Geriatrics
Individual Discipline Training Committee
Chairperson:
Dr Lee Fatt Soon
Members:
Dr Yau Weng Keong
Dr Philip Poi (UMMC)
Dr Rajbans Singh (UPM)
Chairperson will rotate among the senior members of the specialty from Ministry of Health
Functions of the committee:
ƒ Selection of candidates
ƒ Accreditation of training centres and trainers
ƒ Program contents & mode of training
ƒ Plan training schedule of individual trainees
ƒ Review progress of trainees
ƒ Exit evaluation
Entry Requirement
ƒ
ƒ
ƒ
ƒ
ƒ
ƒ
Basic medical degree registrable with Malaysian Medical Council
The candidate must satisfy requirement of the Fellowship committee
Recognized qualification in Internal Medicine such as M..Med (int. medicine)
from the local university , MRCP (UK or Ireland), FRCAP or equivalent
At least a minimum of 1 year post MRCP, FRACP, Master Medicine (Int.
Med.) or equivalent
Candidates should provide evidence of sound and good physical and mental
health with evident interest in the quality of care and welfare of elderly
patients – based upon report by supervising physician
Completed 1 year service in district hospital after basic specialty qualification
Duration
MRCP /
Mmed
equivalent
1 year General
Internal Medicine in
Appropriate hospital
Duration is 3 years – see diagram
Fellowship Training Program
Kementerian Kesihatan Malaysia
Mei 2002
6 months Posting
in Geriatric
1 year
structured
training local
6 months
Posting in
Geriatric
Training Content and Modalities
Post graduate Training Content: UMMC
1 Basic Sciences
2 Clinical teaching and concepts behind Geriatric Medicine
• Health Promotion and disease prevention: primary, secondary and tertiary prevention
• Core competencies:
1. Ability to take a history
2. Formulate a differential diagnosis
3. Preparing management plan for patients & exposure to the multidisciplinary
concept .
Posting of 12 months with Geriatric Unit, UMMC, KL
10 MONTHS acute / Rehabilitation in Geriatric Medicine (clinics, ward rounds,
tutorials, seminars and journal reviews) which will include liaison with the
Orthopedic Unit and Neurology.
• 1 month attachment to Rehabilitation unit (in particular, management of pressure
sores , contractures)
• 1 month attachment at a local or overseas accredited unit should the candidate show
exceptional aptitude during training.
During this period, the trainee is expected to carry out a research project pertaining to
Care of the elderly.
Details as in Appendix
Training Centers & Trainers
Accredited trainers:
Prof Philip Poi (UMMC)
Accredited training centers:
UMMC
(Future training centres and trainers planned in KLGH)
Trainee commitments
1.
2.
3.
4.
The candidate will be required to perform all clinical duties as directed by the
supervisor .
The candidates must participate in geriatric related CME activities and should
attend courses, seminars and lectures
They should have an opportunity to function as a teacher to his colleagues in practice,
to paramedical staffs and students
The candidate should be encouraged to prepare written material in the form of an
Article, case report or even original paper to be published in a refereed journal.
these case reports are to be presented to and assessed by the candidate ’
supervisor before publication .
Fellowship Training Program
Kementerian Kesihatan Malaysia
Mei 2002
CANDIDATE / TRAINEE ’S ATTITUDE
1.
2.
3.
4.
5.
Candidate must be very empathetic to the needs and wants of patients and
their families as Geriatric Medicine is a very “ Family and Social ” oriented
Subspecialty. This attitude is also very important in helping to understand the
nature of the illness, the social and cultural involvement and the need and
goals of the patients and families. Also there are a lot of bioethical issues
which the families must always be involved.
They must also look into psycho-social issue which are important consideration
in Geriatric Medicine .
Inter-disciplinary Teamwork is an essential component of Geriatric Practice.
There is also a lot of overlapping in the role of the different personnel in
Geriatric care. Therefore candidates should develop the appropriate attitude to
work harmoniously with other allied health care personnel.
Candidate should always self reflect on their knowledge, attitude, skills and
the importance of continuing medical education in Geriatric Medicine. Ageism
and ignorance is major obstruction to progress of Geriatric Medicine, therefore
candidate must be willing to share and teach students, trainees from other
discipline and allied health care personnel.
The candidate should show the initiative required to start geriatric services at state
level on their own (in the interest of service).
Logbook
UMMC Log book (appendix UMMC study journal)
Certification
Before certification as a Geriatrician, professional reports from trainers will be required and an
interview with the Accreditation committee is required.
Fellowship Training Program
Kementerian Kesihatan Malaysia
Mei 2002
APPENDIX
Post graduate Training Content: UMMC
Basic Sciences
ƒ Biological of ageing
ƒ Physiological changes of ageing
ƒ Consequences of Ageing on Drug metabolism: Pharmacokinetics and dynamic
ƒ Neuroscience: Age-related CNS changes and degenerative diseases (Alzheimer’s
Disease, Parkinson’s Disease, Prion associated diseases)
ƒ Nutrition
ƒ Social and behavioural aspects of ageing
ƒ Demography
ƒ Ethical and legal issues
Clinical teaching and the concepts behind Geriatric Medicine
• Health Promotion and disease prevention: primary, secondary, and tertiary prevention
• Core competencies which include:
ƒ Ability to take a history
ƒ Formulate a differential diagnosis
ƒ Prepare a management plan for patient with the following:
• Multiple medical problems
• Functional difficulties
• Polypharmacy
• Poor Social support
• The Giants of Geriatrics (instability, falls incontinence, iatrogenic diseases,
dementia and delirium)
• Exposure to the multidisciplinary concept: This will include a short attachment to disciplines closely
allied to Geriatrics (e.g. Physiotherapy, Occupational Therapy, Chiropody, Rehabilitation Medicine,
Social Welfare) and will include site visits to selected nursing homes and day centers. This will ensure
that the trainee understands the potential of these services in improving the quality of medical care to
the elderly patient.
Posting of 12 months with Geriatric unit, UMMC, KL:
10 months of Acute/Rehabilitation in Geriatric Medicine (clinics, ward rounds,
tutorials, seminars and journal reviews) which will include liaison with the
Orthopaedic Unit and Neurology.
• 1 month attachment to Rehabilitation unit (in particular, management of pressure sores,
contractures)
• 1-month attachment at a local or overseas-accredited unit should the candidate show exceptional
aptitude during training.
During this period, the trainee is expected to carry out a research project pertaining to
Care of the elderly, and will be encouraged to sit for the Diploma of Geriatric Medicine,
DGM (UK).
The incumbent will base an assessment of the trainee on close supervision and monthly review
Geriatrician (Assoc. Prof. Dr Philip Poi).
The above study plan will give the trainee a total of 12 months of comprehensive training in
Geriatric Medicine with emphasis on Holistic elder care based in the Malaysian setting. The
trainee can then go to an overseas unit for a period 3-4 months for further subspecialty
(incontinence, memory, falls stroke/neurological rehabilitation, palliative care) exposure.
Attachment with Specialty Geriatric Units in UK, Ireland and Singapore can be arranged by the
existing links with our Geriatric Division and these Units.
Fellowship Training Program
Kementerian Kesihatan Malaysia
Mei 2002