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Geriatrics

Program Director's Message

U.S. News World & Report - high performing specialty in Geriatrics for 2017-18The Geriatric Medicine Fellowship Program at NYU Winthrop 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. NYU Winthrop Hospital was recognized by U.S. News World & Report as having a high performing specialty in Geriatrics for 2017-18.

Clinical Training Sites include:

  • Nursing Homes
  • Outpatient Office
  • Specialized Geriatric Psychiatry Unit
  • Hospice Organization
  • Inpatient Palliative Care
  • Hospital Inpatient and Consult service

We also offer three optional Electives:

  • Palliative Medicine
  • Wound Care
  • Nursing Home Medical Directorship

The Elective in Palliative Care is a specialized educational experience which provides palliative training beyond the traditional Geriatric Medicine fellowship experiences. In addition to the one month inpatient palliative/home hospice rotation which all fellows receive, the fellows who chose the Elective in Palliative Care experience have an additional two week Palliative experience. The additional experience includes one week at Calvary (a long term acute care hospice focusing on palliative care) and one week focused on inpatient hospice/inpatient palliative care unit with an affiliated Hospice agency.

The Elective in Wound Care is a focused educational experience which provides specialized wound care training with the NYU Winthrop Wound Care team. Fellows spend two weeks with the team focusing on topical wound care treatments, debridement (bedside and OR), and hyperbaric treatments. In addition to wound care management, fellows are trained on wound healing risk assessment and multifaceted approaches to improve wound healing.

The Medical Director Elective is a specialized nursing home medical director experience beyond the traditional nursing home experiences in Geriatrics fellowship. Fellows spend two weeks at Parker Jewish Institute with Dr. Conn Foley who is a certified medical director. This rotation focuses on administrative NH duties in a large nursing home environment which provides complex care including hemodialysis onsite and provides many other specialty care onsite.

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 Licensed Social Worker specializing in Geriatrics. Palliative experiences include training with Hospice/Palliative certified physicians, specially trained Nurse Practitioner, and a Licensed Social Worker specializing in palliative care.

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 at national meetings (e.g., American Medical Directors Association and American Association of Geriatric Psychiatry) and at state meetings (New York Academy of Medicine and New York State Department of Health Dementia Conference). Faculty also serve in leadership positions in the New York Chapter of the American College of Physicians, Alzheimer's Associations, and the New York Medical Directors Association.

Dr. Pavel Groysman, Geriatric Medicine Fellow, co-presented an oral symposium on "Impact of a Hospital-Wide Comprehensive Pain Management Interventions on Geriatric Patients" at the national Aging in America Conference with co-fellow Dr. Sukhminder Sahansra, and Attending Physician, Dr. Paula Lester.


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.

At-A-Glance

  • Affiliation with 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.
  • State-of-the-Art Simulation Center providing the opportunity to focus on communication skills.
  • Educational stipend to support conference attendance.
  • Individual copies of “Geriatrics at Your Fingertips” and the latest Geriatric Review Series (GRS) textbook.

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.
  • Interdisciplinary team management conferences include, neuropsychologists, social workers, pharmacists and nurses.
  • Interdisciplinary conferences as part of a formal "Alzheimer's and Related Dementia Program".
  • Weekly Geriatric Grand Rounds series on key Geriatric Medicine topics including major syndromes and relevant basic sciences.
  • Opportunity to participate in hospital "Transitional Level of Care Program".
  • Geriatric Psychiatry lecture series and case conferences with outpatient evaluations led by board certified Geriatric Psychiatrists.
  • Journal Club with critical review and discussion of relevant articles and statistical concepts.
  • Medical Director curriculum led by experienced Certified Medical Directors.
  • Practice management training including proper documentation for billing & coding.

Rotation in Months

Inpatient Service

Outpatient Practice / Ambulatory

Skilled Nursing Facility: Long term care & Subacute Rehabilitation

Physical Medicine & Rehabilitation

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 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 a Skilled Nursing Facility throughout the year, with monthly visits. In addition, fellows serve as the primary physician for residents in Long Term Care and Subacute Rehabilitation for three months, supervised by teaching faculty. Fellows also spend time 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.

