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Senior 'professors' help train San Antonio medical students (9/03/98)

Catastrophic illnesses. Life memories. Medicines. Family members. Daily living skills. Hopes. Fears.

Caring for the older patient is a complex challenge for any physician, and is a mission that requires compassion, understanding and skill.

Fortunately, a new, aggressive curriculum at The University of Texas Health Science Center at San Antonio is placing medical students in the private homes and assisted living facilities of senior citizens. There the students are learning from senior "professors" who are sharing their life situations.

"We are devoting ourselves to developing the next generation of academic geriatricians," said David V. Espino, MD, associate professor of family practice at the Health Science Center and director of the Hartford Center for Excellence in Geriatrics Education. The San Antonio center, established in January with a $525,000 grant from the John A. Hartford Foundation in New York, is one of only 25 nationwide.

The Health Science Center's Medical School curriculum was revised so that students gain clinical experience with seniors very early in their education and training, said Cynthia L. Alford, PhD, assistant professor of family practice and program coordinator with the Hartford Center. "By interviewing seniors about their health history and life events, the abstract classroom learning of the first years of Medical School becomes more relevant," she added.

The Senior Professor Program pairs each senior volunteer with a team of two medical students. The students will visit their mentor's residence or assisted living complex at regular intervals during the first and second years of Medical School and continue to track the senior in the third and fourth years.

Participating collaborators include the Patriot Heights, Morningside Manor, Hamilton House and Merrill Gardens retirement communities in San Antonio, and Sisters Care of San Antonio, a ministry of The Sisters of Charity of The Incarnate Word.

"The population of the country is aging dramatically," Dr. Alford noted. "All doctors need to be comfortable with, and skilled at, taking care of geriatric patients. We also need to recruit doctors into this area as a specialty. There are not enough geriatricians trained to meet the future projected demands."

The fastest growing segment of the U.S. population is 84 and older, she said. By the year 2020, 30 percent of all outpatient practice and 60 percent of the hospital practice is expected to be 65 and older, according to "The Importance of Geriatrics to Family Medicine," a position paper printed in the Journal of Family Medicine in 1995.

The Senior Professor Program is one of many efforts under way at the Hartford Center. The center provides specialized training in geriatrics for residents and supports fellowships for advanced training in the South Texas Veterans Health Care System, Audie Murphy VA Hospital Division. Dr. Espino, the centerís principal investigator and director, also directs the geriatrics programs for the University Health System.

Michael S. Katz, MD, professor and chief of the department of medicine's geriatrics & gerontology division, is the co-principal investigator. Dr. Katz also is director of the Geriatric Research, Education and Clinical Center (GRECC), located in the VA Hospital.

The Hartford Center's offices are at the University Health Center-Downtown.

Seniors are so taken with the program that there already is a waiting list of "professors," eager for the chance to work with the 200 students who will enter the Medical School in 1999, Dr. Alford said.

Contact: Will Sansom