General Attitudes MS1 Courses
Competency Topic Description Course Method
Myths and Communicating with an older patient Physical Diagnosis Lecture Stereotypes Myths and Discussion of stereotyping and heterogenity of older Nutrition Lecture Stereotypes populations Heterogeneity In longevity, cognition, personality, mood Psychiatry Lecture Nutrition can have a significant impact on the rate of Heterogeneity Nutrition Lecture aging Openness and willingness to work Doctor/Patient Interdisciplinary health care team Lecture with other Relationship disciplines Openness and willingness to work Working with teams of health care providers Social Medicine Small Group with other disciplines Developing empathetic connections between physicians Doctor/Patient Compassion Lecture and patients; nonverbal communication Relationship Compassion Communicating with an older patient Physical Diagnosis Lecture Attitude Toward a Attitude Toward a Career in Geriatrics Survey Survey Career in Geriatrics Attitudes Toward Attitudes Toward the Elderly Survey Survey the Elderly Geriatrics Attitudes UCLA Geriatrics Attitudes Scale Survey Survey Scale MS2 Courses
Competency Topic Description Course Method
Openness and willingness to work Essential for comprehensive geriatric assessments; Geriatrics Lecture with other isolated interventions are generally of minimal benefit disciplines Improving and Goal of geriatric medicine is to maximize function, Optimizing decrease decline and improve quality-of-life; older Geriatrics Lecture Function patients want to remain independent Improving and Optimizing Screening functional status Physical Diagnosis Lecture Function
General Knowledge-Related to the Basic Sciences MS1 Courses
Competency Topic Description Course Method
Demography and Increasing numbers; life expectancy Psychiatry Lecture Epidemiology Demography and The future of medicine; community-oriented primary care Social Medicine Lectures Epidemiology
General Knowledge-Related to the Basic Sciences (continued) MS1 Courses
Competency Topic Description Course Method
Demography and Healthy nutritional lifestyle can improve life expectancy Nutrition Module Epidemiology and quality of life Caloric restriction; reactive oxygen species; post- Theories of Aging Biochemistry Lecture translational modification of proteins: glycoslation
Theories of Aging Premature aging syndromes and telomere shortening Hematology Lecture
Aging, immunology and immunosenescence; oxidative Theories of Aging Immunology Lecture stress; cytokine dysregulation
Theories of Aging Free radicals Pathology Lecture
Theories of Aging Oxidative stress; caloric restriction Nutrition Module
"Normal" Aging is Longevity and cognition, personality, and mood Psychiatry Lecture Heterogeneous "Normal" Aging is Loss of lean body mass and aging Nutrition Module Heterogeneous Preventable, Treatable Aging Disuse atrophy Physiology Lecture Processes Preventable, Treatable Aging Sun exposure of skin and aging Histology Lecture Processes Preventable, Nutrition health behaviors and successful aging; Treatable Aging nutritional recommendations; strength training and Nutrition Module Processes healthy aging; vitamin intake and aging Anatomic and Neuronal tissue histology correlated with Alzheimer's Histologic Histology Lecture and Parkinson's disease Changes
Pathology Aging cartilage; osteoporosis Histology Lecture
Pathology Immunobiology of aging Immunology Lecture
Increasing frequency of urinary tract infections with Pathology Microbiology Lecture increasing age Alzheimer's disease and neurofibrillary tangles/amyloid; Pathology Pathology Lecture brain and myocardial infarcts
Physiology Electrolytes and water transport Physiology Lecture
Physiology Changes in various organ systems with aging Psychiatry Lecture
Decline is normal but varies markedly from system to Physiology Nutrition Module system Toxicity of amino glycosides; general emphasis on need Pharmacologic for adequate renal function with antibiotics excreted by Microbiology Lecture Changes kidney; and caution for use in elderly who frequently have impaired renal clearance of many of these drugs
General Knowledge-Related to the Basic Sciences (continued) MS1 Courses
Competency Topic Description Course Method
