University of Pittsburgh
Combined Clinical Years

Geriatrics and Oncology Course
MS-3

October 26, 2009 – October 30, 2009
1 week

Alfred Fisher, MD

Course Director
Alfred Fisher, MD
Assistant Professor
Department of Medicine
afisher@pitt.edu

Michael Lotze, MD

Course Director
Michael Lotze, MD
Professor
Departments of Surgery and Bioengineering
lotzemt@upmc.edu

Course Description

The Geriatrics and Oncology course focuses on an integrated approach to complex issues related to aging and cancer, both of which span the basic sciences, clinical acumen, and profound socioeconomic issues for our society.  The course is intended to help students understand the critical twin issues of aging, and cancer, now the single largest cause of mortality in the US in individuals dying before the age of 85.

This course is placed in the curriculum at the mid-point of the third year, which is a unique teachable moment where students can benefit from focused instruction on key topics which are commonly encountered during the core clerkships.

The Oncology portion of the course is designed to review the current status of the care and treatment of cancer patients, to emphasize the numerous medical fields in which physicians are often treating cancer patients, to review evidence of commonly held views on prevention of cancer through lifestyle changes, to update medical students on the efficacy of currently accepted cancer treatments, and to present current basic science studies that are likely to influence future treatments for cancer.

The Geriatrics portion of the course is designed to provide students with the knowledge, skills, and experience to recognize and approach common problems in older adults in inpatient and outpatient settings and in the nursing home.

Specific objectives include preparing students to:

  1. be aware of the great spectrum of health, functional, and cognitive states among individuals as they age.
  2. identify a patient with a geriatric syndrome, and develop a rational approach to the work-up and management.
  3. be able to describe changes in pharmacologic parameters that occur with aging.
  4. obtain a medication history from a geriatric patient.
  5. recognize common drug-related problems in older patients.
  6. understand the difference between pharmacodynamics and pharmacokinetics.
  7. be able to discuss issues involved in helping patients make medical decisions that are consistent with their treatment goals and preferences.
  8. be able to discuss how the diagnostic, decision-making, and treatment plans for an older patient may be different than those for a younger patient, particularly those with cancer.
  9. be able to explain similarities and differences between assisted living, post-hospital rehabilitation, and a dementia unit, and the patient characteristics associated with each.
  10. be able to conduct a basic functional and cognitive assessment of a patient.
  11. consider issues of establishing a cancer diagnosis and prepare to inform the patient and family.
  12. understand how to initiate a therapeutic oncologic care plan in a multidisciplinary context.
  13. apply current strategies to identify cancer early, be able to describe the advantages and pitfalls of cancer screening.
  14. understand the role of adjuvant therapies in cancer treatment.
  15. recognize common oncologic emergencies.
  16. understand the fundamental approaches to cancer treatment involving and integrating surgical oncologic principles, pharmacology of cancer drugs, radiobiology, and immunobiology.
  17. understand the connection between cutaneous findings and internal malignancies.

The 44 course faculty members are drawn from the departments of Dermatology; Medicine; Otolaryngology; Pharmacology and Chemical Biology; Psychiatry; Surgery; Urology; the Graduate School of Public Health; the School of Health and Rehabilitation Sciences; and the University of Pittsburgh Cancer Institute.

Educational Methods

Lecture Clinical site visits Patient case sessions    
Workshops Small-group cases        

Evaluation

Evaluation for this course is based on the course quizzes and examination, and attendance and participation in the course sessions.

Grading: This course is graded Honors / Satisfactory / Unsatisfactory.

Faculty Note

Faculty member Margaret Ragni, MD, is a recipient of the Kenneth E. Schuit Award. Faculty member Charles Reynolds, MD, is a recipient of the Donald S. Fraley Award for Medical Student Mentoring.  Faculty members Hollis Day, MD, and James Tew, MD have been honored with the Clerkship Preceptor of the Year Award.