Post-Acute/Long Term Care and Rehabilitation Services
Fellows receive a longitudinal experience through the PCOM Geriatrics Post-Acute/Long
Term Care and Rehabilitation Services. Fellows are assigned a panel of patients that
they follow throughout the entire fellowship for regulatory visits. They are also
responsible for admissions, re-admissions, acute visits, discharges and transitional
care evaluations. The program enables regular interaction with multidisciplinary team
members, such as nurses, nurse practitioners, pharmacists, speech therapists, physical
therapists, social workers and psychologists. This is an interprofessional education
experience where fellows work alongside trainees of other disciplines to provide care.
In addition, fellows receive training in the administrative aspects of PALTC.
Fellows are assigned two half days per week in the PCOM outpatient geriatric office
focusing on geriatric health maintenance and preventative health measures, multi-morbidity,
chronic disease management and advanced care planning. Fellows learn how to access
community health resources, perform comprehensive geriatric evaluations, cognitive
evaluation, continence clinic, wound care and wound management and all aspects of
outpatient elder care.
Fellows provide medical consultative services via PCOM geriatric and palliative care
inpatient consult service. They provide house staff with guidance on issues related
to geriatric transitional care management, goals of care/advanced care planning, management
of geriatric syndromes, ethical issues, deprescribing and quality improvement measures.
Fellows are immersed in a month-long home care experience via PCOM Residentialist
Housecall Medical Group. During that time, they manage and care for frail homebound
members of the Philadelphia community as both consultants and primary care providers.
Fellows who are interested in home care as a career can also be afforded additional
Hospice and Palliative Medicine
Fellows have scheduled rotations in the subspecialty areas of hospice and palliative
medicine. Inpatient and outpatient hospice and palliative care consults through the
Holy Redeemer Health System (including their partnership with the MD Anderson Cancer
Center), Roxborough Hospital and PCOM clinic provide fellows with a well-rounded experience.
Fellows learn to care for hospice at all levels of care ranging from routine home
care, to continuous crisis and general inpatient care. Fellows receive training in
administrative hospice and palliative care via participation in interdisciplinary
team meetings and working with the medical directors.
Fellows have a dedicated psychiatry rotation at the inpatient psychiatric unit at
Roxborough Hospital. They also manage patients with psychiatric illnesses in post-acute
and long term care in concert with attending physicians
Fellows have a dedicated wound care month where they learn outpatient and inpatient
wound management. Wound management is also an ongoing part of the geriatric ambulatory
clinic, home care and post acute and long term care. Fellows learn the basics of pressure
ulcer staging, wound characteristics, wound management, wound debridement, principles
of wound dressings, preventive measures and use of support surfaces.
Fellows can elect additional rotations in other areas such as osteopathic manipulative
medicine, rheumatology, orthopedics and neurology or any other specialty of their
choice to better prepare them to care for older patients. They can also choose an
additional elective rotation for research and quality improvement projects.