominence of VA's Geriatric Research, Education, and Clinical Centers (GRECCs)
to provide outstanding training opportunities in clinical practice, to contribute
to the improvement of clinical practice, and to advance scholarly pursuits that
will benefit care for elderly veterans and all older Americans. Physician fellows
must have completed an ACGME or AOA accredited residency, and either already be
certified or are actively pursuing board certification. This program shall not lead
to board-eligibility in Geriatrics for physicians. Non-physicians must be post-doctoral
for an associated health discipline.
Background
For many years, the Office of Academic Affiliations (OAA), the Geriatrics and Extended
Care Strategic Healthcare Group, and the GRECCs have played a leading role in training
health care providers in geriatrics. In 1978, VA established the Geriatric Medicine
Fellowship to develop a cadre of physicians committed to excellence in geriatric
research, education, and clinical care and interested in becoming leaders of local
and national geriatric medicine programs. Presently, approximately one-fourth of
all geriatric medicine training slots and almost 1/2 of all geriatric psychiatry
slots are financially supported by VA; nearly half of all geriatric medicine residents
and 2/3 of geriatric psychiatry residents in the US receive some or all of their
training in VHA facilities.
In the mid-1990s ACGME reduced its accreditation requirements for Geriatrics from
two years of subspecialty training to twelve months. Consequently, OAA changed the
length of its support for individuals in geriatric medicine subspecialty training
from two years to one year. Concerned that more than one year of subspecialty clinical
training was required to continue leadership in the field of geriatrics, VA's Geriatrics
and Extended Care Strategic Healthcare Group, the Geriatrics and Gerontology Advisory
Committee (GGAC), and the GRECC Directors in 2000 recommended that OAA establish
a fellowship to support advanced training in geriatrics. OAA initially supportedAdvanced
Fellowships in Geriatrics at seven of VA's 21 GRECC sites; and in 2006
expanded the number of GRECCs offering Advanced Fellowships in Geriatrics
sites to sixteen.
New in 2006-2007
Research efforts in geriatrics, which are understood as key to survival in academic
medicine, continue to be predominantly accomplished within medical subspecialties.
As the leading proponent for health care geriatric education in the US, VHA has
an obligation to offer a wide variety of clinical research training opportunities
for postdoctoral geriatrics professionals committed to pursuing careers in academic
health care. The fundamentally interdisciplinary nature of geriatric health care
necessitates that Advanced Fellowship in Geriatrics training opportunities not be limited to physicians
with prior training in geriatrics, but be available to physicians of other specialties
and to associated health professionals with advanced training and expertise in geriatric
care within their respective disciplines, and who are committed to academic careers
in their respective fields.
Program Characteristics
The two-year curriculum at each site provides basic overviews and opportunities
to pursue more intensive training in health services research, research methods,
educational and evaluative design, written and oral communication skills, quality
improvement methods, leadership skills, patient safety and project management. Each
of the SFPAG sites is unique in its own area(s) of expertise beyond those basic
skills. Fellows who have not completed approved Geriatrics training shall be offered
fundamentals of geriatrics and gerontology in their course of study.
Fellows spend at least 75 percent of their time in scholarly pursuit of geriatrics
(coursework and research) and no more than 25 percent in clinical care. Fellows
shall develop and implement a research project resulting in some form of professional
recognition such as submission of a manuscript to a peer-reviewed journal or presentation
at a recognized professional forum. The majority of fellows' clinical care responsibilities
are conducted at VA facilities. Every fellow is assigned at least one mentor (preceptor)
in the first quarter year of the program, who will provide assistance with project
and research methodology and content and guidance in personal and professional development
through synthesis of an individualized learning plan.
Eligibility
Physician fellows must have completed an ACGME- or ECCOPT- accredited
physician residency program. Physicians whose initial certification is in Internal
Medicine, Family Medicine, or Psychiatry must also have completed an accredited
subspecialty residency in Geriatrics or other subspecialty. Special Fellows are
expected to be board certified in their primary specialty and either certified or
actively pursuing certification in their subspecialty by the time of VA Special
Fellow appointment and to meet credentialing and privileging requirements to qualify
as a licensed independent practitioner. Physician fellows must have an active, full
and unrestricted license to practice in the US. International medical graduates
must have the required Education Commission for Foreign Medical Graduate (ECFMG)
documentation. Citizens of countries other than the United States must possess an
appropriate visa to participate in this program.
Postdoctoral associated health fellows from nursing, dentistry,
optometry, psychology, podiatry, pharmacy or audiology / speech pathology must have
graduated from an accredited clinical doctoral program including all required residency
or internship experiences that prepare them for eligibility for VA employment. Psychology
fellows must have completed an accredited doctoral program, including an internship
program accredited by the American Psychological Association (APA). In addition,
associated health fellows must have completed one year of post-doctoral clinical
training in their discipline, preferably but not exclusively in geriatrics. Associated
health fellows must be US citizens.
