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Elder Care


Family Medicine

Specific Location:

Johnson City
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James Holt, MD
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Responsible Faculty:

James Holt, MD
423 439-6471

Contact Person:

Connie Clyburn


Initial Meeting-Place and Time:

Mountain Empire PACE  10 AM (Options 1 & 2) or JC FMC 8:30 AM (Option 3)

Periods Offered:

All except first 2 (July) and December

Maximum Students per Period:



This two-week rotation is designed help students progress towards mastery of the basic skills required for care of the aging population in the 21st century.


At the conclusion of this rotation, the student should be able to

• Application of basic history and physical skills to the elderly population

• Formulation of appropriate individual care plans for specific elderly patients

• Management of selected patients within the constraints of the systems available

• Mastery of specific criteria applicable to the aging population (ex. geriatric syndromes) and problems particularly relevant to this group.

Course Outline:

Identify topics to be covered and type of setting(s) students can expect to experience:

Students will spend time with clinicians, in the office setting, PACE, hospital and nursing home.   Students will first be exposed by means of models and lectures, observation, and then actual performance of procedures.

Methods of Instruction and Distribution of Student's Time

Methods of Instruction % Time (1){2}[3]
Case-based learning


Conference (informal topic centered meeting)


Directed study block (instructor assigns topic)
Laboratory: type?
Lectures (Instructor formally speaks before a group on a subject)

({10%}) [30%]

Patient care activities: ({[50%]})
  Other: (describe)
Self-directed learning- (student sets the topic)

(15%) {[10%]}

Web-based course material



Methods of Evaluation:

Students will be evaluated based upon level of participation in activities and enthusiasm by preceptors, as well as performance on the clinical project(s).

Proposed Rotation Schedule:

Option 1: Based in Big Stone Gap, VA, Mountain Empire PACE

At the beginning of the selective, the student travels to Mountain Empire PACE, becoming immersed in the interdisciplinary activities both by: firstly, staying with an assigned through all of their care for up to 3 days, and secondly, working at least a half-day with the MD, the NP, the PT, the OT, and the MSW.  During that time, the student will also go on at least 1 home visit.  The student prepares a report summarizing a geriatric syndrome of interest, preferably one demonstrated by the assigned patient.  In addition, the student presents a short presentation to either the PACE patients or the PACE staff, on a topic selected by the student, (with agreement by the PACE staff that the topic is of value to the patients/staff).

Option 2: Split time between PACE and Johnson City

The student travels to PACE the first week, and stays with an assigned patient, as above, and spends time with the various disciplines.  In the second week, the student spends 2 days in the FM Clinic, 1 day at the nursing home, and half-days in Osteoporosis Clinic, with a preceptor, and preparing and giving the project presentation on a geriatric syndrome, in a case-based format.

Option 3: Based in Johnson City Family Medicine

The student concentrates on geriatric cases at FM Clinic 5 days, nursing home 2 days, Osteoporosis Clinic 1 day, 1 day preparing and giving the project presentation as above, and half-days with a preceptor and on a web-based exercise.

# of hours per week the student is expected be involved in this rotation:


hotel reimbursed if needed




if over-nighting: food reimbursed
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