Palliative Care/Hospice

Palliative Care is a comprehensive and multidisciplinary approach to pain and symptom management for patients with severe, life-limiting illness. Fellows are active participants with the inpatient palliative care team utilizing valuable communication and symptom management skills.

Hospice care for patients at the end-of-life is a Medicare benefit which provides symptom management for patients with a terminal condition. During their week of home hospice experience, as part of their Palliative Care month, fellows join the hospice team on home visits, attend team meetings, and participate in care planning.

Physical Medicine and Rehabilitation

In addition to exposure to rehabilitation at the nursing home, fellows have a dedicated Physical Medicine & Rehabilitation rotation. This includes a rotation in an acute inpatient rehabilitation facility, inpatient PM&R consults in the hospital, and participation in outpatient clinic, team meetings, and didactic sessions.

Specialties: Neurology & Urology

Fellows enjoy a dedicated outpatient neurology experience. This training focuses on neurologic conditions which are more prevalent in the elderly: movement disorders, strokes, seizures and more. Fellows receive excellent training on the neurologic exam, diagnostic modalities and treatment options. Fellows also participate in an outpatient uro-gynecology experience, learning about available diagnostic tools and medication management.

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

Conferences

Alzheimer’s Case Conference: One hour interdisciplinary case discussion including physicians, nursing, social work staff from neurology, psychiatry, geriatric medicine, home care, and more. (Quarterly)

Case Conference: One hour case presentation and discussion by faculty regarding patient care in a various patient care venues. (Twice a month)

Division Quality Improvement Committee: One hour meeting led by faculty to discuss and implement Quality Improvement projects. (Quarterly)

Educational Meeting: Thirty minute session led by faculty on a wide variety of topics, such as proper documentation, billing and coding, effective communication skills, delivering bad news, managing telephone conversations with patients/families, factors to consider in a job search and contract negotiation, and more. Guest speakers are invited for additional topics such as: role of pastoral care, role of risk management, library services, telemedicine, and more. (Twice a month)

Geriatric Grand Rounds: One hour lecture covering a wide range of Geriatric Medicine topics, presented by faculty and guest speakers. (Weekly)

Geriatric Medicine Board Review: Board review in a question/answer format, led by faculty. (Monthly)

Geriatric Psychiatry Series: One hour session with visiting faculty from Geriatric Psychiatry addressing key topics in the field and the Gero-psych approach to management.

Geriatric Team Meeting: One hour interdisciplinary team meeting regarding patient care with a team-based problem solving approach. Attended by faculty, nursing, social work and others. (Monthly)

Journal Club: One hour discussions of current literature led by fellows with an assigned faculty preceptor. Articles are selected based on relevance to Geriatric practice. Statistical concepts are incorporated into the discussions.

Medical Director Series: Presented by regional leaders in Nursing Home Medical Directorship, this eight hour course is divided into four sessions. Topics include: roles and responsibilities of the Medical Director, physician documentation, regulatory and legal issues, state surveys, infection control and quality assurance, and transitions in care.

Neuropsychology Series: Presented by a Neuropsychologist, this series addresses the role of Neuropsychology testing in diagnosing dementia, as well as provides education about dementia and other cognitive disorders. (7 hours, provided in four separate sessions)

Research Meeting: One hour research meeting led by faculty, along with statisticians. During these sessions research concepts are reviewed, with opportunities to formulate and implement research projects via surveys, chart audits or literature reviews, case report, or review article with faculty guidance. (Monthly)



Hospital-Wide Committee Opportunities:
Fellows are encouraged to join faculty in participating on hospital-wide committees, including: Antimicrobial Stewardship, Bioethics, Clinical Decision Support, Delirium Prevention, Preventable Readmissions, Transitional Levels of Care, Pain Management, and Pharmacy and Therapeutics.


