Program Overview

The Geriatric Psychiatry Fellowship Program at Dartmouth Hitchcock Medical Center trains excellent clinical geriatric psychiatrists, preparing them to practice geriatric psychiatry wherever older adults receive healthcare services, and to become leaders in the field, as clinicians, educators, researchers, and advocates. To accomplish this, clinical rotations span a broad range of inpatient, outpatient, and long-term care settings.

In addition to longitudinal experience in the program’s geriatric psychiatry outpatient clinic, fellows spend time in the primary care geriatric medicine clinic. There fellows gain experience working in a primary care environment, consulting to geriatricians and other primary care providers, and delivering geriatric primary care themselves, under the supervision of a faculty geriatrician.

The goal is to ensure that fellows are prepared to manage frail patients with co-morbid, chronic medical and psychiatric conditions, and to develop skills necessary to collaborate successfully with non-psychiatric providers, who deliver the majority of mental healthcare to older adults, and function effectively in general medical settings, where the majority of geriatric mental health services are delivered. Fellows also work in the Neurology Department’s dementia clinic learning cutting-edge principles of dementia evaluation.

In addition to traditional nursing home consultation, the long-term care component of the fellowship includes experiences in an assisted living facility, independent-living, retirement community, and a specialty psychiatric nursing home. Rotations at the New Hampshire Hospital, the New Hampshire’s sole state psychiatric hospital, and the Veterans’ Administration Medical Center at White River Junction, Vermont, round out the fellowship.

Sample of rotations completed throughout the course of the year-long fellowship:

This full range of geriatric care settings affords our program two strengths. First, we have a great deal of flexibility to mix and match, based on individual fellow’s career goals and interests. Second, fellows gain experience with a clinically, demographically, and socially diverse population of older adults.

Despite the wealth of clinical opportunities our program offers, our focus is on quality, not quantity. We strive to ensure that clinical responsibilities leave plenty of time for fellows to delve into the conceptual, methodological, evidentiary, and philosophical underpinnings of geriatric psychiatry, especially with respect to the unique mechanisms by which mental disorders present in late life, and the barriers (patient, provider, system, and societal) to delivery of quality care to older adults.

Didactic teaching centers on a directed reading syllabus of curated, original source references, covering the gamut from seminal articles in the field to reports of cutting-edge research. All have been selected to stay up to date and to stimulate discussion about what makes both geriatric patients and our sub-specialty’s approach to evaluating and treating them differently. We want you to feel fully prepared to step into the new and evolving roles geriatric psychiatrists will fill in the future healthcare delivery system.

At all levels, local, regional, national, and international, geriatric psychiatry comprises an exceptionally collegial, close-knit, supportive, and welcoming sub-specialty niche. You will find this to be the case here. We’re fortunate to be located a bit off the beaten path, in a spectacular region of Northern New England that promotes wellness and wellbeing, complementing perfectly our program’s vibe. Fellows feel welcome as junior colleagues here. You’ll find that as soon as you sign up for geriatric psychiatry, you’re one of the family. Come see for yourself.