GME : Fellowship : Geriatric

Geriatric Fellowship

Program Director's Message
At-A-Glance
Curriculum
Rotations in Months
Key Faculty

Lucy O. Macina, MD

Program Director's Message

The Geriatric Medicine Fellowship Program at Winthrop-University Hospital is a well balanced training program that provides fellows with high quality clinical and academic experiences to graduate expert geriatricians. Our fellowship program effectively provides trainees with the knowledge skills, and confidence to be highly qualified, geriatricians, as demonstrated by the program’s extraordinary board pass rate. Our fellows learn to provide expert care for a wide range of elderly patient populations, including functionally independent community dwellers, frail nursing home residents and acutely ill hospitalized patients. The program has been accredited by the ACGME since its inception in 1990.

Clinical training sites include nursing homes, an outpatient office, a specialized geriatric psychiatry unit, a hospice organization, and a hospital inpatient and consult service. We also offer an optional concentration in palliative medicine.

Our expert and highly dedicated faculty provide close supervision and mentoring in all clinical settings. In addition to certification in geriatric medicine, our core faculty also hold board certifications in clinical pharmacology and hospice and palliative medicine, which uniquely enables our program to offer trainees a rich educational experience. Our attending faculty to fellow ratio is 2:1.

Geriatric clinical pharmacology, neuropsychology, hospice and palliative medicine, and clinical ethics are integrated into the academic structure. Our fellows also work closely with a Neuropsychologist who trains fellows in performing cognitive assessments. Our teaching staff also includes a Certified Geriatric Pharmacologist, and a Palliative Care Nurse Practitioner.

Numerous research opportunities are available. Fellows may join an ongoing research project or develop their own with faculty mentoring. Faculty and fellows have published in many journals including the Annals of Internal Medicine, Clinical Geriatrics, Journal of the American Medical Directors Association, Gerontology & Geriatric Education and the Journal of the American Geriatrics Society. Fellows have presented their research at national conferences including the American Geriatrics Society, American Medical Directors Association, and Society of Geriatric Cardiology.

Faculty have also presented oral symposia national meetings (including the American Society of Bioethics and Humanities and the American Association of Geriatric Psychiatry), and at state meetings (the New York Academy of Medicine and the New York State Department of Health Dementia Conference). Faculty also serve in positions in the New York Chapter of the American College of Physicians, New York State Palliative Care Education and Training Council, Alzheimer’s Associations, the New York Medical Directors Association, the Medical Society of the State of New York, and the New York Academy of Medicine.

Graduates of our Geriatric Medicine Fellowship Program have pursued a variety of careers including medical directorships, private practice in a range of settings, palliative care, and academic positions.

Drs. Lyubarova and Kirtani proudly display their Research Day poster.

Geriatric Fellows, IM Residents and Medical Students engaging in weekly medical education conferences.

Geriatric Fellows in the Fellows' Office, located in the Geriatric Division Suite.

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At-A-Glance

Affiliation with three teaching nursing homes with dedicated full-time, board certified faculty.
End-of-life and palliative medicine training with a highly respected Hospice program and an inpatient hospitalized Palliative Care Consultation Service.
One-on-one mentoring including career guidance.
Research opportunities with support to attend geriatric conferences.
Community speaking opportunities at senior centers.
Supervision and training of Internal Medicine residents.
Generous house staff benefits, including subsidized housing and complimentary meals.

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Curriculum

Our one-year curriculum focuses on gaining comprehensive clinical skills in a number of settings: hospital, outpatient, nursing home care, assisted living, and home care. It also includes outpatient experiences in Neurology and Physical Medicine and Rehabilitation.

Additionally:

Home visit program which allows for a more complete assessment of a patient's health and environment.

Outpatient care in an assisted living facility.

Interdisciplinary team management conferences include, neuropsychologists, social workers, pharmacists and nurses.

Weekly Geriatric Grand Rounds series on key Geriatric Medicine topics including major syndromes and relevant basic sciences.

