Geriatric Medicine 
Fellowship Program

The Department of Geriatric and Palliative Medicine was established at Philadelphia College of Osteopathic Medicine in 1985 to address the need of the increasing aging population for sensitive, competent health care. Since its inception, the department has grown to provide multidimensional services for the Philadelphia community of older persons. With the commitment of our faculty and our interdisciplinary approach to care, geriatrics has evolved into a vital and growing clinical service at PCOM.

The PCOM Geriatric Medicine Fellowship is fully accredited by ACGME and has been approved by the AOA Committee on Postdoctoral Training to train geriatric fellows since 1996. This one-year program is designed to expose physicians to the continuum of care of elderly persons. Dedicated training is provided in ambulatory care, acute and post-acute care geriatrics, long- term care, palliative care and end of life care. In-patient and out-patient geriatric consultations are performed by fellows for a variety of syndromes including but not limited to comprehensive geriatric assessment, dementia evaluation, urinary incontinence, wound care, advanced care planning/goals of care and biomedical ethics.

Special emphasis is placed on utilization of an interdisciplinary team in optimizing care for older adults and allowing individuals to age in place. Osteopathic principles and practices are incorporated into patient care to provide comprehensive geriatric disease management.

Nicol Joseph, DO, MBA, CMD, HMDC

Dr. Nicol Joseph is a certified medical director through the Society for Post Acute and Long Term Care (PALTC). She has been the program director of the PCOM Geriatric Medicine Fellowship since 2012 and is also a graduate of the fellowship. She received her medical training at UMDNJ-SOM (now Rowan-SOM) and went on to complete a family medicine residency at Christ Hospital (Bon Secours Health System). She is board certified in family medicine, geriatrics and palliative care with special interest in PALTC and wound care. She has worked in administrative medicine for both provider and payor programs and currently serves as medical director for a PALTC facility and hospice program. Dr. Joseph is committed to training competent and compassionate physicians who will serve the increasing population of older adults and individuals with chronic illness. Addressing social determinants of health and improving interprofessional education is key to this mission and well aligned with the fellowship's goals and the school's mission. Learn more about Dr. Joseph.

Katherine Galluzzi, DO, CMD, FACOFP, FAAHPM, FAGS

Dr. Katherine Galluzzi is the founding member of the PPCOM Geriatric Medicine Fellowship. She is Professor and Chair of the Department of Geriatric and Palliative Medicine and Director of Comprehensive Care at PCOM; she is the Medical Director of PCOM Clinical Research Center and Medical Director of the Residentialist Group of home care providers in Philadelphia. Dr. Galluzzi is board certified in geriatrics, family medicine, osteopathic manipulative medicine, pain medicine and hospice and palliative care. She is also a Certified Medical Director through the American Medical Directors Association. Learn more about Dr. Galluzzi.

Michael Srulevich, DO, MPH, HMDC, FAAHPM

Dr. Michael Srulevich is an Associate Professor in the Department of Geriatric and Palliative Medicine at PCOM. He is also the program director for the PCOM Hospice and Palliative Medicine Fellowship Program, an ACGME accredited program. Dr. Srulevich is board certified in family medicine with added qualifications in geriatrics, hospice and palliative medicine. He is the lead physician for palliative medicine at Roxborough Memorial Hospital, serves as medical director for hospice, has a clinical practice in PCOM's Specialty Care clinic on City Avenue and provides long term care to residents at four Philadelphia nursing homes. Dr. Srulevich is particularly interested in the continuum of care in working with frail and seriously ill patients to seek treatments that most appropriately ensure a maximum quality of life. Learn more about Dr. Srulevich.

Through participation in clinical rotations, the geriatric medicine care fellow will:

• Gain competency in care and management of frail older adults.
• Achieve a deeper understanding of access to care across the healthcare continuum.
• Apply measures that maximizes quality of life for the older adult.
• Develop care plans that addresses social determinants of health and improve care delivery.
• Improve assessment skills and documentation of functional status of patients over time.
• Perform comprehensive geriatric evaluations including cognitive assessment and transitional care evaluation.
• Develop appropriate and sensitive communication strategies to address goals of care and advanced care planning at various points in the disease process.
• Develop competency in quality improvement and quality assurance measures for geriatric practice.
• Understand the complexity of system based practice and interdisciplinary care of older adults.
• Improve skills as educators, leaders and advocates of geriatric medicine.

Longitudinal Experiences

Post-Acute/Long Term Care and Rehabilitation Services
Fellows receive a longitudinal experience through the PCOM Geriatrics Post-Acute/Long Term Care and Rehabilitation Services. Fellows are assigned a panel of patients that they follow throughout the entire fellowship for regulatory visits. They are also responsible for admissions, re-admissions, acute visits, discharges and transitional care evaluations. The program enables regular interaction with multidisciplinary team members, such as nurses, nurse practitioners, pharmacists, speech therapists, physical therapists, social workers and psychologists. This is an interprofessional education experience where fellows work alongside trainees of other disciplines to provide care. In addition, fellows receive training in the administrative aspects of PALTC.

