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ACGME Advancing Innovation in Residency Education (AIRE)

Caring for older adults is intellectually demanding clinical work that requires advanced synthesis across medical, functional, cognitive, and social complexity. Multimorbidity, polypharmacy, and competing evidence‑based recommendations are common, requiring clinicians to weigh risks and benefits, adapt guidelines thoughtfully, and align care with patient goals and quality of life. Geriatrics training builds on the skills developed during Internal Medicine residency, extending them into advanced clinical judgment, interdisciplinary leadership, and high‑stakes decision‑making that support the delivery of Age‑Friendly care.

The UAB Tinsley Harrison Internal Medicine–Geriatrics Integrated Residency & Fellowship Program is structured to prepare trainees for this level of clinical complexity by integrating Geriatrics throughout Internal Medicine residency, culminating in a dedicated fellowship year. Rather than concentrating geriatrics into a single year, experiences are layered across PGY‑1 to PGY‑4 so that clinical skills, judgment, and continuity develop progressively over time. By the PGY-4 fellowship year, trainees are prepared to function at a high level while also pursuing individualized interests in clinical focus, scholarship, leadership, and professional development.

 

At-a-Glance

  • 4 years total: Internal Medicine residency followed by Geriatrics fellowship
  • Geriatrics starts early: Integrated experiences during PGY‑1 to PGY‑3
  • Thoughtful progression: Fellowship begins with a strong clinical foundation already in place
  • More flexibility during fellowship: Greater capacity for electives, scholarship, and professional development
  • Longitudinal mentorship: Relationships developed over multiple years rather than a single fellowship year
  • High‑value skills: Advanced training in complexity, care transitions, and interdisciplinary leadership

 

Training Timeline

YearFocus
PGY-1 Standard IM rotations + required Geriatrics/Palliative Medicine block
PGY-2 Mix of IM and Geriatrics continuity clinics; electives in Geriatrics
PGY-3 Advanced Geriatrics electives; leadership in interdisciplinary care
PGY-4 (Fellowship) Full Geriatrics fellowship: consults, nursing home, house calls, research, and professional development

 

Stacked bar chart comparing the number of months spent in Medical Clinical Experience, Geriatrics Clinical Experience, and Geriatrics Development or Research across PGY-1, PGY-2, PGY-3, and PGY-4. The first three years are dominated by medical clinical experience with minor geriatrics exposure, while PGY-4 shifts heavily toward geriatrics clinical and development or research training.Continuity experiences in Geriatrics begin in PGY‑2 and expand through PGY‑3, supporting a smooth transition into fellowship. By incorporating selected continuity clinic requirements during Internal Medicine residency, trainees start fellowship with a stronger clinical foundation and greater flexibility to pursue individualized clinical interests, scholarship, leadership development, and sustained mentorship.

 

 

Contact

Additional information is available by contacting Dr. Mark Newbrough at mnewbrough@uabmc.edu or Elizabeth McAlister at emcalister@uabmc.edu.