Geriatric Psychiatry lecture series and case conferences led by board certified Geriatric Psychiatrists.

Journal Club with critical review and discussion of relevant articles.

Practice management training including proper billing & coding.

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Rotations in Months

	Inpatient Service	Outpatient Practice / Ambulatory	Nursing home: Long term	Nursing home: Subacute Care/Medical Directorship	Geriatric Psychiatry	Hospice Care
PGY-4	3	3	3	1	1	1

Inpatient Service:

Geriatric fellows function as junior attendings providing care for hospitalized geriatric patients (as primary physicians and as geriatric consultants). Fellows are also involved with teaching interns and residents.

Outpatient Practice:

In addition to weekly continuity clinic, fellows have three one-month outpatient rotations which include assisted living and home visits. Fellows see healthy elderly, frail elderly and medically complex patients including those with cognitive impairment.

Nursing home: Long term and subacute care:

Fellows are responsible for managing a panel of long-term care patients in the nursing home throughout the year with monthly visits. In addition, fellows serve as the primary physician for residents in long term care for three months and are supervised by teaching faculty. During a one month sub-acute rotation, fellows care for subacute skilled nursing need rehabilitation patients. Fellows also work closely with the medical director in order to gain administrative experience.

Geriatric Psychiatry:

This rotation provides exposure to multiple aspects of care including partial day program, inpatient, and outpatient care with special focus on the consult-liaison service of Geriatric Psychiatry for medical inpatients in the hospital.

Hospice Care:

Hospice care for patients at the end-of-life provides training in pain & symptom management and communication skills. Fellows are active participants in the treatment team, attend team meetings and participate with care planning. Sites include home visits and an inpatient hospice unit.

Concentration in Palliative Medicine:

Elective track which is optional for all Geriatric Medicine Fellows. This specialized educational experience provides palliative training beyond the traditional Geriatric Medicine fellowship experiences. The Concentration in Palliative Medicine track has one month inpatient palliative rotation and one month of outpatient/nursing home palliative as part of a nursing home rotation.

Other Benefits:

Heavily subsidized housing in nearby apartment complexes and free-standing houses
Health and dental insurance for residents and qualified dependents.
Meal cards valid for three meals daily regardless of call schedule
Free ACLS training
Free business cards
Career conferences (as approved by program director)
Long-term disability insurance
Professional liability insurance
Uniforms and laundry service
Suburban setting conducive to family living
Discounts for theater, sports and other events
Subsidized health club memberships
Convenient location to Mineola train station – only 35 minutes to Penn Station

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Key Faculty

Irving Gomolin, MD, CMD, FACP, AGSF, FCP, FRCPC, Chief, Division of Geriatric Medicine, Chief, Division of Clinical Pharmacology, Professor of Clinical Medicine, SUNY Stony Brook School of Medicine.
Research Interests: Drug Therapy in the Elderly, Pharmacokinetics.
Selected Achievements: Member, Medical & Scientific Advisory Board, Alzheimer's Association, Long Island Chapter; Member, Board of Directors New York Medical Directors Association; Best Doctors: New York Magazine.

Lucy O. Macina, MD, Fellowship Program Director, Assistant Professor of Clinical Medicine, SUNY Stony Brook School of Medicine.
Research Interests: Dementia in the Elderly
Selected Achievements: Outstanding Community Physicians Award, Hospice Care Network; Best Doctors: New York Magazine

Jeffrey T. Berger, MD, FACP, Director of Clinical Ethics. Associate Professor of Medicine, SUNY Stony Brook School of Medicine.
Research Interests: Cross-Cultural Ethics, Research Ethics, Geriatric and End-of-Life Ethics.
Selected achievements: Member, Ethics, Professionalism & Human Rights Policy Committee of the American College of Physicians; Member, Clinical Ethics Consultation Advisory Committee, American Society for Bioethics and Humanities; Governor’s appointee to the New York State Palliative Care Education and Training Council; Chairman, Medical Ethics Committee, Medical Society of the State of New York

