By Tyler Kung (DO '27)
Osteopathic medical student Tyler Kung (DO '27) reflects on his third-year clinical rotations at Beebe Healthcare and shares this perspective on what caring for geriatric patients has taught him about autonomy, complexity and dignity in medicine.
Just under 60% of the Lewes, Delaware, population is over the age of 65. Yes—you read that correctly. Last year, after the clinical rotation lottery, I learned that I would spend my third-year core rotations at Beebe Healthcare in Sussex County, Delaware, where much of my training centers on caring for the geriatric population. Although I first became interested in medicine after working in a nursing home during college, I was not fully prepared for the complexity of geriatric care.
Throughout this year, I have realized that geriatric healthcare is both critically important and often under-discussed. These patients bring a lifetime of experience and perspective, and the stories they share allow us to connect more deeply beyond their diagnoses.
When I took time to sit with patients and hear their stories, I saw how diverse and personal the experience of aging is. I met vibrant and independent 95-year-olds and cared for a 105-year-old living on her own. Their individuality reinforced the importance of individualized, patient-centered care—an essential principle at the core of osteopathic medicine.
From day one at PCOM, we are taught to consider the connection between mind, body and spirit. While this philosophy applies to all patients, it is especially important in geriatric care. Many geriatric patients are medically complex, often having undergone numerous interventions over the course of their lives.
Providing the best care begins with understanding the full context of a patient's life and shaping treatment to preserve autonomy and align with their goals. For some, that may mean pursuing aggressive treatment for serious illness; for others, it may mean managing chronic conditions in a way that allows them to maintain independence and quality of life.
During my internal medicine rotation, many patients were living with multiple conditions affecting different organ systems that required careful coordination and thoughtful treatment planning. Some patients had severely reduced kidney function, poor cardiac ejection fractions, or multiple comorbidities requiring constant reassessment and coordination. These experiences reinforced for me the need to understand every patient's individual treatment goals. No two patients with chronic kidney disease or congestive heart failure had the exact same treatment goals.
Another challenging aspect of my internal medicine rotation involved conversations about palliative and hospice care. I initially naively viewed hospice as a sign that we had failed to prevent decline. Over time, I realized that by alleviating suffering or helping patients define how they wish to live their remaining time, we are restoring autonomy and allowing them to live life on their own terms.
As a future physician, I hope to ensure that every patient receives the support and care they need—not only to improve clinically, but to live the life that they want for themselves. This experience strengthened my medical knowledge but, more importantly, deepened my ability to practice with empathy and compassion to care for the whole person.
Established in 1899, Philadelphia College of Osteopathic Medicine (PCOM) has trained thousands of highly competent, caring physicians, health practitioners and behavioral scientists who practice a “whole person” approach to care—treating people, not just symptoms. PCOM, a private, not-for-profit accredited institution of higher education, operates three campuses (PCOM, PCOM Georgia and PCOM South Georgia) and offers doctoral degrees in clinical psychology, educational psychology, osteopathic medicine, pharmacy, physical therapy, and school psychology. The college also offers graduate degrees in applied behavior analysis, applied positive psychology, biomedical sciences, forensic medicine, medical laboratory science, mental health counseling, physician assistant studies, and school psychology. PCOM students learn the importance of health promotion, research, education and service to the community. Through its community-based Healthcare Centers, PCOM provides care to medically underserved populations. For more information, visit pcom.edu or call 215-871-6100.
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