University at Buffalo - The State University of New York

Published: August 28, 2003

By LOIS BAKER
Contributing Editor

UB has received a grant of $1,999,200 from the Donald W. Reynolds Foundation of Las Vegas to establish a Geriatric Center of Excellence in its School of Medicine and Biomedical Sciences.

The four-year project will focus on strengthening training in geriatrics across the medical spectrum—from medical students to physicians practicing in the community.

The project, to be based clinically in the UB-affiliated Kaleida Health System, is a natural fit for Western New York. The proportion of people ages 65 and older in the region reached 18.8 percent in 2000, larger than the percentage for New York State or the nation as a whole.

While the UB medical school curriculum provides significant exposure to medical problems of the elderly, several critical areas need to be enhanced, said Bruce Naughton, head of the UB Division of Geriatrics and director of the project.

"The initiative has three overarching objectives—undergraduate, graduate and continuing medical education, each with its own approach," said Naughton, associate professor of medicine. "All are united by common themes: the importance of knowing specific geriatric syndromes, such as delirium, falls, incontinence and depression; the need to perform comprehensive assessments, and understanding the risks of polypharmacy (prescribing too many medications).

"Moreover, the graduate medical education experience both builds on the undergraduate experience and contributes to it. Faculty development also is woven into each component, with a week-long intensive course in geriatrics planned for generalist, emergency and surgery faculty."

Undergraduate education in geriatrics will be enhanced in several ways: by incorporating conditions affecting the elderly into the school's organ-centered, problem-based learning curriculum; adding a geriatrics component to the two-year "Clinical Practice of Medicine" course during the second year, and offering eight competitive summer externships in geriatrics to students entering their second year.

Third- and fourth-year medical students will receive intensified geriatrics experience during their eight-week hospital rotations. Fourth-year students will admit, follow and discharge acutely ill older adults and spend more time on geriatrics issues during rotations in community-based clinics.

New geriatric training for residents will include a series of lectures targeted to geriatric medicine; use of individuals posing as "standardized patients" to simulate geriatric problems; conducting comprehensive assessments of patients in ambulatory settings, including mental and functional status, social resources and psychiatric condition; conducting chart reviews; keeping journals on polypharmacy, and presenting cases to residents and faculty for review.

Additional components designed for surgery and emergency medicine residents will be incorporated.

Components of the initiative aimed at improving geriatric care provided by physicians and surgeons in hospital settings include developing and implementing standards for recognizing post-operative delirium, controlling pain and providing better end-of-life or palliative care.

The grant is part of "The Campaign for UB: Generation to Generation," now in its final phase.

The Donald W. Reynolds Foundation is a national philanthropic organization founded in 1954 by the late media entrepreneur for whom it is named. Reynolds was the founder and principal owner of the Donrey Media Group, which he created in 1940 with the purchase of the Okmulgee (Oklahoma) Daily Times and the Southwest (Arkansas) Times Record.

During Reynolds' lifetime, he owned and operated more than 70 businesses, the majority of which were in the communications/media field. These holdings were primarily in the field of daily newspapers, outdoor advertising and cable-television companies. Headquartered in Las Vegas, the Donald W. Reynolds Foundation is one of the 50 largest private foundations in the United States.