Pharmacologic Biologic changes affecting pharmacologic treatment Psychiatry Lecture Changes Clinical pharmacokinetics - altered drug elimination in Pharmacologic elderly; changes in volume of distribution with age; Pharmacology Lecture Changes factors mitigating against medication compliance MS2 Courses Demography and Demographic imperative Geriatrics Lecture Epidemiology "Normal" Aging is Occurs at varying rates among individuals and within Geriatrics Lecture Heterogeneous Preventable, Normal aging isn't always disease but lifestyle and Treatable Aging prevention significantly affect aging; priority of geriatric Geriatrics Lecture Processes medicine is to maximize function and quality of life Loss of Impaired with aging Geriatrics Lecture Homeostasis Loss of 74 yo male with fractures resulting in increased risk for Geriatrics Small Group Homeostasis frailty Anatomic and Multi- Histologic Temporal lobe lesions and aphasia Neuroanatomy disciplinary Changes case Disorders of autonomic nervous system with age; brain Pathology lesions and visulospatial deficits; deficits of cerebral Neuroanatomy Lecture cortex; Alzheimer's disease Pathology cases - stroke; meningitis in elderly patient; Pathology Neurology Small Group Alzheimer's disease Sleep pathology; age-related macular degeneration; glaucoma; diabetic retinopathy; pathology of the Pathology degenerative diseases of the central nervous system Neurology Lecture (Alzheimer's, Parkinson's, dementia with Lewy bodies); stroke pathology Pathology of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies; subdural hemorrhage; stroke (embolic Pathology Neuropathology Lecture and due to cerebral vascular disease); glioblastoma multiforme; 81 yo with meningitis; 68 yo male with probable Alzheimer's disease Pathology Pulmonary embolism and aging; obstructive sleep apnea Pulmonary Lecture Nursing home resident with pneumonia; elderly female Pathology with alkalosis and electrolyte disturbances; pulmonary Pulmonary Small Group embolism and aging; obstructive sleep apnea Osteoporosis; abnormal uterine bleeding; urinary Pathology Reproductive Lecture incontinence Physiology Baroceptor reflex, hippocampus and memory Neuroanatomy Lecture Physiology Normal sleep physiology Neurology Lecture
General Knowledge-Related to the Basic Sciences (continued) MS2 Courses
Competency Topic Description Course Method
Neurotransmitters and receptors of the central nervous Physiology Neuropharmacology Lecture system Neurophysiology of post-herpetic neuralgia in older Physiology Neurophysiology Lecture individuals Decreasing FEV1/FVC with aging; DLCO variability and Physiology Pulmonary Lecture age
Physiology Decreasing pulmonary capacities with age Pulmonary Physiology Lecture
Menopause; pharmacology of estrogens and progestins Physiology Reproductive Lecture and hormone replacement; male climacteric Physiology of successful aging; functional limitations Physiology result from physiologic decline; chronic disease burden Geriatrics Lecture and lifestyle choices Pharmacologic Age-associated physiologic changes that affect Geriatrics Lecture Changes prescribing of medications Pharmacologic 68 yo woman and diminished creatinine clearance Geriatrics Small Group Changes
General Knowledge-Related to the Clinical Practice MS1 Courses
Competency Topic Description Course Method
Amyloid & relationship to Alzheimer's disease; Dementia aggregation of misfolded proteins in Alzheimer's and Biochemistry Lecture Parkinson's disease Dementia Alzheimer's disease Genetics Lecture Alzheimer's & Parkinson's diseases as major causes of Dementia Pathology Lecture death Alzheimer's disease and inheritance; cognition and Dementia Psychiatry Lecture aging Mood disorders and neurotransmission; depression and Depression associated medical diseases; depression and brain Psychiatry Lecture imaging; human aging; bereavement and grief Falls Fall statistics; subdural hematoma Pathology Lecture Intrinsic (deep) muscles of the back and vertebral Osteoporosis Gross Anatomy Lecture column (kyphosis) Osteoporosis Changes in resorption/formation of bone with aging Histology Lecture Non-specific Presentation of older patient with low white blood count Presentation of Pathology Lecture with acute infection Disease MS2 Courses Dementia Mini-Mental State Examination Neurology Lecture Dementia Drugs for Alzheimer's disease; antipsychotics Neuropharmacology Lecture Dementia Screening for cognitive impairment Physical Diagnosis Lecture General Knowledge-Related to the Clinical Practice (continued) MS2 Courses
