Meet Member of AAGP
I cannot pinpoint any one experience that led me to geriatric psychiatry, but I can tell you what makes me passionate about it now. My parents instilled in me a deep respect for my elders, even though my own grandparents were many thousands of miles away. Through elementary, middle school and high school, I volunteered at various nursing homes, visiting with residents, playing cards and helping them with anything I could, but I never thought of these experiences as preparation for my career.
When I was in medical school, I was drawn to geriatric medicine, but as I quickly realized, no one is truly healthy without mental health and I switched to geriatric psychiatry. In this society, youth is more highly valued than wisdom. We are taught to hide our wrinkles and lie about our age. We celebrate youth and hold our aging in contempt. I truly believe that there should be dignity for all people no matter what your age. We do not deserve less as we age. We should be honored and respected, and we must protect that ideal. Depression and anxiety are common, but they are not a normal or necessary part of aging. My work with Aging Service Providers, Adult Protective Services and law enforcement to protect our elders against abuse and neglect is focused on that goal. As our Elder Abuse Prevention Program brochure says, “It should not hurt to be old.”
My subspecialty training in Geriatric Psychiatry gives me the privilege to work with exceptionally caring professionals in all arenas to care for our older adults. However, time and again I am asked to bring other colleagues on board and I have to talk about the need for geriatric psychiatrists in the world. As the director of the Geriatric Psychiatry Fellowship Program at the University of Rochester School of Medicine and Dentistry, it is my mission to train psychiatric colleagues in the art of caring for older adults with compassion and skill. I believe that as the population continues to age, other psychiatrists will hear the call to serve our elders.
Elizabeth J. Santos, MD | Assistant Professor of Psychiatry | University of Rochester School of Medicine and Dentistry
I am a 5th year psychiatry resident in McGill University, Montreal Canada. Soon, I will be doing clinical and research fellowship training in geriatric psychiatry in Toronto. I am very much excited to start a career in geriatric psychiatry as a clinician-researcher.
I became interested in geriatric psychiatry after having been exposed to geriatric medicine rotations in early residency. The interdisciplinary holistic care provided by the team, as well as the combination of knowledge from psychiatry, medicine, and neurology needed to treat our patients made this field a good fit intellectually and spiritually.
Rotating in a dementia unit, doing psychotherapy with older people, being involved in research projects, as well as meeting mentors locally and in other institutions all helped consolidate my interest. My interactions with patients and with professionals in our field made me feel very much at home.
The vast possibilities for research in geriatric psychiatry make our field particularly exciting in the coming years and decades - we can hope for new treatments and approaches to help our patients, as well as public health interventions to care for our quickly aging population.
Being able to attend the AAGP conferences for the past four years has allowed me to meet many of the kind, approachable, energetic and warm individuals in our field. The Scholars program has been helpful in making it possible to attend the annual meetings as well as to connect with mentors and other trainees. I am thankful to the AAGP and my mentors in geriatric psychiatry for their support and hope to continue coming back to the AAGP conferences in years to come.
Soham Rej, MD | Psychiatry Resident | McGill University
I am currently a PGY-4 psychiatry resident at Western Psychiatric Institute & Clinic, and plan to pursue a career in academic psychiatric research upon completion of my training. I completed my undergraduate studies at Columbia University and received my medical degree from the University of Pennsylvania School of Medicine. While my interest in academic psychiatry first developed during medical school, my interest in geriatric psychiatry emerged more recently, during an inpatient rotation at the beginning of my PGY-2 year. I found this rotation incredibly rewarding, and was stimulated by the complexity of the cases that I managed, as well as the diagnostic and therapeutic challenges that they presented. I also became excited by the research opportunities that the field has to offer, and believe that specializing in geriatric psychiatry will provide an exciting arena in which to pursue my long-held interest in the study of evidence-based pharmacotherapies. Next year, I will be returning to the University of Pennsylvania to complete a fellowship in geriatric psychiatry. If you are considering a career in academic psychiatry, and hope to contribute to discoveries that will improve the care of your patients, there is no better place to be (in my opinion) than the field of geriatric psychiatry!
