The Geriatric Medicine Fellowship Program at the University of Texas Medical School at Houston (UTH) offers a one-year clinical fellowship program in geriatrics accredited by the ACGME.  The goal of this program is to train board-certified geriatricians to teach geriatrics to other clinicians and trainees as well as to be excellent clinicians who care for older patients in a wide-variety of settings.  Clinical training is offered across many types of care venues including: inpatient consultative and primary care services, geriatrics ambulatory and home-visits clinics, nursing homes, subacute and acute rehabilitation settings, geriatric psychiatry unit, neurology subspecialty services, palliative care consultative services and hospice care, and in wound-care clinics.  Didactic education is a key component of the training with formal education in aging physiology, clinical geriatrics, evidence-based medicine and biostatistics, palliative care, ethics, health care financing and regulations, and introduction to research study design. 

The Geriatric Medicine Fellowship Program at UTH will enroll its first cohort of fellows, two per year, in July 2008.  The Division of Geriatric and Palliative Medicine is new to the Department of Internal Medicine at UTH and was created in January 2007 with the recruitment of our Chief, Dr. Carmel Dyer to UTH.  Thus, the Division is a new, energetic division that is rapidly growing.   The Division currently has four geriatrician faculty with a fifth to begin in July 2008, as well as one palliative care physician, with one more to join in July 2008, two geriatric nurse practitioners and one physician assistant.  In this short period of time, the Division has received multiple awards and grants including a Geriatric Education Center through the Department of Health and Human Services, and two Geriatric Academic Career Awards.  Dr. Dyer has published widely with 10 publications in the last year including JAMA and the American Journal of Public Health.  She has also entered 10 papers as a special supplement in the Journal of the American Geriatrics Society on Elder Abuse and Neglect in 2008.  The Division is actively applying for several other large grants in the fields of research in elder abuse and neglect, and in geriatrics education.  

The Director of the Geriatric Medicine Fellowship Program at UTH is Dr. Kathryn Agarwal.  For more information about the program, you may contact her preferably via email.  Her contact information is below.

Dr. Kathryn Agarwal

Director, Geriatric Medicine Fellowship Program
Division of Geriatric and Palliative Medicine
University of Texas Medical School at Houston

6431 Fannin St., MSB 4.200
Houston, TX 77030

Email – Kathryn.S.Agarwal@uth.tmc.edu
Office (713) 500-6397
Fax (713) 500-0706

To learn more about all of our faculty, please click here.

 

Clinical Activities

The Geriatric Medicine Fellowship at UTH is based at two main teaching hospitals:  Memorial Hermann Hospital (MHH) and Lyndon B. Johnson General Hospital (LBJ). 

To learn more about Memorial Hermann Hospital, please click on the following website:  http://www.memorialhermann.org/aboutus/default.html. 

To learn more about the Lyndon B. Johnson General Hospital, which is part of the Harris County Hospital District, please click on the following website:
http://www.hchdonline.com/about/facilities/lbjgh.htm.

For a summary of the fellows’ planned clinical rotation schedule, please click here.

Our clinical activities at Memorial Hermann Hospital include:

• An inpatient Acute Care of the Elderly Unit (12-bed inpatient unit with interdisciplinary team, geriatric nurse practitioner, internal medicine resident, directed by Dr. Nasiya Ahmed).  The unit is opening in April 2008.  Currently we have an active inpatient service, that is not yet centrally located, but keeps a census of approximately 5 patients.
• An inpatient Geriatrics Consult Service.  The consult service is directed by Dr. Kathryn Agarwal, and is typically also staffed with an internal medicine resident.  The consult service is busy with approximately 1-2 new consults per day and approximately 3-5 follow-up visits.  Most of our consults are with the medicine services but we also collaborate with orthopedics, neurology, general surgery and cardiology. 
• A Palliative Care Consult Service, directed by Dr. Grace Varas.  The palliative care consult service was previously only nurse directed and still works closely with an excellent interdisciplinary team.  The service is still growing and we expect to have approximately three palliative care inpatient beds in the hospital in mid-2008. 

Other services through which the fellows will rotate at Memorial Hermann Hospital include: the Wound Care Clinic with Dr. Erik Maus, the Acute Rehabilitation Unit with Physical Medicine and Rehabilitation, Dr. Stephen Yang, and the Acute Stroke Service with Dr. Sean Savitz.  During the fellows’ time on the inpatient services at MHH, they will spend ½ day every other week with the wound care nurses who see consultations on the floors, and during palliative care will have the opportunity to visit hospice patients. 

