Duke University Hospital Program

The Duke University Hospital Program in Geriatric Psychiatry offers a comprehensive 12-month fellowship designed to equip trainees with essential skills in the subspecialty of geriatric psychiatry. Led by Tracey Holsinger, MD, the program emphasizes direct patient care, consultation roles, research interpretation, and education.

The increasing population of older adults in the United States is driving the demand for specialized psychiatric care. By 2030, it is estimated that over 70 million baby boomers will be older than 65, necessitating a focus on geriatric mental health. The fellowship provides advanced training to address complex mental health issues faced by older adults, fostering professional development opportunities in various clinical settings 1.

Curriculum

The educational framework begins with a foundational lecture series in the first quarter. Seminars focus on long-term care, research methods, and quality improvement within geriatric psychiatry. Additionally, psychiatry-specific seminars are arranged throughout the year. The curriculum includes site-specific didactic education tailored to each rotation, including a structured electroconvulsive therapy (ECT) lecture series 9. Fellows are encouraged to engage with medical students and residents, fostering collaboration.

Clinical Training

Clinical training is integral to the fellowship, enabling fellows to provide patient care across various settings. Clinical sites include the Duke Behavioral Health Broad Street Clinic, which serves as the primary continuity clinic offering mental health services to older adults. Other sites include Central Regional Hospital, offering interdisciplinary teamwork among psychiatrists, social workers, and other healthcare professionals 8.

Fellows are also involved with the COACH program, which provides in-home evaluations for veterans with dementia. This program emphasizes comprehensive care and safety measures. The fellowship incorporates specialized rotations in areas such as sleep medicine, palliative care, and substance abuse, allowing flexibility based on trainee interests. Additionally, time spent at the Duke Memory Disorders Clinic provides exposure to multidisciplinary dementia care and research opportunities 6.

Research Opportunities

The program supports fellows in engaging in funded clinical research projects within the field of aging. This hands-on experience allows fellows to develop their academic skills while contributing to the body of knowledge in geriatric psychiatry. Formal mentorship is provided throughout the training, promoting a culture of inquiry and exploration 1.

Unique Aspects of the Program

One distinctive feature of the Duke Geriatric Psychiatry Fellowship is its collaboration with other geriatric training programs across disciplines. This interdisciplinary approach enriches the learning experience. Fellows are given opportunities not just to excel in clinical care but also to participate in educational sessions that include seminars on structural competency, ethics, and health disparities 5.

Application Requirements and Competitiveness

Applicants must submit a fellowship application through ERAS, accompanied by a personal statement, medical school transcripts, and letters of recommendation. Strong emphasis is placed on achieving a passing score in all attempts of USMLE or COMLEX 3. Foreign medical graduates must secure ECFMG certification and are required to hold a J-1 visa, as Duke does not sponsor H1-B visas 10. The fellowship is competitive, attracting candidates from diverse backgrounds, including international medical graduates (IMGs) and Doctor of Osteopathic (DO) candidates.

Diversity and Inclusion

An integral part of the Duke program is its commitment to equity, diversity, and inclusion. The fellowship program empowers fellows to advocate for marginalized communities through education and clinical practice. This pledge to diversity enriches the fellowship experience, ensuring that all perspectives are recognized and valued 7.

Visa Support

The Duke University Hospital Program sponsors J-1 visas for eligible international applicants. This support is crucial for foreign medical graduates who wish to pursue a career in geriatric psychiatry within the U.S., as it allows them to engage in this specialized residency training while adhering to immigration requirements 10.

Training Sites

Fellows will rotate through a variety of training sites to gain comprehensive exposure and experience. Core training locations include the Durham Veterans Affairs Medical Center and the Duke Memory Disorders Clinic, both excellent environments for tackling age-related psychiatric conditions 6. The program also emphasizes community engagement, with fellows participating in clinical evaluations at skilled nursing facilities and other community settings.