Aaron M. Koenig, MD | Western Psychiatric Institute & Clinic (of UPMC)
I hail from the Southern Indian State of Kerala and completed my medical school training at the University of Kerala in 1996. I then moved to York, England to pursue post graduate training in psychiatry. During my training at York, I also attained a Post Graduate Diploma in Clinical Psychiatry from the University of Leeds, Leeds, England. In 1999, I moved to the University of Vermont in Burlington to continue my postgraduate training in psychiatry. In 2001, I moved to New Haven to start geriatric psychiatry fellowship training at Yale. I chose the field of geriatric psychiatry as it encompasses the disciplines of neuroscience, medicine, and psychiatry. I enjoy the intellectual stimulus of neuroscience, the diagnostic challenges of medicine and the humanistic values of geriatric psychiatry. Geriatric psychiatry affords me the satisfaction of practicing the art and science of medicine with compassion, integrity, and dignity.
After my fellowship training, I joined the Department of Psychiatry at Yale and have since held the positions of the Geriatric Psychiatry Co-Service Manager, Associate Residency Program Director, and the Geriatric Psychiatry Fellowship Director. My research interests are the treatments for Alzheimer’s disease and behavioral disturbances in dementia and late life psychiatric disorders. I have been a principal investigator and a sub-investigator on various clinical-trails at Yale and have published over 75 journal articles, editorials, book reviews, book chapters, and educational materials on various topics in geriatric psychiatry. I also serve on several editorial boards and am a reviewer for many journals. While at Yale, I have received awards for outstanding teaching, research, and clinical work. I also was a recipient of the Geriatric Academic Career Award instituted by the Department of Health and Human Services and received the American Association for Geriatric Psychiatry Clinician of the Year Award in 2013.
Currently, I hold faculty appointment as an Associate Clinical Professor of Psychiatry at Yale and an Associate Professor of Psychiatry at the University of Texas, San Antonio. I am also the President-Elect of the International Medical Graduates Caucus at the American Psychiatric Association and the founding psychiatry residency program director at University of Texas Rio Grande Valley School of Medicine in South Texas.
Rajesh R. Tampi, MD, MS, FAPA
I became interested in geriatric psychiatry after graduation from college, when I worked on a research project with Chip Reynolds and his research group. I have been drawn to geriatric psychiatry because of the fascinating overlap among psychiatry, neurology, medicine, psychology, and social systems. There is so much to learn about the aging brain, changes in behavior across the life span, and approaches to improve quality of life for older adults; this is a wide-open field. My daily work has a lot of variety. I direct several NIH-funded clinical trials studying older adults with comorbid pain and mood disorders. I also treat patients with psychiatric disorders at the pain clinic and with our consultation liaison service. One of my greatest pleasures at work is to train and mentor medical students, residents, and fellows. I direct the geriatric psychiatry fellowship at the University of Pittsburgh Medical Center. It’s an honor for me to help grow the field of geriatric psychiatry and get people as excited about working in this area as I am!
Jordan Karp, MD
I attended Dartmouth College and later went onto Dartmouth Medical School. In Boston, I completed an internship in medicine at Massachusetts General Hospital followed by three years of psychiatry at McLean Hospital in Belmont, MA. My fellowship in geriatric psychiatry was done at Dartmouth Hitchcock Medical Center. I am currently an Assistant Professor of Psychiatry at Harvard Medical School.
My interest in geriatric psychiatry came about through two main factors: 1) I have always like older people: during family gatherings I usually found myself in the corner of the room listening to the fascinating stories of my grandmothers who lived through most of the 20th century. 2) In medical school I had a hard time deciding between a career in internal medicine and psychiatry. Geriatrics is the one specialty in psychiatry in which you must understand and appreciate the interaction between medical illness, neurological disorders, medication side effects and psychiatric symptoms. I most enjoy trying to figure out the many complex biopsychosocial factors influencing psychiatric problems in an older person. Geriatric patients with psychiatric issues do in fact get better and can lead a much more fulfilling and enjoyable life. Families may also be eternally grateful!
What is most exciting about geriatric psychiatry is connecting with a patient who has been suffering and being able to figure out why and do something about it. I spend more time taking patients off medications that are doing harm than putting patients on new medications that may only add to the problem. This takes patience and also a fair amount of good detective work. I also feel that with the aging of our population, there is a tremendous need for physicians who specialize in geriatrics to be treating these patients and educating other health care providers and families. I think that in the next ten years or so we will have new understandings about the causes of and treatments for late life psychiatric disorders such as depression and dementia. This may come about through research using developing technologies such as genetics and functional neuroimaging.
Characteristics that geriatric psychiatrists should have include traits common to all good doctors: a sense of humor, patience, a willingness to listen and explore possibilities and not jump to conclusions. I also think an interest in medicine, neurology and psychiatry is helpful. Working with families is a key part of what we do so some desire or interest in this would be important.