Key Faculty

Irving Gomolin, MDIrving 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, MDLucy 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



Rachel A. Fermo, MDRachel A. Fermo, MD, Sub-acute Rehabilitation Site Coordinator for Fellowship Training; Assistant Professor of Clinical Medicine, SUNY Stony Brook School of Medicine; Associate Medical Director for NYU Winthrop Transitions of Care at Townhouse Center for Rehabilitation & Nursing
Research Interests: Transitional Care, Dietary Rehabilitation
Selected Achievements: Director of the Stony Brook Medical Student Geriatric Medicine Selective, Safe Discharge Committee Member


Paula E. Lester, MDPaula E. Lester, MD, FACP, CMD
Associate Fellowship Program Director, Assistant Professor of Clinical Medicine, SUNY Stony Brook School of Medicine; Associate Medical Director for the NYU Winthrop Transition Level of Care (TLC) Program at Sunharbor Manor, Roslyn Heights, NY
Research Interests: Advance Directives, Safety in Dementia, House-staff Education, Palliative care in the nursing home
Selected Achievements: Board Member & Webmaster, Metropolitan American Geriatrics Society;  Board Member & Webmaster, New York Medical Directors Association; Former Nassau County East Councilor, NYACP; Member Clinical Practice Guidelines Committee for The Society for Post-Acute and Long-Term Care Medicine


Alka Nischal-Rednam, MDAlka Nischal-Rednam, MD
Research Interests:Studying the differences in outcomes of dementia treatment in the context of patients cultural & ethnically based needs and its impact on overall prognosis.
Selected Achievements: Medical Student Site Coordinator for Geriatric Medicine Elective, Residency Program Evaluation Committee, Fragility Fracture Service, Morbidity & Mortality Committee Member, Physician Coordinator of Quality Assurance And Performance Improvement Program- Physician Quality Reporting System (QAPI/PQRS)


Sukhminder (Simmi) Sahansra, MD 
Selected Achievements: CME Director for Geriatric Division; Director of Quality Improvement, Division of Geriatric Medicine; Morbidity & Mortality Committee Member
Research Interests: Attention disorders in patients with Alzheimer's Disease


Nancy S. Foldi, PhD, Director of Neuropsychology, Division of Geriatric Medicine; Associate Professor of Psychology, Queens College and The Graduate Center, CUNY
Research Interests: Alzheimer’s Dementia, Subacute Rehabilitation, Coordination of care between transitions


Sum Lam, PharmD, BCPS, FASCPSum 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, LCSW, ASW-G, Geriatric Social Worker, Program Coordinator for NYU Winthrop's Alzheimer's program, Geriatric Support Group Facilitator
Research Interests: Caregiver support, Impact of dementia on families, Community education programs


Ana Sanchez, RN, Certified in med/surg nursing;
Research Interests: Reducing caregiver stress, Wound care


Gregory Maddox, LPN
Research Interests: Wound care, Behavioral management of advanced dementia

Adjunct faculty participate at other teaching sites.


Current and Past Fellows

2015-2016 Fellows

Eghosa Eronmwon Geriatric Hospitalist Long Island, NY
Swe Swe Myo Geriatric Hospitalist California
Rochelle Remolana Geriatric Hospitalist Queens, NY
Sartaj Sandhu Geriatric Primary Care California

2014-2015 Fellows 

Nagham Ali Memorial Hospital Quesnel, BC, Canada
Keith Brennan Hospitalist South Nassau Communities Hospital, Long Island, NY 
Noah Canlas Outpatient Family Practice One Medical Group, Manhattan, NY
Brian Son Geriatrics Practice Unity Geriatrics Associates, Rochester, NY

2013-2014 Fellows

Josephine DelaCruz Hem/Onc Fellowship Winthrop-University Hospital, Mineola
Ricardo Elagio Subacute Rehabilitation Physician Stern Center for Health Care & Rehabilitation/Northwell Health, Manhasset, NY
Pavel Groysman Palliative Medicine Faculty Winthrop-University Hospital, Mineola, NY
Sukhminder Sahansra

Geriatric Medicine Faculty

Subacute Rehabilitation Physician

Winthrop-University Hospital, Mineola, NY

Sun Harbor Manor, Roslyn Heights, NY

2012-2013 Fellows

Sara Gitte General Practice Lakeview Internal Medicine, Ocala, Florida
Yelena Khaitin ElderOne/PACE Rochester Regional Health System, NY
Nadia Malik Hospitalist Laconia, New Hampshire
Lucan Rodrigues Director, Palliative Medicine Flushing Hospital Medical Center, NY

