The Department of Psychiatry at UT Health San Antonio offers an accredited fellowship in Geriatric Psychiatry. Psychiatry resident graduates are invited to compete for two fellowship positions which allow participants to gain additional knowledge in outpatient, inpatient, consultation, nursing home, hospice, home health, and rehabilitation medicine as it pertains to elder care. Board eligibility requirements will be complete after one year of training. Clinical service is supplemented with weekly Grand Rounds, journal club, and didactic seminars. Each fellow receives mentorship for a self-directed academic or research project.
Fellowship Goals and Objectives:
Upon completion of the 12-month Geriatric Psychiatry residency, the resident will be able to perform a comprehensive diagnostic assessment of elderly patients with a broad range of psychiatric disorders. This will include a detailed examination of the biological, psychological and social aspects of such conditions. Residents will be able to critically evaluate and integrate findings from mental status examination, physical examination, laboratory testing, imaging, psychological testing and psychosocial assessments. They will be able to formulate an individualized treatment plan for patients with a broad range of psychiatric disorders, utilizing biological, psychological and socially-oriented strategies. This will include functioning as an effective leader of a multidisciplinary treatment team. Residents will provide consultations to physicians, non-physicians and administrative bodies regarding issues related to mental illness in the elderly. They will function as an educational leader in the field of Geriatric Psychiatry and be prepared to embark on a career in academic medicine. Residents will also be able to describe the current knowledge and literature base of Geriatric Psychiatry including, but not limited to;
- The current scientific understanding of aging and longevity, including theories of aging, epidemiology and natural history of aging and differences between biologic/physiologic functioning in health and disease.
- The range of responses to stressors such as retirement, widowhood, role changes, interpersonal and health status losses, financial reversals, environmental relocations and increased dependency.
- The relevance of cultural and ethnic differences and how they bear on clinical presentations and use of services.
- The epidemiology, diagnosis and treatment of all major psychiatric disorders seen in the elderly. These include cognitive disorders, mood disorders, anxiety disorders, psychotic disorders, adjustment disorders, substance use disorders and personality disorders.
- Issues related to abuse in the elderly.
- The relationship between psychiatric illness and caregivers and its effect on outcome.
- The indications, side effects and limitations of psychoactive medications and the pharmacologic alterations that occur with aging. This includes changes in pharmacodynamics/kinetics, drug interactions, overmedication, problems with compliance and polypharmacy.
- The appropriate use of non-pharmacologic treatment approaches and their limitations including behavioral strategies and electroconvulsive therapy.
- Psychodynamic issues that contribute to developmental problems, adjustment difficulties and other issues that may complicate clinical presentations and influence the doctor-patient relationship and treatment planning.
- The ethical and legal issues pertinent to Geriatric Psychiatry including competence, guardianship, right to refuse treatment, wills, informed consent, patient abuse and the withholding of treatment.
- Current aspects of supporting services, including but not limited to Title III of the Older Americans Act, Medicare, Medicaid, other third-party payers, cost containment, and how economic issues contribute to the quantity, quality and distribution of health care to patients, particularly the elderly.
- Research methodologies including biostatistics, clinical epidemiology, medical information sciences, decision analysis, critical literature review and research design
- Salary for PGY-5: $60,677.51
- Vacation: 15 days
- Sick Leave: 10 days
- Liability Insurance at no cost to fellow
- Health Insurance coverage at discounted cost for fellow and family though University Health System
- $500 stipend for meeting attendance, purchase of educational/study materials
- AAGP Membership Dues Reimbursed by program
- Lab Coats provided by University Hospital
For additional information contact:
Primary Teaching Faculty:
Jeffrey A. Cordes, M.D., Geriatric Psychiatry Fellowship Director
Donald R. Royall, M.D., Chief of the Division of Aging and Geriatrics
Jason E. Schillerstrom, M.D., Director of UT Health San Antonio’s Geropsychiatry Clinical Services
Mark Burns, M.D., Director of Nursing Home Education
Christine Joy, M.D., Associate Geriatric Psychiatry Program Director, Assistant Professor
Primary Teaching Sites:
- South Texas Veteran’s Health Care System (STVHCS) – Audie L. Murphy VA Hospital
- UT Health San Antonio’s Geropsychiatry Clinic
- Eden Hill Nursing Home
- San Antonio State Hospital
- University Hospital
- Air Force Village Retirement Community
- Laurel Ridge Treatment Center