Brent Forester, MD
One of the unifying experiences of being human is to grapple with the loss of an older adult that is close to us. For those of us fortunate enough to reach older adulthood ourselves, we will each grapple with profound changes in our physical, emotional, and mental well-being. I was lucky to have grown up alongside my grandmother, and to have been exposed to her sensibility, wisdom, and sense of humor that I have since discovered belong uniquely to older adults. Upon entering medical school, I knew I would either dedicate my career to geriatric medicine or geriatric psychiatry. During my surgery rotation, I even seriously thought about becoming a urologist -- it wasn't until later that I realized that a big part of my interest had been the high proportion of older adults I got to see during my urology subspecialty elective!
The field of geriatric psychiatry is enticing on multiple levels - on an individual level where I get to have incredibly enriching relationships with older adult patients, on a family/community level where I get to work together with families in helping them to make better decisions for their older adult family members, and on a societal level where I get to provide care to, and advocate for, one of the fastest growing segments of our population.
In addition, one of the best-kept secrets of the field of geriatric psychiatry is that it attracts some of the nicest and most collaborative physicians out there! I first learned this when I did three sub-internships during my MS4 year: outpatient geriatric psychiatry at UCSF, inpatient geriatric psychiatry at Stanford, and combined medicine-psychiatry at UC Davis. Early in my residency I was awarded an AAGP Geriatric Mental Health Scholar fellowship, where I attended the AAGP Annual Meeting and can still recall how warmly I was welcomed into the AAGP professional community, including the more senior and highly accomplished geriatric psychiatrists.
I had planned to do a geriatric psychiatry fellowship after completing my general adult psychiatry residency at UCSF, but I decided to first take some time to return to being by my grandmother's side, this time instead of teaching me multiplication tables and Vietnamese proverbs, she is teaching me about her fascinating life.
Uyen-Khanh Quang-Dang, MD, MS | PGY-4, University of California, San Francisco
My interest in geriatric psychiatry began when I did my fourth year medical school elective in the geriatric psychiatry clinic. What impressed me was the breadth of cases I saw, which ranged from providing psychotherapy for a relatively healthy older man who was having difficulty coping with his stage-of-life issues; to treating a patient with lifelong depression who had become delirious after ECT; to diagnosing an elderly woman who had failed to thrive for unclear reasons, despite an extensive medical workup and numerous consultations with other medical specialists. As a resident, perhaps the most rewarding part of my work was listening to my patients in geriatric psychiatry clinic share their life stories and learning more about other generations and cultures. At the VA in the Bronx, I heard reminiscences from World War II veterans about their experiences of fighting on D-Day in Normandy and in the Pacific and being in a segregated military service. Together, these experiences inspired me to plan to pursue a career in geriatric psychiatry.
Many people have asked why I am doing a subspecialty fellowship, in addition to my seven years of clinical research experience with the Mount Sinai Alzheimer’s Disease Research Center. First, I realized that additional training is imperative to provide the best care for the aging population, especially given the current influx of information about geriatric mental health. Second, the geriatric psychiatry fellowship has a fair amount of flexibility to pursue other activities including doing research and teaching residents. Finally, I wanted to belong to a diverse group of people who were warm, down-to-earth, tight-knit, and passionate about their careers but also had balanced work-family lives. In July 2012, I started my geriatric psychiatry fellowship at UCSF run by Drs. Craig Nelson and Kristine Yaffe, and am very delighted about the various clinical experiences I have had and the potential career pathways fellowship has given me.
Sophia Wang, MD
Fortunately, I have been exposed to many aspects of medicine and psychiatry over the years. Clinically trained at Beth Israel Medical Center, New York, and at University of California, San Diego, I have been blessed with great mentors and role models in the care of our elderly population.I have worked hard to understand the complexities of medical practice from perspective of public health and medical economics. I have been involved in research projects and fortunate enough to teach and supervise younger peers. Throughout it all, as I reflect back on my young career, I am more certain than ever that our generation of physicians will be judged by how we have worked to improve the health and dignity of the elderly population.
I went to medical school with the death of my grandfather fresh in my mind. I remember thinking how difficult it was to find someone who could deal with his delirium and dementia. I thought that perhaps, with some training, I can be someone who can provide some sense of relief for families dealing with their elderly loved ones. Was my choice of a career in geriatric psychiatry initially borne from my sense of helplessness in seeing my grandfather pass? Perhaps. However, this career path has given me more than I could have possibly asked for.
