| Center of Excellence
Excelling at Baylor College of Medicine
At the May 20, 2004, Huffington Center on Aging (HCOA) Development
Board meeting, Anita Woods, Ph.D., Assistant Professor, Department
of Medicine, gave the following report on the HCOA’s
Center of Excellence (COE). Dr. Woods came to Baylor College
of Medicine in 1994 to direct the project “Geriatrics
in Primary Care Residency Training” along with Dr. Robert
J. Luchi. She is a member of the COE Executive Advisory Committee
and the faculty mentor for the COE Medical Student special
interest group in geriatrics. Here are Dr. Woods’ remarks:
“What is the COE? It is a designation of excellence
in education and training awarded and funded by the John A.
Hartford Foundation of New York City. The HCOA was awarded
its first COE funding in 1998. This was in large part in recognition
of the extraordinary efforts of Dr. Robert J. Luchi in founding
the HCOA and championing the development of the education,
training, research and clinical care programs in the field
of geriatrics at Baylor College of Medicine (BCM). Dr. Luchi
described it as the ‘Good Housekeeping Seal of Approval’
and it is recognized internationally as an accreditation of
superior programs in geriatrics. Each of the approximately
20 COEs, throughout the country, has its own personality,
but each has this mandate: To recruit and train physicians
committed to careers in academic geriatrics. Part of the COE
mission is to assist in the professional development of our
geriatric physicians so that they advance and are promoted
into tenured faculty. A good start to achieving this goal
is to provide a superior fellowship-training program for geriatricians.
By being designated a COE, we are ranked in the highest echelon
of geriatrics programs in the country. Before 1998, there
were two COEs on the West Coast, and 12 dotting the East Coast
and Northeast. We put Texas on the map. Right now there are
two COEs in Texas, one at The University of Texas at San Antonio,
and the other at BCM. We are in our third three-year cycle
of funding now; 1998-2000, 2001-2003, and 2004- 2006. Renewing
funding and keeping the designation of COE is highly competitive.
Roy G. Smith, Ph.D., Director of the Huffington Center on
Aging, along with George E. Taffet, M.D., Chief of Geriatrics,
give their full support to these efforts.
Why are COEs important? We do not now have, nor will we
have in the future, enough geriatricians for our current and
projected numbers of adults over the age of 65, which will
comprise 20% of the U.S. population by the year 2030. COEs
train geriatricians to assume leadership roles in academic
medicine. What do these leaders do? They provide the gold
standard of clinical care for our elderly; they conduct the
research that gives us evidence-based scientific guidelines
for such care; and they help train our young physicians, and
other health care professionals of the future in the comprehensive
and compassionate care of older adults.
The Center of Excellence at the Huffington Center on Aging
has graduated 16 fellows between 1998 and 2003. Three more
are graduating this summer and over 2/3 have gone into academic
positions. These fine physicians have set up practices here
in Houston as well as in cities across the United States.
The COE gives preference to physicians wanting to enter into
two years of advanced training in geriatric medicine. Why?
Because in one year a fellow learns excellent clinical skills
both inpatient and outpatient, long term care, and home visits.
But, in TWO years they learn advanced skills in clinical teaching,
research, and leadership (e.g., Medical Director accreditation,
certification in palliative care, and hospice care).
Our COE helps fund the second year of training, but additional
funding is needed because federal monies will cover only one
year of training. Through the generosity of the HCOA Development
Board, funding for two fellows to enter their second years
of training has been provided. Our COE also pays a lot of
attention to our medical students. Why target students who
are so early in their training? Research has found that students
are more negative about older adults after they complete medical
school than before they enter medical school. We know that
something happens in their four years of training that has
a negative impact on their desire to care for older adults.
It could be because they have fewer positive role models (e.g.,
geriatricians); or negative stereotypes of
aging; or it could be that the medical education model of
success is to “cure”, and there is no “cure”
for aging at this time. Instead, geriatrics focuses on “care”
and improving the quality of life for
older adults.
During their four years of medical school, at Baylor College
of Medicine, the students can participate in activities to
encourage interest in geriatrics, such as; student interest
groups, special skills training in geriatrics, and clinical
exposure in different settings. The COE supports a student
interest group in geriatrics that includes medial students
from UT Medical School-Houston and BCM. This joint student
group is made up of about 50 students who attend six or seven
noon lectures per year, participate in community service with
frail elders, attend two socials at the homes of faculty members,
and participate in the Shadow a Geriatrician experience. All
of these activities reinforce the positive aspects of working
with a geriatric population.
In summary, the HCOA Center of Excellence initiatives help
keep BCM in the forefront of education, training, research
and clinical care of older adults. It is a priviledge to be
a resource for the training of our geriatricians of the future.
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