Competency Topic Description Course Method
Dementia Risk factors; criteria; types; pathophysiology; diagnosis Geriatrics Lecture 90 yo woman with hallucination, poor memory and Dementia Geriatrics Small Group propensity to fall; 90 man with poor memory Inappropriate Side effects are accentuated in the elderly and certain Prescribing of Geriatrics Lecture medications contraindicated in the elderly Medications Depression Drugs for treatment of depression Neuropharmacology Lecture Depression Screening for depression Physical Diagnosis Lecture Presentation; diagnosis; suicide; evaluation; treatment Depression Geriatrics Lecture options 84 yo woman hospitalized for two months with acute Depression Geriatrics Small Group myocardial infarction now complicated by depression Delirium Coma and delirium Neurology Lecture Delirium Difficult diagnosis; criteria; assessment Geriatrics Lecture Delirium Hallucinating 90 yo woman Geriatrics Small Group Falls Gait disorders Neurology Lecture Multi- Potential clinical case scenarios developed by students, Falls Physical Diagnosis disciplinary includes suggestion of elderly patient with recurrent falls case Falls Screening for falls Physical Diagnosis Lecture Cycle and prevention of falls; look for decline due to Falls Geriatrics Lecture other organ systems Pathogenesis of osteoporosis; clinical presentation of Osteoporosis Endocrinology Lecture osteoporosis Musculoskeletal Osteoporosis Osteopenia; kyphosis due to compression fractures Lecture Pathology Osteoporosis Etiology of osteoporosis in the elderly Geriatrics Lecture Alterations in Decreased smell and aging Neuroanatomy Lecture Special Senses Alterations in Hearing and balance disorders; testing visual acuity; Neurology Lecture Special Senses glaucoma Age-related macular degeneration; pinguecula in elderly Alterations in with sun exposure; glaucoma; cataracts; retinal disease Neuropathology Lecture Special Senses in diabetes mellitus Alterations in Small group exercise on glaucoma Neuropharmacology Small Group Special Senses Alterations in Treatment of glaucoma Neuropharmacology Lecture Special Senses Presbyopia and cataracts; age-related macular Alterations in degeneration; diabetic retinopathy; glaucoma; decreased Neurophysiology Lecture Special Senses hearing with age Failure to Thrive Decline associated with frailty Geriatrics Lecture Sleep Disorders Sleep apnea; restless leg syndrome; depression Neurology Lecture Sleep Disorders Sedative/hypnotic drugs Neuropharmacology Lecture Sleep Disorders Analysis of sleep using EEG Neurophysiology Lecture Sleep Disorders EEG and sleep Neurophysiology Lab
Knowledge of Disease and Disorders MS1 Courses
Competency Topic Description Course Method
Rheumatologic Glucosamine/chondroitin & osteoarthritis; gout Biochemistry Lecture Diseases Rheumatologic Myology of the upper limb (rotator cuff) Gross Anatomy Lecture Diseases Rheumatologic Dermatomyositis; age and malignancy Pathology Lecture Diseases Genito-urological Midgut and hindgut (colon cancer) Gross Anatomy Lecture Diseases Neurological Neurotransmitters and Parkinson's disease Biochemistry Lecture Diseases Stroke; Ach receptors; GABA receptors; L-DOPA & Neurological Parkinson's disease; neurotransmitter serotonin & General Physiology Lecture Diseases depression Neurological Multi-infarct dementia Pathology Lecture Diseases Neurological Parkinson's disease and neurotransmitters; Psychiatry Lecture Diseases psychological dimensions of aging Cardiovascular Acute myocardial infarction resulting from reduced Biochemistry Lecture Diseases oxygen supply Heart and middle mediastinum (coronary artery Cardiovascular disease); posterior abdominal wall (abdominal aortic Gross Anatomy Lecture Diseases aneurysm); superior and posterior mediastina (aortic aneurysm) Cardiovascular Increase of vascular resistance with aging Histology Lecture Diseases Cardiovascular Cardiovascular