"This program offers a balanced exposure to all aspects of Geriatric Medicine, where teaching takes place at all levels. The atmosphere imparts both guidance and independence so that fellows can gain the knowledge, skills, and confidence to care for their patients. My training experience has equipped me with the skills that are essential for becoming an effective, efficient, and compassionate Geriatrician who can make a positive impact on healthcare for the elderly in a variety of settings. Completing my fellowship in Geriatrics at Winthrop-University Hospital was the best decision I ever made!"–RF

Learn more about what recent graduates have to say about the program

Research/Publications

Recent academic accomplishments by our Fellows:

  • Impact of Computerized Physician Order Entry Alerts on Prescribing in Older Adults. Lester PE, Rios-Rojas L, Islam S, Fazzari M, Gomolin IH. Drugs and Aging. March 2015,32 (3):227-233; First place winner: Annual Performance Improvement Project Poster Session, NYU Winthrop Hospital. Winner of top Quality Symposium abstract at NewYork-Presbyterian Healthcare System's Quality Symposium, 11/2012 at the New York Athletic Club in Pelham Manor, NY.
  • Medical Therapy with of Malignant Bowel Obstruction with Octreotide, Dexamethasone, and Metoclopramide in Malignant Bowel Obstruction. Rodrigues L, Lester PE, Berger J. American Journal of Hospice and Palliative Medicine. Epub. 2015 Feb 2.
  • Impact of a Hospital-Wide Comprehensive Pain Management Intervention on Geriatric Patients (National Oral Symposium). Groysman P, Sahansra S, Lester PE. ASA's 2014 Aging in America Conference, San Diego, CA 03/2014.
  • Wandering and Elopement in Nursing Homes. Lester PE, Garite A, Kohen I. Annals of Long-Term Care. 2012 March:20(3) 32-36.
  • Smoking rates in dementia patients in the outpatient setting. Lester PE, Lyubarova R, Kirtani V, Macina LO, Kohen I. Arch Gerontol Geriatr. 2011 May-Jun;52(3):281-3
  • Surrogate Consent for Percutaneous Endoscopic Gastrostomy. Berger JT, Hida S, Chen H, Friedel D, Grendell J, Arch Intern Med.2011;171(2):178-179
  • Why Geriatrics? A Survey of New Patients in a Geriatric Practice. Kalim S Akula S, Vadnerkar A, Haq M, Feuerman M, Lester PE, Gomolin I. Poster presentation at the 2011 American Geriatrics Society (AGS) Annual Meeting, May 2011.
  • Inflammatory Bowel Disease in a nonagenarian. Lester PE, Lyubarova R, Macina LO, Kongara K. Clinical Geriatrics. 2009;17 (6):28-31.
  • Falls in the nursing home setting: does time matter? Lester P, Haq M, Vadnerkar A, Feuerman M. Journal of the American Medical Directors Association. 2008 Nov;9(9):684-6.
  • Internal medicine residents' perception of nursing home demographics and regulations: a pilot study. Lester PE, Doubrovskaia M, Ghosn M, Gomolin IH. Journal of the American Medical Directors Association. 2008 Feb;9(2):120-3.
  • The Reporting of Informed Consent and Related Issues in Critical Care Research. Berger JT, Khalil E, Khan S, Varghese T. Research Ethics Review. 2008;4(1):10-14.
  • An Unusual Presentation of Gastric Volvulus in an Older Woman. Lester PE, Ghosn M, Berger JT. Clinical Geriatrics. 2008;16 (11):21-24.
  • Case Report: Delirium in a nursing home resident. Lester PE, Varghese T.  Annals of Long-Term Care: Clinical Care and Aging. 2007; (15) 10: 36-37.

NYU Winthrop Geriatric Faculty Publications

View the publications by NYU Winthrop Geriatric Faculty at the National Library of Medicine's (NLM) Medline database (PubMed).

Application Process

Please apply through the ERAS Fellowships Applicant Site. We participate in the NRMP match. NYU Winthrop Geriatric Medicine Fellowship is fully committed to the NRMP match process and has signed the "Geriatric Medicine Fellowship Match Code of Ethics." For more information, see the ADGAP webpage.

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):

POGOe (Portal for Geriatric Online Education)

The American Geriatrics Society