Application
To inquire about the application process and to learn more about the program, interested
parties should write to the site(s) of their choice, including a cover letter and
current curriculum vitae.
Fellowship Locations
VISN 11 Ann Arbor, MI
Director: Robert Hogikyan, MD, MPH
Administrative Assistant: Laural Marshall
VA Ann Arbor Healthcare System
GRECC (11G)
2215 Fuller Road
Ann Arbor, Michigan 48105
(734) 845-3072 telephone
(734) 845-3298 fax
Research Focus: Mobility, infection control, resource utilization in nursing homes, influenza, exercise, insulin action, hypertension, assessment measures, healthcare outcomes measures, calcium signaling in neuronal cells, signal transduction and neuronal survival, immune system, genetics of differential longevity, autoimmunity, oral health in long term care.
VISN 5 Baltimore, MD
Director: Andrew Goldberg, MD
Administrative Officer: William Woodcock
Baltimore VA Medical Center
GRECC (BT/GR/18)
10 North Greene Street
Baltimore, Maryland 21201
(410) 605-7185 telephone
(410) 605 -7913 fax
Research Focus: Basic Biomedical : Researchers address the molecular, cellular and genetic mechanisms underlying aging and associated abnormalities in glucose, fat, and lipid metabolism, and the effect of exercise training and weight loss in subjects with diabetes, stroke, obesity and sedentary lifestyles. Applied Clinical : Effects of exercise and diet modification on risk factors for CVD in older veterans. Researchers address the effects of gene-environment interactions on the mechanisms underlying the effects of exercise and weight loss interventions on hypertension, diabetes and hyperlipidemia. Researchers also examine the effects of task-oriented treadmill training on central and peripheral neural mechanisms, fitness levels, cardiovascular disease risk factor profiles and functional status of older patients with chronic cardiovascular diseases, including stroke, peripheral arterial disease and coronary artery disease. Health Services : Researchers examine the effects of exercise and chronic rehabilitation interventions on functional performance and quality of life in veterans with chronic cardiovascular diseases. Rehabilitation : The rehabilitation (tertiary prevention) involves studies of older patients disabled by stroke, peripheral arterial disease, and coronary artery disease.
VISN 7 Birmingham, AL / Atlanta, GA
Director: Kathryn Burgio, MD
Associate Director: Theodore (Ted) Johnson, MD, MPH
University of Alabama at Birmingham
Administrative Support: Felicia Williams
Atlanta VA Medical Center
Birmingham/Atlanta GRECC
1670 Clairmont Road
Decatur, Georgia 30033
(404) 321-6111 ext. 5080 telephone
(404) 417-2912
Research Focus: Please contact site for more details.
VISN 6 Durham, NC
Director: Kenneth Lyles, MD
Associate Director: Mitchel T. Heflin, MD
Program Support Clerk: Sandra Giles
Durham VA Medical Center
GRECC (182)
508 Fulton
Durham, North Carolina 27705
(919) 286-6932 telephone
(919) 268-6823 fax
www.geri.duke.edu
Research Focus: Basic biomedical: immunology and aging, cardiovascular disease and aging, Applied clinical: Herpes zoster, cardiovascular disease, osteoporosis and Paget's disease of the bone, exercise interventions to improve functional impairments, Health services: medication appropriateness and drug reactions
VISN 16 Little Rock, AR
Director: Dennis Sullivan, MD
Administrative Officer: Kay Guthrie
Central Arkansas VA Healthcare System
GRECC
4300 West 7th Street (3J/NLR)
Little Rock, Arkansas 72205
(501) 257-5547 telephone
(501) 257-4531 fax
Research Focus: Exercise physiology, cellular aging, Alzheimer's disease pathogenisis, nutrition and metabolism, outcomes research.
VISN 12 Madison, WI
Director: Sanjay Asthana, MD
Administrative Officer: Cecilia Doskocil
William S. Middleton Memorial Veterans Hospital
GRECC
2500 Overlook Terrace
Madison, Wisconsin 53705
(608) 256-1901 ext. 11675 telephone
(608) 280-7291 fax
Research Focus: Please contact site for more details.
VISN 8 Miami, FL
Director: Jorge Ruiz, MD
Fellowship Coordinator: Andrea Ruiz
Miami VA Healthcare System
GRECC (11GRC)
1201 NW 16th Street
Miami, Florida 33125
(305) 575-7231 telephone
(305) 575-3365 fax
Research Focus:
Musculosketetal problems, telecare, neuroregeneration, prostate disease, falls prevention, acute geriatric medicine, prostate cancer, arthritis, osteoporosis, geriatric psychiatry and, geriatric primary care. Many more opportunities are available based on trainees interests. Please contact site for more information.
