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New Curriculum Addresses Aging and Geriatrics

Kris Manlove-Simmons is a fourth-year medical student who plans to specialize in geriatric medicine. She is thrilled about the new geriatric and gerontology curriculum being implemented at the Wayne State University School of Medicine.

“Teaching medical students about the aging process is different than spending a day in a nursing home,” Simmons said. “Seniors shouldn’t automatically be associated with sickness, death and dying. There are plenty of healthy, functional, active seniors who simply have a special set of health and wellness needs. All physicians, regardless of their specialty, need to understand those needs.”

With a $100,000 grant from the Association of American Medical Colleges and the John A. Hartford Foundation, the Wayne State University School of Medicine is instituting a geriatric and gerontology curriculum that will be integrated across the four-year program for medical students. Leading this effort are Drs. Robert Frank, Lavoisier Cardozo, Joel Steinberg, Bruce Deschere, Jennifer Mendez and Sharon Popp.

Dr. Popp explains that there are three major goals of the curriculum: to help students gain introductory knowledge of the diagnosis and management of common conditions in older patients; to foster positive student attitudes toward elders and the aging process; and to develop an experience-based student advocacy program in which medical students interact personally with healthy seniors. These goals are being implemented through a partnership with the St. Patrick Senior Center, a comprehensive resource for elderly people in Detroit.

“Unfortunately, many physicians have negative associations with elderly patients,” Dr. Frank said. “The only antidote is to present eldercare in a positive framework where it truly exists. St. Pat’s is a remarkable place where seniors interact independently in a positive and nurturing environment. This is the baseline experience we’d like our students to have.”

First-year medical students visit with seniors at St. Patrick’s during their Food and Friendship Lunch Program.

More than 100 first-year students volunteered to be part of the test group that began in the fall 2001 semester. Those students will meet two times with a senior at St. Patrick’s. During the first visit, the student and senior will complete a cardiovascular health assessment survey, outlining the seniors’ cardiovascular health, with diet, exercise and cholesterol checks. During the second visit, students will assist seniors in preparing an advanced directive.

Dr. Popp says although the advocacy program only equates to approximately four total hours of interaction, she expects the payoffs to be rewarding. “First of all, it’s great, because we are providing a genuine service to the community. We asked the staff at St. Pat’s what medical students could do for the seniors. They asked for assistance with health assessments and advanced directives. Furthermore, we think these experiences, although brief, will foster positive attitudes about eldercare. Other literature and gerontology studies have used similar attitudinal surveys and found measurable changes. We want future physicians to develop attitudes that contribute to an appreciation of the aging process as a normal part of the life cycle.”

The plan is to introduce fundamental knowledge at logical points in the first two years of the curriculum. For example, physiology lectures could include information about the biology of normal aging, immunology courses could address the effects of aging on the immune system, and pathophysiology could cover common conditions in geriatric patients such as arthritis, Parkinson’s disease and dementia. Geriatric skills and knowledge can then be tested in the third and fourth years through clinical rotations.

Future geriatrician, Kris Manlove-Simmons, she thinks this is one step forward in helping an underserved population. “All physicians need to be familiar with the complexities surrounding eldercare. Aging patients will need care in all medical specialties, so this basic training is fundamental.”

WSU was one of 20 medical schools to be awarded this curriculum grant in 2001.

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