The experience is enriched by the fact that I am working in Mount Sinai Hospital’s world-class Emergency Department that has become an international leader in the provision of ED-based geriatric care. Furthermore, over the course of my fellowship, I have also been able to explore every other clinical aspect of providing care to older adults beyond the ED, including in their communities, in their homes, and in the hospital with the different sorts of professionals who work in these settings as well. Indeed, understanding what care can and should look like allows me to not only provide better care but also understand how I can build an elder-friendly ED wherever I end up that benefits my patients in a broader system of care that serves them well.
Fortunately, I was encouraged to do the Geriatric Emergency Medicine Fellowship by an amazing person I met — Dr. Don Melady, an ED physician at Mount Sinai Hospital in Toronto who specializes in delivering emergency medicine to older adults and founded Canada’s first fellowship with the support of generous donors. Furthermore, thanks to Dr. Melady’s guidance and mentorship, I took the leap and am set to become the first doctor in Canada to complete a Geriatric Emergency Medicine Fellowship.
The decision to do this fellowship was the best decision I could have made, and it was also the greatest challenge of my life. A new city, a second language, a new health care system, a new team. This put me completely out of my comfort zone, but I think this is when you can also get the most amazing and rewarding experience as a result.
Dr. Don Melady’s career has focused on improving the care of older patients in the ED.
One of the most valuable lessons I have learned is how different and unique older adults are, and how they must be evaluated and treated differently. I am also learning how to communicate that to other health care professionals and how to manage resources and staff to deliver the best possible care. I am also learning from others’ experiences in geriatric ED care initiatives from hospitals across the country through my participation as a faculty member in Mount Sinai Hospital’s Acute Care for Elders (ACE) Collaborative, sponsored by the Canadian Foundation for Healthcare Improvement and the Canadian Frailty Network.
I am now more than halfway through my Geriatric Emergency Medicine Fellowship, and with only four months left, it’s gone by too fast because I still have so many projects to work on, so many more opportunities to explore, so many more bright and intelligent people to meet.
I found one of those opportunities in an incredible research group. The interRAI group is a collaborative network of researchers, clinicians and policy makers in over thirty countries committed to improving care for persons who are disabled or medically complex. Working with Dr. Andrew Costa of McMaster University, who completed his Post-Doctoral Fellowship at Mount Sinai Hospital, I presented a paper today on frailty in the ED at the Global Acute Care Excellence forum in Brisbane, Australia.
One of the other lessons I have learned during my fellowship is that establishing Elder-Friendly EDs needs to be part of the future of emergency medicine. Every small step in that direction is beneficial for patients, staff, administrators and the hospital, as well as the health care system’s bottom line. Geriatric Emergency Medicine is not just good for older adults, it’s good for everyone. There is absolutely no reason for EDs to not become Elder-Friendly, especially with the rapidly ageing population.
Geriatric Emergency Medicine needs to have more attention and recognition, and I will make sure of that. This is my mission now, my career, my passion.
If you want to keep following my journey, you can follow my blog where I have been regularly posting my thoughts and experiences throughout this year: www.geriemfellow.blog. Who knows? It may inspire you to be the next one to pursue a Geriatric Emergency Medicine Fellowship!
Date modified: 2017-02-21
