In our comprehensive fellowship program, you will receive a broad range of hands-on clinical experience and individualized instruction from nationally known physicians and investigators in a collegial environment.

Fellowship Experience

Our program provides superior endocrine training in a collaborative environment. We have specialty clinics across our medical campus, which is anchored by our 1,200 bed inpatient center UAB Hospital—the eighth largest public hospital in the nation. The hospital is in close proximity to the Birmingham VA Medical Center, UAB Hospital Highlands campus, The Kirklin Clinic, and Children's Hospital of Alabama where fellows also train.

Patients come from all over the state to take advantage of our life-changing care, offering a diverse population and breadth of clinical learning opportunities. We approach medicine in a multi-disciplinary modality across a broad variety of endocrine-related conditions through mandatory and elective rotations. We accept applications through the Electronic Residency Application Service.

Longitudinal Experiences

Through the UAB Outpatient Geriatric Continuity Clinic, you will provide care for complex older adults with multiple medical, social, and psychological problems. In most situations, you will provide ongoing primary and geriatric subspecialty care for these patients. For fellows more interested in a primary care career, the frequency of the continuity clinic experience may be increased to meet individual learning and career goals.

Fellows also attend the VA Geriatrics Assessment Clinic several times per month while on a block month rotation, providing outpatient consultative care focused on comprehensive geriatric assessments where you will become accomplished at assessing, diagnosing, and managing many geriatric syndromes including mood disorders and dementia. You may function as “junior attendings” in this clinic in the second half of your fellowship year.

You will provide care for patients in skilled post-acute care and long-term care settings. Common conditions include post-hip fracture or joint replacement, infections, stroke, metabolic disorders, cardiovascular disorders, musculoskeletal pain syndromes, malnutrition, and polypharmacy. Common conditions for the long-term stay residents include the same spectrum of medical illnesses, but also include a high incidence of geriatric syndromes such as dementia, incontinence, falls, and pressure ulcers.

The most common medical conditions and geriatric syndromes will be assessed and managed in the home setting. Emphasis is placed on the interprofessional team approach. The goal of this experience is to build your skills in the diagnosis and management of medical problems in frail, homebound adults and to align care plans with patient and family/caregiver-oriented goals. There are two sites where you will have a home based experience during your UAB fellowship: House Calls through the UAB Geriatrics Clinic, and Home Based Primary Care through the Birmingham VA. Each is unique and offers a slightly different experience for fellows.

You will carry your own panel of home visit patients through the UAB Geriatrics Clinic. Home visits will occur approximately once monthly and may be in lieu of an in-clinic session. The goal will be for you to visit patients independently, or with a member of the interprofessional House Calls team as needed.

You will also perform home visits with the VA Home-Based Primary Care (HBPC) team. These sessions are usually scheduled once weekly over the course of three months during Block rotations, and are made simultaneously with an attending and may include other members of the HBPC interprofessional team.

Block Rotations

The inpatient consult rotation provides experience in preventing, evaluating, and managing geriatric syndromes in hospitalized older adults. As a member of an interdisciplinary team and as a geriatrics consultant, you provide recommendations on management of common geriatric syndromes such as cognitive impairment, delirium, polypharmacy, falls, complex discharge situations, elder abuse, depression, pain, and facilitate discussion of goals of care.

You will gain experience in both inpatient and outpatient Physical Medicine & Rehabilitation by attending a wide variety of clinics and will spend a quality time learning principles of rehabilitation consultation. In addition to working in UAB Spain Rehabilitation Center, a state-of-the-art free-standing acute rehabilitation facility on the UAB campus, settings also include the VA Cerebrovascular Disease (“Post-Stroke”) Clinic, UAB Movement Disorders Clinic, VA Fall Prevention and Mobility Clinic, Physical Therapy, and Speech Therapy. Most of these highly specialized clinical venues are described below under “Subspecialty Clinics.”

You will join psychiatry attendings in several geriatric psychiatry settings (private practice clinic, UAB Memory Disorders Clinic, VA Home-Based Psychiatry, and VA inpatient palliative care psychiatry) with the goal of building experience in the diagnosis and management of psychiatric problems in older adults.

In the palliative medicine rotation, you will gain experience in the provision of palliative medicine care to geriatric patients in a variety of settings, with an emphasis on complex pain and non-pain symptom management, management of palliative care emergencies, managing conflict and establishing goals of care, estimating and communicating prognosis, managing withdrawal of advanced life-sustaining therapies, and caring for the imminently dying patient.

During your Health Care Leadership rotation, you will work with health system leaders and medical directors in the hospice, nursing home/assisted living, managed care, and inpatient settings at UAB, the VA, local hospice(s), and VIVA (the health insurance agency for UAB) to gain expertise in health system leadership and medical direction in hospice, nursing home, managed care, and inpatient settings.

On our subspecialty rotations, you will gain experience in the diagnosis and management of a variety of common geriatric syndromes by working with interprofessional teams in various UAB and VA Outpatient Subspecialty Clinics. You will have 2-4 Subspecialty Block rotations throughout the year with clinics typically scheduled on a weekly basis. These ambulatory clinics include UAB Memory Disorders Clinic, UAB Movement Disorders Clinic, UAB Osteoporosis Clinic UAB and VA Continence Clinics, UAB and VA Wound Care Clinics, VA Cerebrovascular Diseases Clinic, and the VA Fall Prevention and Mobility Clinic.

Conferences, Research Opportunities, and Other Responsiblities

UAB Gerontology, Geriatrics and Palliative Care Division Grand Rounds is held most Thursdays at noon throughout the year and includes talks on Clinical, Inter-professional, and Educational topics related to the treatment of Geriatric Medicine and Hospice & Palliative Medicine patient populations.The goal of these conferences is to provide educational opportunities and updates on the latest research within the division and globally within the field of geriatrics and palliative medicine.

Fellows will participate in a monthly Fellows’ Most Difficult Case Conference (FMDCC) and will have the opportunity to present their own case once during their fellowship year. FMDCC was created by our geriatric medicine partners at Aurora Sinai in Wisconsin and brings together fellows from coast to coast, as well as geriatrics and psychiatric teaching faculty from leading academic programs including UAB to provide a biopsychosocial model (the Wisconsin Star Method) as a rubric to address particularly challenging cases.

The UAB Geriatric Medicine Fellowship will support the travel and registration expenses for 2 conferences a year, the American Geriatric Society (AGS) Annual Meeting and the Society for Post-Acute and Long-Term Care Medicine (AMDA) Annual Meeting. Fellows are strongly encouraged to create a scholarly project such as an abstract/poster to submit and present at the AGS Meeting which is held during the month of May.

You will meet quarterly with Palliative Medicine fellows to plan, develop, and present a scholarly or quality improvement project. Workshop topics include: 1) Defining a Question, Methodologies, and Mentorship, 2) Works-in-Progress, 3) Abstracts and Posters, and 4) Presentation and Dissemination. Over the course of your fellowship, you will submit your scholarly project to local and national meetings, present 1-2 journal clubs, 1-2 case conferences, and the final Grand Rounds presentation of your scholarly project.

Beginning in the Fall, you will have at-home call for the UAB Geriatrics Clinic and Nursing Home 2-4 weeknights per month and 2 weekends per quarter. You will have attending back-up for your call nights.

Frequently Asked Questions