The Journal of the Arkansas Medical Society Med Journal Dec 2019 | Page 9

Medical Graduates in Training
are in academic houses or on rotation participate
each year [through this group] in senior fairs like
senior expo or Alzheimer’s walk.”
Caring for Older Patients
Taking care of older patients is a slower pro-
cess, by nature and necessity. “We spend 30-45
minutes with a patient whereas the average pri-
mary care is only able to spend considerably less,”
said Dr. Brooks. “I’m fortunate in that here at NEA,
even though we are not a senior health center, I’m
able to practice geriatrics at my own speed rather
than having to see 32 patients a day.”
“It comes down to their ability to function. When
old age and associated conditions start to inter-
fere with daily activities, a geriatrician can be
helpful. I do a lot of memory testing, mobility
exams, bone densities, and that sort of thing.”
Geriatricians like Dr. Brooks are also called
on for hospital consults related to dementia, de-
lirium, general geriatric care, and end-of-life care.
Geriatrics as a subspecialty is relatively new
and is one of the least chosen areas by medical
students in the U.S. and across the world, sec-
ond only to nephrology. However, geriatric physi-
cians are among the highest rated in physician
job satisfaction. “To enter the field, residents
from internal or family medicine do an additional
fellowship in geriatrics,” explained Dr. Mendi-
ratta, who is happy to see growing interest in
the area by students. Aside from this, however,
there is required training in the field at a handful
of medical schools across the nation. “Since the
number of folks who are older adults continues
to rise in the U.S. and in our state, our medical
students at UAMS have a required fourth-year
clerkship or rotation in geriatrics. Other medi-
cal schools are now introducing geriatrics as a
clerkship. Currently, 15 medical schools have
such a program.
“A large part of our responsibility at UAMS
is in training and educating multiple learners –
medical students, residents, and PA students –
in the care of older adults. Our past geriatric fel-
lows are all leading in the field to help with this
and other missions, including clinical. UAMS re-
quires its internal and family medicine residents
to train in geriatrics during their residency. After-
NUMBER 6
wards, some of those students decide to further
pursue the specialty. In the last two years, the
geriatric fellowship slots have stayed full and
some fellows pursued a second-year position.”
Dr. Mendiratta emphasized the importance
of keeping students engaged in geriatrics. “To
that end, newer innovations have been employed
and presented at national meetings,” she said,
describing some things that have been popular
with learners. “These include virtual reality for
dementia training, a culinary medicine workshop
for geriatric friendly recipes, interprofessional
simulations in geriatrics, telemedicine simulation
in geriatrics, and development of tools by medical
students each month that can be used to educate
older adults. Also, several of our students who
Dr. Jennings explained that the slower pace
of practice makes sense considering the well-
documented slowdown in processing speed that
goes along with the aging process. “If you live
long enough, you’re going to be visually and/or
hearing impaired,” stated Dr. Jennings. “You’re
talking about patients who are visually impaired
and hearing impaired, with age-related slow-
ness in processing. If you then put them in front
of a computer and tell them to access the pa-
tient portal to schedule a mammogram, they’re
just not going to do anything. Or take a patient
who is challenged to keep up with a technical
conversation in the office, and tell him to call the
health system phone line to book an appoint-
ment or to clarify instructions with a nurse. He
does that and gets an automated recording that
he can’t hear (well) – and can’t rewind – that tells
him to choose one of several choices. This goes on
> Continued on page 130.
Used by permission (Dr. Mendiratta) UAMS 2018 Geriatric fellows with Drs. Wei and Mendiratta.
DECEMBER 2019 • 129