It is an ideal field for someone with diverse interests and looking for great personal and professional satisfaction in the day-to-day work. By its nature, it demands intellectual curiosity, larger societal perspectives, work with family members, emphasis on not only the disease but the individual dignity of the person, and collaborative work with our allied professional colleagues. I have never doubted my choice in geriatric psychiatry and continue to wonder at how lucky I have been to find a career path that embraced me.
Steve Koh, MD, MPH, MBA | University of California, San Diego
I trace my fondness for working with the elderly back to my high school “candy-striping” volunteer work at Kaiser. I was known as “Young Beverly” in our team of 65-year-olds plus myself. The devoted teammates all competed for my eager ears as they told stories of their past experiences and their new “aches and pains.” I eventually graduated from UC Berkeley with a degree in chemistry but maintained an interest in seniors. I began work at “The Over 60 Health Center,” a community clinic in Oakland, CA. Working in an interdisciplinary setting with social workers, psychiatrists, and medical physicians provided the experience I needed to convince myself to apply to medical school.
I had seen how access to resources was difficult for so many elderly without close support and I wanted to be a better advocate for their needs.
While in medical school at UC Irvine, I participated in the Geriatrics Interest Group and was guided by Laura Mosqueda, MD, Family Practice Geriatrician. I worked with her for a summer to complete research in Elder Abuse. I also completed a medical humanities research project as a 4th year elective. The study focused on results of utilizing “Medical Readers Theater” to bring medical students and older adults together to discuss issues in aging. These experiences helped me realize the importance of geriatric mental health and the issues unique to this population.
Now I am in the UCSF Fresno Psychiatry Residency program. In my experience, all those involved in caring for geriatric patients wear multiple hats: geriatrician, social worker, neurologist. This was particularly stimulating for me, because I enjoy the complex medical issues in older adults. I will pursue Geriatric Psychiatry because it provides a balance between all of these specialties. My grandmother is struggling with memory loss and aging. Family friends are drained emotionally by their loved ones with dementia. It is my hope that we can offer hope and comfort as we continue to investigate and understand the pathology behind geriatric mental health.
Beverly Cho, MD
Geriatric psychiatry attracted me because it can focus on aspects of positive aging while caring for the mentally ill and medically complicated patients. Doing so can be challenging, but very rewarding. Being in psychiatry, patients share incredible stories about their lives.
My grandfather was an inspiration in positive aging. Well into his 80s, he was still riding his bike to visit people in the nursing homes and at times, up on his roof “fixing things.” I too began to volunteer and work in nursing homes, senior centers, and assisted living facilities from elementary school through medical school. In medical school when I discovered that geriatric psychiatry was a subspecialty in its own right, I was incredibly excited! I could spend time with the elderly for a career!
Geriatric psychiatry has been the perfect compromise between psychiatry and internal medicine, both specialties I considered as a career when in medical school. In addition to clinical work, I’ve been very active in psychiatry specialty organizations like AAGP to reach a broader scope. I hope my efforts work for quality care for all psychiatric patients.
Laurie Boore, MD | University of Michigan
I am thrilled to begin my career in geriatric psychiatry at such an exciting time in our field. Geriatric psychiatry is at the forefront of the complicated health care issues created by our aging population. It is the perfect field for someone like me who enjoys the challenges of patient care, health policy, and research.
Throughout my training, I have found myself surrounded by many wonderful mentors and drawn to working with older patients. My clinical training at Duke, MGH/McLean, and Yale exposed me to leaders in the fields of geriatric medicine and psychiatry, who fostered my developing interests. I was encouraged not only to pursue my passion for providing clinical care to older adults, but also to develop my health policy and research skills.
As a result, my path has been enriched with a variety of experiences, from public policy graduate school to working on Capitol Hill on Medicare policy to completing post-doctoral training in health services research. It is the combination of these experiences, along with a strong desire to improve the care provided to older patients with comorbid medical and mental illness, which has led me to a career in academic geriatric psychiatry.
I consider myself fortunate to have chosen to practice and conduct research in geriatric psychiatry. I am continually challenged while at the same time rewarded by my work. It is a privilege to have my patients share with me their life experiences, wisdom, and struggles.
Ilse R. Wiechers, MD, MPP | Yale School of Medicine | VA Connecticut Healthcare System
This information is courtesy of the AAGP MIT Caucus.
© American Association for Geriatric Psychiatry. June 2013