Clinical Program

GERIATRICS FELLOWSHIP CLINICAL PROGRAMGeriatric Fellows 2019-2020 with Dr. Mendiratta and Dr. Azhar

The program’s mission is to provide supervised Geriatrics opportunities for fellows to develop clinical and interpersonal skills, knowledge, professional attitudes, and practical experience required of a physician competent in the care of the aged.  The goals and objectives for each experience in this 12 month, ACGME-accredited fellowship program are based on the general competencies formulated by the Accreditation Council for Graduate Medical Education.  Upon completion of the program, Fellows are expected to take the exam and obtain the Certificate of Added Qualification in Geriatric Medicine. Fellows pursuing a Clinical, Clinician-Educator, or Reynolds Scholars track participate in the one year clinical program.



  • The Central Arkansas Veterans Healthcare System (CAVHS), a flagship Veterans Affairs (VA) healthcare provider, is one of the largest and busiest VA medical centers in the country. Its two hospitals, located in Little Rock and North Little Rock, anchor a broad spectrum of inpatient and outpatient healthcare services, ranging from disease prevention through primary care, complex surgical procedures, and extended rehabilitative care. This System serves as a teaching facility for more than 1,200 students and residents enrolled in approximately 90 specialty programs. Throughout its rich 81 year history, CAVHS has been widely recognized for excellence in education and research, and – first and foremost – for a tradition of quality and caring for Arkansas
  • The University of Arkansas for Medical Sciences (UAMS) is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, six centers of excellence and a statewide network of regional centers. UAMS has 2,435 students and 715 medical residents. It is one of the state’s largest public employers with about 9,400 employees, including nearly 1,000 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. UAMS and its affiliates have an economic impact in Arkansas of $5 billion a year. For more information, visit
  • Additional sites include several local nursing homes/health and rehabilitation centers.

Longitudinal Experiences

Fellows follow a cohort of home care, nursing home, and clinic patients during the 12 month fellowship.  The outpatient clinic experiences occur on two half days each week while visits to the home care and nursing home patients occur on alternate Wednesdays each month.  These experiences give the fellows training in longitudinal care for patients in a variety of settings.

Didactics / Conferences

  • Didactic sessions include weekly Geriatric Grand Rounds, weekly board review and lecture series, and specialty lectures from our Long Term Care, Palliative Care Medicine divisions and Memory Center.
  • Fellows attend at least one national conference, usually AGS, and several local conferences each year.
  • The department supplies each fellow with a copy of the Geriatric Review Syllabus and provides study time to assimilate this material.


The rotations are designed to give the fellows a broad experience in patient care.  Attending physicians are responsible for supervising and evaluating the fellows in each of the rotations, giving the fellows the opportunity to work with our geriatricians throughout the year at multiple sites and venues of care.  A broad clinical experience in geriatrics is offered at the following sites.

  • Outpatient Clinic (IOA; CAVHS)
    Follow a longitudinal patient panel, see walk-in patients, gain experience in specialty clinics, and serve as a preceptor for junior medical students.
  • Rehab (Community Rehabilitation – CAVHS-NLR)
    Learn some of the basic principles of rehabilitation for common geriatric syndromes and gain an understanding of the roles of physical therapy, kinesiotherapy, occupational therapy, and speech therapy in maximizing functional independence in the elderly.
  • Consults (CAVHS or UAMS) 2 months
    Participate in geriatric consults on general, medical and surgery subspecialty and intensive care units, make recommendations regarding the work up and management of geriatric syndromes, and participate in discharge planning for frail elderly patients.
  • Geropsychiatry (CAVHS – NLR)
    Assist with management of geriatric patients who have a variety of behavioral problems and psychiatric symptoms; observe and discuss neuropsychological testing.
  • HBPC (Home Based Primary Care – CAVHS)
    Assess patients in the home and evaluate patient’s need for home care; conduct weekly interprofessional staff meetings and develop individual treatment plans for new patients.
  • Nursing Home (Community Nursing Homes)
    Learn to approach the diagnosis and treatment for both acute and chronic problems within the nursing home environment; focus on management of chronic illness, restoration and maintenance of function, and recognition and alleviation of pain in the elderly population.
  • Palliative Care/Hospice Care (UAMS, CAVHS, Community Hospices)
    Learn the principles of palliative care, pain management, symptom management, and comfort care and develop an expertise for addressing end-of-life issues.
  • GEM (Geriatric Evaluation & Management Unit – Inpatient, CAVHS) 2 months
    Direct the unit which focuses on geriatric patients with specialized needs for recuperative and rehabilitative care.
  • Elective
    Pursue an area of specific geriatric interest such as experiences with strong outpatient components involving common problems of the elderly including rheumatology, dermatology, neurology, incontinence, etc.

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