Ambulatory Care
Fellows are assigned two half days per week in the PCOM outpatient geriatric office focusing on geriatric health maintenance and preventative health measures, multi-morbidity, chronic disease management and advanced care planning. Fellows learn how to access community health resources, perform comprehensive geriatric evaluations, cognitive evaluation, continence clinic, wound care and wound management and all aspects of outpatient elder care.

Scheduled Rotations

Inpatient Geriatrics
Fellows provide medical consultative services via PCOM geriatric and palliative care inpatient consult service. They provide house staff with guidance on issues related to geriatric transitional care management, goals of care/advanced care planning, management of geriatric syndromes, ethical issues, deprescribing and quality improvement measures.

Home Care
Fellows are immersed in a month-long home care experience via PCOM Residentialist Housecall Medical Group. During that time, they manage and care for frail homebound members of the Philadelphia community as both consultants and primary care providers. Fellows who are interested in home care as a career can also be afforded additional opportunities.

Hospice and Palliative Medicine
Fellows have scheduled rotations in the subspecialty areas of hospice and palliative medicine. Inpatient and outpatient hospice and palliative care consults through the Holy Redeemer Health System (including their partnership with the MD Anderson Cancer Center), Roxborough Hospital and PCOM clinic provide fellows with a well-rounded experience. Fellows learn to care for hospice at all levels of care ranging from routine home care, to continuous crisis and general inpatient care. Fellows receive training in administrative hospice and palliative care via participation in interdisciplinary team meetings and working with the medical directors.

Geriatric Psychiatry
Fellows have a dedicated psychiatry rotation at the inpatient psychiatric unit at Roxborough Hospital. They also manage patients with psychiatric illnesses in post-acute and long term care in concert with attending physicians

Wound Care
Fellows have a dedicated wound care month where they learn outpatient and inpatient wound management. Wound management is also an ongoing part of the geriatric ambulatory clinic, home care and post acute and long term care. Fellows learn the basics of pressure ulcer staging, wound characteristics, wound management, wound debridement, principles of wound dressings, preventive measures and use of support surfaces.

Elective Rotations

Fellows can elect additional rotations in other areas such as osteopathic manipulative medicine, rheumatology, orthopedics and neurology or any other specialty of their choice to better prepare them to care for older patients. They can also choose an additional elective rotation for research and quality improvement projects.

Participation in geriatric research and quality improvement measures is an ongoing part of a fellow's education. The program provides training in teaching, administration and research to prepare fellows for careers as academicians, clinical educators, leaders and public health advocates.

Teaching
Fellows are required to participate in and lead lectures in geriatric and palliative care topics for various learners throughout their training. Fellows engage in community health programs with the department and are leaders on committees for health advocacy.

Scholarly Activity
Fellows are also required to identify, formulate and produce either a paper suitable for publication; or a quality improvement project before the end of fellowship. In addition, they are encouraged to present at local and national conferences.

Centennial Healthcare and Rehabilitation Center	Philadelphia, PA
Monumental Post-Acute Care at Woodside Park	Philadelphia, PA
PCOM Geriatrics and Palliative Care	Philadelphia, PA
Redeemer Health	Philadelphia, PA
Roxborough Memorial Hospital	Philadelphia, PA
St. Ignatius Nursing & Rehab Center	Philadelphia, PA

The PCOM Geriatric Medicine Fellowship participates in ERAS (Electronic Residency Application Service), and the match is conducted through NRMP (National Resident Matching Program). Deadlines and additional information may be found on the NRMP website.

Prior to appointment in a program, fellows must have completed an American Osteopathic Association (AOA) or ACGME accredited program in family medicine or internal medicine.

Program requirements

Family and internal medicine residents can elect to enter geriatric medicine fellowship training upon completion of their PGY-3 year. Candidates are encouraged but not required to sit for their family and internal medicine board exam prior to entering the fellowship. After completion of the fellowship, and successfully passing the family or internal medicine board exam candidates are eligible for certification in geriatrics.

Designated Osteopathic Residents

All PCOM residents/fellows will be Designated Osteopathic Residents. All must have sufficient background and/or instruction in osteopathic philosophy and techniques in manipulative medicine to prepare them to engage in the program's curriculum.

The Eligibility Requirements must be met before an applicant is eligible to receive an invitation to interview.

Other information

All applicants for PCOM fellowship programs must be authorized to work in the United States.

For more information about the geriatric medicine fellowship program, please contact:

Brenda Hoffman
Program Coordinator
Phone: 215-871-6371
Email: brendaho1@pcom.edu