disease Genetics Lecture Diseases Age as a risk factor for cardiovascular disease; Cardiovascular aneurysm of aorta; peripheral vascular disease and Pathology Lecture Diseases claudication Cardiovascular Lidocaine dosing in older patient; antioxidants and heart Pharmacology Lecture Diseases disease Endocrinological Insulin resistance; type 2 diabetes mellitus Biochemistry Lecture Diseases Endocrinological Diabetes mellitus and aging Histology Lecture Diseases Endocrinological Diabetes mellitus Genetics Lecture Diseases Anterior thoracic wall; breast and lymphatic system Cancer of Various (breast cancer); male reproductive system (benign Gross Anatomy Lecture Organs prostatic hypertrophy and carcinoma of prostate) Cancer of Various Prostate cancer Histology Lecture Organs Cancer of Various Hyperosmolar coma and non-insulin-dependent diabetes Pathology Lecture Organs mellitus
Infections Immunologic dysfunction and infection in elderly Immunology Lecture Knowledge of Disease and Disorders (continued) MS1 Courses
Competency Topic Description Course Method
Strep group B as source of infection in elderly; salmonella infection and elderly; anaplasma phagocytophilum and elderly; mycobacterium and long- Infections Microbiology Lecture term care facilities; malaria in elderly female with compromised immunity; astrovirus and nursing home infections; influenza and vaccination Gastroenterological Gall stones and aging Histology Lecture Disorders Gastroenterological Poor nutrition in the elderly Pharmacology Lecture Disorders Psychiatric Parkinson's disease and neurotransmitters; Psychiatry Lecture Diseases psychological dimensions of aging Other Disease and B12 and pernicious anemia Histology Lecture Disorders MS2 Courses
Competency Topic Description Course Method
Rheumatologic Cardiovascular Case study of temporal arteritis Lecture Diseases Pathology Advanced age as a risk factor for septic joints; Rheumatologic osteoarthritis; polymalgia rheumatica; hip fractures; Musculoskeletal Lecture Diseases lumbar spinal stenosis Rheumatologic Paget's disease (disease of elderly Caucasians); Musculoskeletal Lecture Diseases rheumatoid arthritis; osteoarthritis Pathology Genito-urological Alpha adrenergic receptors; urinary incontinence and Neuropharmacology Lecture Diseases antimuscarinic agents Genito-urological "Senile vaginitis" Reproductive Pathology Lecture Diseases 67 yo male with cerebrovascular disease; 66 yo with progressive weakness of both legs (amyotrophic lateral Neurological sclerosis); 63 yo male with cerebrovascular accident; 63 Neuroanatomy Small Group Diseases yo female with Parkinson's disease); neuro-imaging of 63 yo with cerebrovascular disease Intention tremor; basal ganglia and Parkinson's disease; Neurological hypothalamus and homeostatic regulation (heat loss and Neuroanatomy Lecture Diseases conservation, body temperature, regulation of water balance) Neurological Parkinson's disease and dementia; normopressure Neurology Small Group Diseases hydrocephalus and dementia Neurological Temporal arteritis; tremor types; Parkinson's disease; Neurology Lecture Diseases essential tremor; chronic subdural hematomas; stroke Neurological Anti-parkinsonian agents Neuropharmacology Lecture Diseases Neurological Memory: recent and long term memory; molecular basis Neurophysiology Lecture Diseases for memory Neurological Cognition impairment and aging Geriatrics Lectures Diseases Knowledge of Disease and Disorders (continued) MS2 Courses
Competency Topic Description Course Method
Acute myocardial infarction; dyslipidemias; hypertension Cardiovascular increases with age; occlusive arterial disease; transient Cardiovascular Lecture Diseases ischemic attacks and strokes Congestive heart failure; ischemic heart disease Cardiovascular Cardiovascular (myocardial infarction, angina; atherosclerosis and Lecture Diseases Pathology hypertension; aortic aneurysms) Cardiovascular Congestive heart failure and thirst regulation Neurophysiology Lecture Diseases Cardiovascular Pulmonary Use of loop diuretics in the elderly Lecture Diseases Pharmacology Cardiovascular Systolic hypertension; ischemic heart disease; Geriatrics Lecture Diseases cardiovascular reserve lowers threshold for