Postrgraduate School of Geriatric Medicine

Integrated training objectives (i.e. common core)
The trainee must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, even in emergency-urgent conditions, of the most common internal medicine pathologies. The trainee must acquire the fundamental knowledge of physiopathology of the various organs and systems, the theoretical and practical knowledge necessary for the recognition of diseases that affect the various systems of the body, the theoretical and practical knowledge of the main sectors of instrumental and laboratory diagnostics relating to the aforementioned diseases, the acquisition of the ability to evaluate internal medicine and specialist connections and influences. He must therefore be able to recognize the symptoms and clinical-functional signs with which diseases of various organs and systems manifest themselves, having acquired the fundamental diagnostic, therapeutic, psychological and ethical knowledge necessary for a global vision of the patient. To this end, he must develop the ability to clinically frame the patient on the basis of the anamnesis and objective examination; develop critical and analytical diagnostic skills; become familiar with the main diagnostic procedures and laboratory-instrumental investigations; recognize and be able to deal with the main medical emergencies; become familiar with the therapeutic resources to plan their optimal use and recognize their indications and contraindications, as well as the effects of interaction and possible iatrogenic incidents; acquire the fundamental notions relating to clinical research methodologies and pharmacological trials; know the fundamental issues relating to prevention, public health and social medicine. The trainee must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency-urgency conditions, of the most common pathologies. Finally, the trainee must also know, from a clinical and therapeutic perspective, the most common pathologies within the competence of the other typologies of the class

Basic training objectives
Knowledge of the biological bases and physiology of aging; notions of demography and epidemiology of aging; notions of statistics necessary to interpret epidemiological data and scientific literature in the clinical and experimental field; knowledge of quality of life assessment methods

General training objectives..
Computer knowledge adequate for the creation and analysis of databases, with the specific purpose of computerizing the geriatric record for the assessment of the quality of care: and for the multidimensional assessment of the patient.

Educational objectives of the School typology
- In-depth knowledge of the relationships between aging, frailty and geriatric diseases, of the physiology of aging and its effects on the function of organs and systems, on the homeostasis of the organism and on the global functional state;
- Knowledge of the changes in pharmacokinetics and pharmacodynamics in the elderly and of the problem of polypharmacotherapy; knowledge of the methods of prevention and non-pharmacological therapy of the main diseases and syndromes of the elderly: clinical nutrition, physical exercise, lifestyle habits, behavioral techniques;
- Acquisition of integrated skills to develop the ability to approach the clinical patient in geriatrics;
- Knowledge of the peculiar ways in which diseases present in old age;
- Knowledge of the major geriatric syndromes: cognitive decline, incontinence, falls, malnutrition, immobilization syndrome, bedsores;
- Mastery of multidimensional assessment techniques: clinical, functional, cognitive, psycho-affective, socio-economic (including the ability to detect any abuse on the elderly), environmental;
- Ability to coordinate the interdisciplinary intervention and the integrated treatment plan of the geriatric patient;
- Knowledge of the principles of care of the elderly in different care situations;
- Management of the elderly with acute pathology: objectives and risks of hospitalization; methodologies of care of the hospitalized elderly; scheduled discharge;
- Knowledge of the territorial network of services, of the methodologies of care to avoid repeated hospitalization, and of the operating methods and objectives of the main services for the elderly: Acute Hospital; Residential Health Care Facility; Day Center; Integrated Home Care;
- Ability to coordinate the Geriatric Assessment Unit with the objective of global care of the elderly patient;
- Knowledge of selection criteria, objectives, principles and methods of rehabilitation in the elderly, with particular reference to the orthopedic, cardiological, neurological and cognitive sectors;
- Knowledge of objectives, principles and methods of palliative care for the elderly, of the methodological bases of research on the elderly, of the planning of controlled research and of the implementation, also for the geriatric patient, of "evidence based medicine".

Mandatory professionalizing activities for achieving the educational objectives of the type are:
- having drawn up and signed 100 medical records of hospitalized or outpatient patients;
- having personally performed the following medical procedures: 20 rectal examinations; positioning of 20 peripheral venous lines, 10 nasogastric tubes and 10 bladder catheters; 20 invasive procedures (performing 10 thoracenteses and 10 paracenteses);
- having performed cleansing and dressing of at least 40 bedsores, trophic ulcers, "diabetic foot" lesions;
- having performed the hydro-electrolytic and nutritional balance of at least 20 patients;
- having acquired experience in the clinical, instrumental and laboratory evaluation of caloric-protein malnutrition and clinical nutrition interventions
- knowing how to use practical diagnostic tools such as the electrocardiograph, pulse oximeter, reflectometer, dynamometer;
- have performed and countersigned at least 50 electrocardiographic tests and 30 arterial blood gas analysis tests;
- have acquired competence in basic and advanced cardiopulmonary resuscitation techniques (BLS and ACLS) and have participated in or performed at least 10 resuscitation maneuvers on a patient or manikin; - have discussed at least 20 echocardiographic tests and 10 angiographic tests with an expert;
- have discussed at least 20 brain CT or MRI scans with an expert;
- have discussed at least 50 chest X-rays and 50 between spine X-rays, chest CT and abdomen with an expert;
- have participated in at least 50 multidimensional assessment procedures in different nodes of the service network (District, RSA, Day Center), learning to manage the continuity of care for the geriatric patient;
- have performed at least 20 geriatric consultations in other Departments;
- having discussed at least 20 spirometry tests
- having participated in the conduct of at least 2 controlled clinical trials;
- having acquired experience in the use of educational programs related to telemedicine;
- having served for at least 2 weeks in each of the following clinics/services;
dementia; Parkinson's/movement disorders; diabetology; urodynamics; functional rehabilitation, with particular reference to balance disorders and fall prevention; osteoporosis; vascular and internal medicine ultrasound; respiratory physiopathology; pain therapy and palliative therapy.

The trainee may compete for the diploma after completing the professionalizing activities.

The trainee, as part of the training course, must learn the scientific bases of the School typology in order to achieve full maturity and professional competence that includes an adequate capacity for interpreting scientific innovations and a critical knowledge that allows him to consciously manage both assistance and his own updating; In this context, participation in meetings, conferences and the production of scientific publications and periods of attendance at qualified Italian and foreign institutions useful for his/her training may be foreseen.