VISN 1 New England: Bedford, ME & Boston, MA
Bedford Director: Neil Kowall, MD
Boston Director: Michael Gaziano, MD, MPH
Administrator: Liz Grant
New England GRECC (182JP)
VA Boston Healthcare System
150 South Huntington Avenue
Jamaica Plain, Massachusetts 02130
(857) 364-2564 telephone
(857) 364-4454 fax
Research Focus: Please contact site for more information.
VISN 21 Palo Alto, CA
Director: Mary Goldstein,
MD, MS
Associate Director: Karyn Skultety
VA Palo Alto Healthcare System
GRECC (182B)
3801 Miranda Avenue
Palo Alto, California 94304
(650) 493-5000 ext. 66946 telephone
(650) 496-2505 fax
Research Focus: Basic biomedical: adult stem cells, dysmobility in aging, cellular and molecular biology of aging, physiological and metabolic concomitarits of aging, endocrinology and metabolism of aging, autoimmunity in aging, immune system—cell biology and cancer, impact of oxidative stress on aging, Alzheimer's disease pathophysiology and disease-animal models- Applied Clinical: depression and anxiety in the elderly, arthritis, autoimmunity in aging, osteoarthritis management- Health Services: clinical decision support systems, health preferences of older adults (quality of life).
VISN 4 Pittsburgh, PA
Directors: Steven Graham, MD, PhD
Associate Director, Education/Evaluation: Stephanie Studenski, MD, MPH
Health Educational Specialist: John Hennon, EdD
VA Pittsburgh Healthcare System
GRECC
7180 Highland Drive, 00GR-HD
Pittsburgh, Pennsylvania 15206
(412) 365-5758 telephone
(412) 365-5769 fax
Research Focus: Mechanisms of ischemic neuronal cell death, new therapies to treat stroke, mechanisms of gait instability, treatment of aphasia, quality of life outcomes for stroke survivors, treatments that reduce stroke factors, reducing polypharmacy in aging. More opportunities are available. Please contact site for more information.
VISN 20 Puget Sound, WA
Director: Alvin Matsumoto, MD
Administrative Officer: Chris Foster
VA Puget Sound Healthcare System
S-182 GRECC
1660 South Columbian Way
Seattle, Washington 98338
(206) 764-2308 telephone
(206) 764-2569 fax
Research Focus:
Neuroendrocrinology, neurogenetics, health services research, molecular genetics, psychopharmacology, andrology, prostate cnacer, medical ethics, end of life care, metabolic basis of Alzheimer's disease.
VISN 19 Salt Lake City, UT
Director: Byron Bair, MD
Contact: Scott Capps
VA Salt Lake City Healthcare System
GRECC (182)
500 Foothill Drive
Salt Lake City, Utah 84148
VISN 17 San Antonio, TX
Director: Laura Chiodo, MD
Contact: Chris Gaspard
South Texas VA Healthcare System
GRECC (182)
7400 Merton Minter Blvd
San Antonio, Texas 78229
(210) 617-5311 telephone
(210) 617-5312 fax
Research Focus:
Osteoblast function and second messengers, risk factors associated with development of frailty, disability in nursing home residents, medical decision making in long term care, health professionals education in geriatrics and gerontology, genetic influences in aging, wound healing, animal models of aging, ethnicity and aging.
VISN 22 Los Angeles, CA
Director: Cathy Alessi, MD
GRECC Associate Director of Education: Josea Kramer, Ph.D
Administrative Officer: Paul McIntyre
Greater Los Angeles Healthcare System
GRECC (11E)
16111 Plummer Street
Sepulveda, California 91343
(818) 895-9311 telephone
(818) 895-8181 fax
Research Focus: Basic and clinical research programs in osteoporosis, osteoarthritis, fracture repair, wound healing, falls, immunosenescence, Alzheimer's disease and neoplasia in aging, cellular aging, bone-cartilage-lymphocyte cell biology, sleep disorders, nursing home quality of care, barriers to VA care utilization, innovative geriatric programs and educational research in undergraduate and graduate medical care training in geriatrics and gerontology.
VISN 15 St. Louis, MO
Director: Julie Gammack, MD
Contact: Linda Smith
VA Medical Center
GRECC (11E)
#1 Jefferson Barracks Drive
St. Louis, Missouri 63125
(314) 894-6510 telephone
(314) 894-6614 fax
Research Focus: Hormonal interventional trials, nutritionin the elderly, aging in the blood brain barrier, aging in African-American populations, molecular biology of aging, aging-related memory deficits, aging related osteoporosis, end of life care, health services research, quality improvement in the nursing home.
VISN 9 Tennessee Valley, TN
Director: Robert Dittus, MD, MPH
Contact: LaJuana Fleming
VA Tennessee Valley Healthcare System
GRECC/HSR/CRCoE
1310 24th Avenue South
Nashville, Tennessee 37212
(615) 340-2354 telephone
(615) 327-5381 fax
Research Focus: Please contact site for more information.
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