heart failure 70 yo with atrial fibrillation and risk of stroke/death and Cardiovascular anticoagulation with Coumadin; 63 yo male with Science of Medicine Small Group Diseases pancreatic cancer and deep vein thrombosis; treatment of 70 yo male with congestive heart failure Endocrinological Pathogenesis of osteoporosis; clinical presentation of Endocrinology Lecture Diseases osteoporosis Case study of 68 yo female with hyperaldosteronism; Endocrinological Endocrinology 74 yo female with iatrogenic Cushing's syndrome and Lecture Diseases Pathology osteoporosis; hypothyroidism With aging: association with type 2 diabetes mellitus; metabolic syndrome; increasing fat mass; reduction in mitochondrial oxidative and phosphorylative function; treatment of type 2 diabetes; dyslipidemia; oxidative Endocrinological stress and athero-sclerosis in diabetes; hypo-thyroidism Nephrology Physiology Lecture Diseases increases with increasing age; screening for hypothyroidism; adrenal androgens decrease; osteo- malacia; male reproductive physiology (decreasing testosterone); treatment of andropause with testosterone Endocrinological Hypophalamic regulation of pituitary hormones (in Neurophysiology Lecture Diseases particular TSH, growth hormones and sex hormones) Cancer of Various Skin cancers Dermatology Pathology Lecture Organs Cancer of Various 70 yo demented nursing home resident with Hematology Small Group Organs pancytopenia Acute non-lymphoblastic leukemia; chronic lymphocytic Cancer of Various leukemia; monoclonal gammopathy of undetermined Hematology Lecture Organs significance/multiple myeloma Cancer of Various Metastatic bone cancers (prostate, breast, kidney, Musculoskeletal Lecture Organs thyroid, lung); multiple myeloma Pathology Cancer of Various Renal cell carcinoma; bladder cancer Nephrology Pathology Lecture Organs Cancer of Various Breast cancer; endometrial cancer Reproductive Pathology Lecture Organs Decreased numbers of nephrons with age; decreased Infections Nephrology Physiology Lecture creatinine production in elderly and females
Knowledge of Disease and Disorders (continued) MS2 Courses
Competency Topic Description Course Method
Benign prostate hypertrophy; prostate cancer; Renal Diseases transitional cell bladder cancer-nonmalignant; Nephrology Pathology Small Group hypertension
Renal Diseases Decreased creatinine clearance with age and frailty Geriatrics Lecture
Renal Diseases 68 yo woman and diminished creatinine clearance Geriatrics Small Group
67 yo with lung cancer and syndrome of inappropriate antidiuretic hormone; 64 yo female with metabolic acidosis; 70 yo female with chronic obstructive Renal Diseases Nephrology Small Group pulmonary disease induced acid/base disturbance; 70 yo female with ruptured aortic aneurysm with acute tubular necrosis Urinary obstruction and prostatic hypertrophy; urinary tract infection in females > age 60 and estrogen Renal Diseases Nephrology Lecture deficiency; creatinine clearance - relationship to muscle mass production of creatinine; Cockcroft-Gault equation Type 2 diabetes and nephropathy: obstructive nephropathy and prostate disease; BPH and prostate Renal Diseases cancer; nephrosclerosis and hypertension; acute Nephrology Pathology Lecture interstitial nephritis in elderly males with obstructive uropathy Older age as risk factor for Barrett's esophagus; NSAIDs as risk factor for peptic ulcer disease in aging Gastroenterological population; perforation of peptic ulcer and elderly; age GI and Nutrition Lecture Disorders as risk factor for colon cancer; constipation; inflammatory bowel disease and aging; cholelithiasis and aging Gastroenterological 68 yo with cholelithiasis; 67 yo with peptic ulcer disease GI and Nutrition Small Group Disorders due to NSAIDs Diverticular disease of colon; colon cancer; Gastroenterological GI and Nutrition cholelithiasis; pancreatic carcinoma and age Lecture Disorders Pathology association; Use of COX 2 agents in elderly; agents used to treat Gastroenterological GI and Nutrition constipation; age as a risk factor for drug induced liver Lecture Disorders Pharmacology disease Gastroenterological Treatment of 75 yo female with osteoarthritis Science of Medicine Small Group Disorders Psychiatric