Our clinical activities at Lyndon B. Johnson Hospital include:

• A combined Geriatric and Palliative Care Consult service directed by Dr. John Halphen.  The service is quite busy with a mixture of geriatrics and palliative care consultations, averaging 2 new consults a day and approximately 5 follow-up patients.  In July 2008, a new physician will be joining the practice who is boarded in both palliative care and geriatrics. 
• An Inpatient Geriatrics Unit has just opened at LBJ with approximately 6 beds. The unit is also directed by Dr. John Halphen. The unit does not take direct admissions from the emergency room but takes admissions from consultations done at LBJ or from the LBJ geriatrics practice. The inpatient unit and the consult service benefit from the assistance of a geriatric social worker, case manager, and physicians assistant. 
• A Wound Care Clinic and Pre-operative Evaluation Clinic occur weekly at LBJ and is also directed by Dr. Halphen.  The fellows will take advantage of these clinics while they are on service at LBJ. 

Continuity Clinical Experiences

The geriatrics fellow will be required to have an ambulatory clinic continuity experience weekly, a nursing home continuity panel experience every other week, and a home visit continuity panel experience every other week. 

• An Ambulatory Geriatrics Clinic is located at LBJ Hospital and will be the location of the fellows’ continuity clinic experience.  The Clinic is directed by Dr. Carmel Dyer, and is also attended by Dr. Halphen.  The clinic also has the shared resources of the interdisciplinary team at LBJ. 
• A Home Visits Program is also directed from LBJ by Dr. Dyer.  The home visits are typically seen by our experienced geriatrics nurse practitioners, Susan Gorman and Sabrina Pickens.  The fellows will go on home visits every other week and will experience both a continuity panel of patients as well as evaluations of patients as requested by Adult Protective Services.
• The Nursing Home Continuity Experience will be one-half day every other week at St. Dominic’s Nursing Home with Dr. Julia Reyser.  The fellow will obtain a panel of approximately 10 nursing home patients who they will follow and function as their primary care provider over the course of the year. 

Other Clinical Sites:

• Subacute Rehabilitation and Hospice Rotation

Dr. Bijou Oommen is directing this rotation.  Dr. Oommen is a busy private geriatrician who practices in three local skilled nursing facilities (including subacute rehabilitation and nursing home) and medical director at a local hospice.  During this month, the fellow will join Dr. Oommen in his busy practice and learn more about practice management issues, and regulatory issues, as well as patient management in these diverse settings. 

• Geriatric Psychiatry Rotation at Harris County Psychiatry Center

The Geriatrics Fellows will spend one month at the Harris County Psychiatry Center on the new Geriatric Psychiatry Unit working with a geriatric psychiatrist as well as a geriatric medical consultant.  Geriatric psychiatry is a critical element in geriatric fellowship training. 

• Specialty Clinics in Neurology and Urology

The Geriatrics Fellows will spend two weeks visiting the neurology and urology clinics in the UT Professional Building.  Many opportunities are present including, general neurology clinics, movement disorder clinics, geriatric epilepsy clinic, general urology and incontinence clinics. 

Didactic Teaching Conferences

The fellowship program will have conferences for the sole purpose of teaching the geriatrics fellows at least weekly as well as conferences affiliated with the weekly ambulatory clinic.  Many other conferences are available and their attendance will be strongly encouraged throughout the medical school.  We are also pleased to share teaching resources with the Geriatrics Fellowship Program at Baylor College of Medicine, so many conferences may be held jointly with Baylor.

The conference schedule is available by clicking here.

Application Process

The Geriatric Medicine Fellowship program at UTH is not currently on ERAS.  We are currently accepting applications for July 2008, and July 2009.  We encourage residents from accredited Internal Medicine or Family Practice Residency programs in the United States to apply.  Unfortunately, UTHSC does NOT accept H1B visas.  We require the following materials:

Required Materials:

1. Curriculum Vitae
2. 3 Letters of Reference (should be from your current colleagues if you are already in practice, at least one letter should be from your residency program director)
3. Personal Statement (why you want to do geriatrics fellowship, what are your goals and interests)
4. Medical School Diploma (translated if needed)
5. Medical School Transcript (translated if needed)
6. USMLE Step Scores (Steps 1 & 2 required, 3 can be scheduled/planned)
7. ECFMG Certificate
8. Visa Status / citizenship status

Please send these materials electronically and / or by mail to:

Dr. Kathryn Agarwal
Director, Geriatric Medicine Fellowship Program
Division of Geriatric and Palliative Medicine
University of Texas Medical School at Houston
6431 Fannin St., MSB 4.200
Houston, TX 77030
Email – Kathryn.S.Agarwal@uth.tmc.edu
Office (713) 500-6397
Fax (713) 500-0706

Pay and Benefits

Fellows’ pay and benefits are controlled by the office of Graduate Medical Education at the University of Texas Medical School at Houston.  The Geriatrics Fellows will typically receive pay as a PGY-4 level trainee.  Please click on the following link to learn more about the leave, benefits, and pay through the Office of Graduate Medical Education.   http://med.uth.tmc.edu/administration/gme/benifits.html