Rachel A. Fermo, MD, Sub-acute Rehabilitation Site Coordinator
Research Interests: Behavioral issues in Dementia, Comprehensive geriatric assessments
Selected Achievements: Fellowship trained in Geriatric Medicine, Director of Quality Improvement - Division of Geriatric Medicine, WUH

Adrianna Garite, DO, Palliative Subspecialty Student Education Coordinator, Winthrop-University Hospital.
Research Interests: Feeding Tubes in Dementia, Palliative care
Selected Achievements: Hospice Medical Director, Fellowship trained in Geriatric Medicine and Hospice & Palliative Medicine

Paula E. Lester, MD, FACP, Associate Fellowship Program Director, Assistant Professor of Clinical Medicine, SUNY Stony Brook School of Medicine. Geriatric Subspecialty Resident Education Coordinator, Winthrop-University Hospital.
Research Interests: Advance Directives, Safety in Dementia, Resident Education, Palliative care in the nursing home
Selected Achievements: Board Member & Webmaster, Metropolitan American Geriatrics Society; Nassau County East Councilor, New York State Chapter, American College of Physicians

Marjorie Mombeleur, MD, Director, Medical Education, Cold Spring Hills Center for Nursing Rehabilitation.
Research Interests: Long Term Care, Resident Education.

Muhammad Khan, MD, Director, Resident Education, Cold Spring Hills Center for Nursing Rehabilitation.
Research Interests: Falls in the nursing home.

Nancy S. Foldi, PhD, Director of Neuropsychology, Division of Geriatric Medicine; Associate Professor of Psychology, Queens College and The Graduate Center, CUNY
Research Interests: Attention disorders in patients with Alzheimer's Disease

Jessica T. Weinberger, MS, FNP-BC, ACHPN, Coordinator, Palliative Care Services.
Research Interests: Palliative care, communication skills, nursing education, complementary therapies
Selected Achievements: Chairperson, Membership Committee, Hospice and Palliative Care Nurses Association.

Sum Lam, PharmD, BCPS, FASCP, Associate Clinical Professor, St John's University College of Pharmacy and Allied Health Professions
Research Interests: Clinical therapeutics, drug use in older adults

Linda Martinez, LMSW, Geriatric Social Worker, Winthrop Program Coordinator for LIGEC (Long Island Geriatric Education Consortium), Geriatric Support Group Facilitator
Areas of interest: Caregiver support, Impact of dementia on families, Driving assessment

Ana Sanchez, RN, Certified in med/surg nursing; Areas of interest: Reducing caregiver stress, Wound care
Adjunct faculty participate at other teaching sites.

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Winthrop Geriatric Faculty Publications

Use this link to open a new window to see a listing of National Library of Medicine's (NLM) Medline database (PubMed) of publications by Winthrop Geriatric Faculty.

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For further information, contact:

Lucy O. Macina, MD
Fellowship Program Director, Division of Geriatric Medicine
Winthrop-University Hospital
259 First Street
Mineola, NY 11501

Tel: (516) 663-4631
Fax: (516) 663-4644
E-mail: LMacina@winthrop.org

Melissa Ghaney
Academic Coordinator, Division of Geriatric Medicine
Winthrop-University Hospital
259 First Street
Mineola, NY 11501

Tel: (516) 663-4640
Fax: (516) 663-4644
E-mail: MGhaney@winthrop.org

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Applications for fellowship are considered on a rolling admissions basis. Please apply through the ERAS Fellowships Applicant Site. We participate in the NRMP match.

Necessary components of an application are:

Common Application Form (CAF)
Curriculum Vitae
Personal Statement
Medical School Transcript
USMLE scores or COMPLEX scores
ECFMG (if applicable)
NBME
Visa Status
Three letters of recommendation

Websites of Interest:

Geriatric Educational Resources Websites:

GERI Pearls (printable concise review geriatric topics):

Fast Facts on Palliative Care:

POGOe (Portal for Geriatric Online Education):

The American Geriatrics Society:

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