Dementia; delirium; depression Geriatrics Lecture Diseases Other Diseases and Myelodysplastic syndromes in older adults Hematology Lecture Disorders Other Diseases and 75 yo with right total hip and pulmonary embolism; 75 yo Science of Medicine Small Group Disorders debilitated smoker with possible pulmonary embolism Other Transfusion in elderly to avoid myocardial ischemia; Hematological chronic lymphocytic leukemia in older adults; Hematology Pathology Lecture Disease and lymphadenopathy in older age may represent neoplastic Disorders disease; non-Hodgkin's lymphomas Other Hematological Tutorial: 72 yo male with iron deficiency anemia; 65 yo Hematology Pathology Small Group Disease and male with chronic lymphocytic leukemia Disorders Knowledge of Disease and Disorders (continued) MS2 Courses
Competency Topic Description Course Method
Other Pulmonary Pulmonary edema; community-acquired pneumonia Diseases and Pulmonary Lecture and older age Disorders Other Pulmonary Pneumonia (bacterial and tuberculosis; chronic Diseases and obstructive pulmonary disease; lung cancer; Pulmonary Pathology Lecture Disorders paraneoplastic syndromes and lung cancer
Knowledge of Psychosocial Issues MS1 Courses
Competency Topic Description Course Method
Normal Behavioral Attitude toward aging, retirement, death of loved one & Psychiatry Lecture Late-Life Changes own mortality Normal grief versus pathologic grief; stages of grief; Psychopathology Psychiatry Lecture depression Community Social support and caregivers Psychiatry Lecture Resources Community Small group experience in aging-related community Social Medicine Small Group Resources services - a portion of students choose this activity Adaptation to Care in Alternative Living Assisted living and nursing home Psychiatry Lecture Situations MS2 Courses
Competency Topic Description Course Method
Under-reporting of Symptoms and Occurrence in elderly Hematology Pathology Lecture Illnesses Under-reporting of Symptoms and Patients are reluctant to complain of functional decline Geriatrics Lecture Illnesses
Knowledge of Prevention MS1 Courses
Competency Topic Description Course Method
Primary Prevention Preventive Health Care Social Medicine Lecture
Primary Prevention Nutritional recommendations for successful aging Nutrition Module
Primary Prevention Pneumococcal vaccination; influenza vaccination Pulmonary Lecture
Knowledge of Prevention (continued) MS2 Courses
Competency Topic Description Course Method
Benefits of comprehensive geriatric assessment have Primary Prevention been proven; appropriate interventions decrease frailty Geriatrics Lecture decline Anticipation of potential deficits and institution of Secondary preventive measures is the goal of functional Geriatrics Lecture Prevention assessment; early identification of geriatric syndromes; comprehensive geriatric assessments Screening for functional decline due to hospitalization Tertiary prevention with appropriate intervention strategies reduces re- Geriatrics Lecture hospitalization and admittance to nursing homes
Knowledge of Ethical Issues MS1 Courses
Competency Topic Description Course Method
End-of-Life Care Attitudes toward death; giving bad news Psychiatry Lecture Passed MS2 Courses
Competency Topic Description Course Method
Pain Management Pathophysiology and management of pain Neurology Lecture Passed Opioids; under treatment of pain; side effects of Pain Management Neuropharmacology Lecture opioids Pain Management Evaluating pain/pain scales Neurophysiology Lecture Doctor/Patient End-of-Life Care Delivering bad news Lecture Relationship Health Care Improving function decreases time of disability or Geriatrics Lecture Financing frailty and medical expenditures
Skills MS2 Courses
Competency Topic Description Course Method
Geriatric Screening for cognitive impairment Physical Diagnosis Lecture Passed Assessment Geriatric Screening for falls Physical Diagnosis Lecture Assessment Geriatric Lecture and Functional assessment (ADLs and IADLs) Geriatrics Assessment demonstration Skills-Physical Use of the Mini-Cog to assess cognitive impairment Physical Diagnosis Lab Diagnosis Skills-Physical Use of the “Timed Up and Go” to assess fall risk Physical Diagnosis Lab Diagnosis