Carol Monson, DO. MS. FACOFP, FAAFPMSU College of Osteopathic Medicine

1. Develop and create the infrastructure for the implementation of a state-wide administrative division of geriatric medicine for MSUCOM affiliated Family Medicine and Internal Medicine Residencies to establish a network of osteopathic geriatric fellowships in the State of Michigan.

2. Build and sustain the development of a series of geriatric educational modules that will be available to all network geriatric fellowships and residency training programs; with the goal of achieving a continuum of geriatric medicine through the entire post-doctoral curriculum; and develop distance learning modules that can be implemented within the network training Programs.

3. Develop a Geriatric Medicine Curriculum that will be a required class for all medical students during the first two years of their pre-clerkship curriculum at MSUCOM. This course will be delivered by distance learning methods to all three campuses. FCM and DGIM will also begin integrating geriatric medicine into the existing Primary Care Ambulatory Clerkship (PCAC) in Unit Three of the clerkship years to achieve a firm continuum of geriatric medicine through the entire pre-doctoral curriculum.

4. Develop a second geriatric fellowship track curriculum that will allow for fellows in the program to extend their fellowship over a longer period of time, so they may be employed and working in a related medical practice while they are completing their requirements for certification in geriatric medicine.

5. Encourage the continuing development of new geriatric fellowship programs by documentation and dissemination of the fellowship projects, enduring materials, pre-doctoral and post-doctoral curricula to: additional osteopathic and allopathic geriatric fellowships, other hospital affiliates, and medical and nursing schools throughout the US.

12.4 % of the US population is age 65 or older

by 2020 this figure will double with the most rapid growth among ages 85 plus.

Michigan has more citizens older than 65 than 80% of other states in this country (US Census bureau 2000).

In 2005 the majority of Michigan’s 82 counties already had age 65 plus populations greater than 13%, with nearly half of the counties exceeding 15% and 14 counties greater than 20%.

While an aging population is a national problem, Michigan will be even further impacted by the continual loss of our younger citizens seeking employment in other states.

Four years ago, all but 10 counties (or 88%) in Michigan were designated as partial Primary Care Health Professional Shortage (HPSA) areas, now all but six counties (93%) in Michigan have this designation.

It will be the family physicians, general internists, physician assistants and nurse practitioners who will be the sources of primary medical care for these older adults with the consultation of fellowship-trained geriatricians.

Yet, there is a significant shortage of fellowship-trained geriatricians, and at the same time we are seeing fewer of our graduating medical students choosing family medicine or internal medicine as their areas of specialization

CONSEQUENCES More inappropriate use of Emergency

Room Sicker patients when they do present for

care Higher Cost Health Care Unhappy Patients and families

ALTERNATIVES Increase Geriatric Fellowships New Philosophies of Training and

Treatment◦ Optimal aging - The capacity to function across

many domains—physical, functional, cognitive, emotional, social, and spiritual – to one’s satisfaction and in spite of one’s medical conditions

New Philosophies of Training and Treatment◦ Successful aging - Absence of disease and

disability; high cognitive and physical functioning; and active engagement with life

◦ Geriatric Patient Centered Medical Home◦ Group Visits◦ Integrated Treatment Team◦ Development of Educational Modules for Training,

Medical Students, Residents, Fellows, Integrated Team and PatientsInclude Mind and Spirit as well as Body in Treatment