1. Continuity clinic:
This experience consists of the evaluation and following over the residency of ambulatory older persons as they receive primary medical care. It will consist of one 4 hour session per week for the entire residency in a primary care geriatric office. The experience will include new patient evaluations, yearly assessments and interval care. Patients will be selected in a way to insure a broad mix of outpatient geriatric problems. The Fellow will see patients independently and will organize treatment plans under the supervision of the attending.

2. Assisted Living (Piper Shores):

The Fellow will admit and follow over the course of the residency selected older persons living in the assisted living unit of a local retirement community called Piper Shores. The supervising physician is the Medical Director of the facility. The Fellow will also provide some acute illness care, when needed, for the patients of the Medical Director.

3. Nursing Home and Skilled Care (Maine Veterans Home, Scarborough):
Throughout the residency experience the Fellow will spend one four-hour session weekly at the Maine Veterans Home (Scarborough) under the supervision of the Medical Director and the Assistant Medical Director (Drs. Harper and Braun). The Fellow will admit and care for a panel of patients over time and will be an integral part of the teaching of other Internal Medicine and Family Medicine residents at that site.

4. Outpatient geriatric assessment (The Geriatric Center):
The clinic meets weekly and is designed to provide comprehensive geriatric assessment in a multidisciplinary form to elderly patients who are community living and perceived to not be functioning well. The Fellow will work with geriatricians, geriatric psychiatrists and other clinical staff in the evaluation of new patients, provision of early dementia patient and family services and other clinic functions. The Fellow will perform and participate in the physician portion of the assessment and will play a major part in the synthesis of information in order to create a list of diagnoses and a treatment plan. The Fellow will also conduct the family/caregiver meetings. The assessment is supervised by faculty who have experience with Geriatric Assessment in outpatients.

5. Acute Care for the Elderly unit (ACE Unit):
The ACE Unit is a geographically and structurally distinct unit of the Maine Medical Center designed to provide the team concept of care for complicated acutely ill elderly patients. While assigned to the Acute Care Rotation (four months per year) the Fellow will be an integral member of the ACE unit team. The unit and the Fellow are supervised by a member of the geriatric faculty (Dr. Weirman). All patients assigned to the unit are seen daily by the ACE team and the principles of geriatric medicine are utilized to shorten the length of stay, prevent hospital related complications, and to maintain maximal function and independence.