Geriatric Medicine Fellowship Program

The geriatric medicine fellowship, an ACGME-accredited program of Jackson Memorial Medical Center of the University of Miami School of Medicine, is administered through the Division of Gerontology and Geriatric Medicine of the Department of Medicine of the University of Miami School of Medicine. Eligible applicants are physicians who have completed training in an accredited program in Internal Medicine or Family Medicine. Although specialty board eligibility is met by a one-year fellowship, applicants who are interested in pursuing an academic or other leadership career in geriatrics are urged to apply for additional fellowship years.

Our JMMC/UM Geriatric Medicine Fellowship is a dynamic and evolving program, blending clinical, research, and teaching activities to meet the needs of fellows in training according to ACGME guidelines. Fellows trained in Miami have consistently graduated to career opportunities in clinical medicine, academic medicine, or health-care administration.

Affiliated Institutions

Jackson Memorial Hospital (JMH) is a licensed 1,558-bed teaching hospital located on the UM medical campus. This county hospital provides the bulk of specialty consultations and didactic support for the fellowship. It houses the geriatrics primary care clinic, and the acute care of the elderly (ACE) unit, where our fellows teach housestaff and medical students the basic elements of geriatric care. These clinical experiences also provide an important exposure for the fellows to many of the special issues facing our area's growing, yet underserved, minority elderly populations. The JMH patient population is ethnically diverse, with large numbers of African-Americans, Haitian-Americans, and Hispanics of Cuban, Central American, and South American origin. Inpatient and outpatient care is provided to a large population of Medicaid and uninsured residents of Miami-Dade County.

The Miami VAMC [Geriatrics and Extended Care (G/EC) and Geriatric Research, Education, and Clinical Center (GRECC)], a 400-bed academic medical center located on the UM campus, serves one of the oldest patient populations in the nation. More than 70% of our hospitalized patients are over 65, and a third of these are under the direct care of our G/EC and related medical service units, geriatric evaluation and management (GEM), extended care (ECU), hospice service, Home Based Primary Care (HBPC) and nursing home (NHCU) units. In addition, under the auspices of the GRECC, a wide range of clinical research and interdisciplinary geriatric care models exist and others are being developed within GRECC's clinical research and education foci (musculoskeletal problems, telecare, neurodegeneration, and prostate disease): falls prevention, acute geriatric medicine, prostate cancer, arthritis, osteoporosis, geriatric psychiatry, and geriatric primary care. Some patients in these models comprise the longitudinal outpatient and inpatient care portion of the fellowship training, including geriatric psychiatry patients. In addition, fellows are exposed to new models of care delivery, including telemedicine and care coordination. The nursing home is physically attached to the acute care hospital; the base fellowship office with its director and coordinating administrative assistant are located in the GRECC, which is housed in the nursing home, near the library; and the acute, subacute, and extended care units are located within the hospital. The primary care clinic is located in the main ambulatory clinic section of the medical center.

The Miami Jewish Home and Hospital for the Aged (MJHHA) PACE, the site of the state of Florida’s Teaching Nursing Home program, offers a range of levels of care, from adult living facilities to chronic and skilled nursing care for subacute and acutely ill totally dependent elderly persons. This private nonprofit facility serves predominantly women and exposes the fellows to concepts of Medicare/Medicaid and private pay services, as well as dedicated dementia units and the opportunity to observe over time the aging process in the institutional setting. The chief academic officer, medical director, and other geriatricians at MJHHA are full-time faculty members. In addition to fellowship rotations in geriatric medicine and psychiatry, MJHHA is the site of a required medical student clerkship in gerontology and geriatric care in which our fellows participate as junior faculty. Several of our visiting professors have lectured at MJHHA, which encourages attendance by both professional staff and persons from MJHHA and neighboring communities. While primarily known for its outstanding services as a long-term care facility, MJHHA also houses a 30-bed acute care unit (Olson Hospital) and a geriatric outpatient service. This small acute care unit provides our trainees opportunities to manage moderately ill patients in a limited-services hospital. Research by one of our former fellows demonstrated that patients with pneumonia cared for in the Olson unit fared no differently from patients cared for within our larger tertiary-care hospitals.

Peace River Regional Medical Center in Port Charlotte is one of two major acute care institutions serving Charlotte County, one of the oldest (nearly 40% of the population is over 65) counties in Florida and the nation. The hospital provides a full range of acute care services, but sends some major cases — e.g., liver transplantation, open-heart surgery — to nearby larger communities. The strength of this rotation is the unique opportunity for involvement in a retirement community and interrelated group practice experience and exposure to an active rehabilitation (skilled nursing) unit. Because of the lack of geriatricians (only 3 in the county several years ago; now the number is 6), the division became involved with the care providers and with the community's senior cultural center and related health services.  In addition to on-site supervision by a fellowship-trained geriatrician and a primary care board-certified internist (official division faculty members), the fellows round and review their activities with visiting geriatric medicine faculty, including the division director and the fellowship director, on a regular basis. The Port Charlotte rotation introduces our fellows to caring for active community-dwelling adults and the need, opportunities, and realities for a geriatrician-community leader in a prototypic lower-middle-class retirement community.

Joseph L. Morse Geriatric Center is a not-for-profit 280-bed skilled nursing facility located on the 37-acre Marilyn & Stanley M. Katz Seniors Campus in West Palm Beach, Florida. The campus provides a continuum of services that includes residential health care, an adult day care center, home health care, Kosher Meals-on-Wheels, and community educational and social programs. The newest addition, The Tradition of the Palm Beaches, opened in 2004. The Tradition offers 102 independent and 42 assisted-living rental residences in an environment that puts a premium on customer services and quality of life.

The Morse Geriatric Center serves predominantly Medicaid-funded, older women with an average age of 85 years. This clinical experience provides the fellows an important training opportunity to observe well “young” elders volunteering services for “old” elders, to create care partnerships with families geographically removed, and to appreciate patients’ perceptions of a broad sense of community and commitment associated with the Jewish faith. This institutionalized setting offers insight into married couples’ cohabitation and coping with combined frailties, shared cohort experiences such as holocaust survivorship, and institutional response to needs such as kosher food. The center also offers short-term rehabilitation care for seniors after a hospitalization or acute incident, as well as on-site hospice services under the direction of its full-time medical director, a fellowship-trained geriatrician and two geriatric nurse practitioners.

Geriatric Medicine Fellowship website: http://fellows.geriu.org

Contact Information
Please address all correspondence to: 

 Andrea Ruiz
 Fellowship Coordinator
 Geriatric Medicine Fellowship
 VA Medical Center, GRECC (11GRC)
 1201 NW 16th Street
 Miami, FL  33125

 aruiz2@med.miami.edu
 Office: 305-575-3388
 Direct Line 1: (305) 575-7231
 Direct Line 2: 1(888)276-1785
 Fax: 305-575-3365