AAIM


Insight Summer 2003: APDIM Receives Geriatrics Subcontract, Begins Work at Spring Meeting

APDIM Receives Geriatrics Subcontract, Begins Work at Spring Meeting

This winter, the Association of Program Directors in Internal Medicine (APDIM) received a $180,000 grant from the John A. Hartford Foundation (JAHF)—through a subcontract with the Society of General Internal Medicine (SGIM)—for the project entitled “Training for Excellence in the Care of Older Americans.” The project began with activities at the 2003 APDIM Spring Conference, March 31-April 2, in San Diego, CA.

Led by Principal Investigator and former APDIM President Lisa Wallenstein, MD, the project is one of three parts of a larger JAHF/SGIM initiative entitled “Increasing Education and Research Capacity to Improve Care of Older Americans.” The largest project under this initiative funds 10 medical research and education centers designed to promote the collaboration of general internal medicine and geriatrics. Another project involves a review of the geriatrics content of key internal medicine residency examinations by the American Board of Internal Medicine, the In-Training Examination Committee, and SGIM.

The APDIM project, “Training for Excellence in the Care of Older Americans,” has four primary objectives:
  • Identify a core group of APDIM officers, councilors, and staff engaged in and committed to the initiative.
  • Assess the adequacy of internal medicine residency training in the care of older Americans.
  • Develop “Training for Excellence in the Care of Older Americans” as a central theme for APDIM in its core activities, including national meetings.
  • Identify strategies to support program directors in implementing initiatives to improve residency training in the care of older Americans.

“This funding will allow APDIM to make significant strides in assessing the quality of residency training in geriatrics from the perspective of both program directors and residents,” said Dr. Wallenstein. “Most importantly, we hope this project will be the first step in a national effort to enhance and improve the care of older Americans,” she added.

Activities related to this project commenced at the 2003 APDIM Spring Meeting. Rosanne Leipzig, MD, PhD, Vice Chair for Education in the Division of Geriatric Medicine at Mount Sinai School of Medicine and Kelley Skeff, MD, PhD, Program Director of the Department of Medicine at Stanford University School of Medicine, presented a plenary session entitled, “Training Internists to Care for Aging Patients: A Model for Systems-Based Practice.” Dr. Leipzig discussed ways in which geriatrics is well suited to teach and assess the competencies of systems-based practice, while Dr. Skeff asked participants to identify knowledge, skills, and attitudes that need improvement for geriatrics to be taught more effectively to residents.

Using an audience response system, attendees participated in an interactive survey throughout the plenary session. Results from this survey will be used to assess the status of residency training in geriatrics and to develop programs at future APDIM meetings.

Dr. Leipzig also led a workshop entitled “When Should Old People Get New Drugs?: An Evidence-Based Approach.” The workshop demonstrated methods for critically appraising pharmaceutical advertisements, evaluated whether older adults can expect additional value with new medications, and identified ways to minimize adverse effects when prescribing new drugs to older adults.

During the 20th Annual Chief Residents’ Workshop, held in conjunction with the APDIM Spring Conference, a number of chief residents shared personal experiences in geriatric training in a focus group sponsored by the grant and facilitated by Dr. Wallenstein. Participants recounted their own residency experiences in geriatric training, described the benefits and frustrations of caring for older patients, and suggested strategies and resources that might improve the quality of residency training in geriatrics. In addition, a number of chief residents who participated in the focus group indicated interest in continuing to work with APDIM on this project.

Focus groups with recent residency program graduates currently in practice are planned for fall 2003. These focus groups are designed to provide an additional perspective on the quality of residency training in geriatrics. In addition to the recent graduate focus groups, Dr. Wallenstein and AAIM staff will analyze the data from the program director’s survey. A summary of the chief residents focus group and highlights of the program director’s survey will be included in the next issue of the Academic Internal Medicine Insight.

For more information about this project, please contact AAIM Grants Assistant Irene S. Sonu at (800) 622-4558 or isonu@im.org.