ABFM Geriatric Medicine study plan

Build a one-page table of normal age-related changes in renal, hepatic, cardiovascular, pulmonary, GI, and sensory systems, flagging which changes alter drug handling or symptom presentation.

Differentiate normal aging from disease for 10 common presentations (systolic hypertension, impaired glucose tolerance, constipation, altered sleep architecture, reduced thirst, decreased muscle mass) in written notes.

Map each component of the comprehensive geriatric assessment to a validated instrument you can name and score (Katz/Barthel ADL, Lawton IADL, Mini-Cog, PHQ-2, Timed Up and Go, Mini Nutritional Assessment, Braden).

Practice administering and scoring three screening tools on two real or standardized patients, and write the score plus the next clinical step for each.

List the eight highest-yield concepts from domains 1 and 2 that you will re-test in week 8.

Compare DSM-5-TR criteria for major versus mild neurocognitive disorder and apply them to five written vignettes.

Construct a comparison table distinguishing Alzheimer disease, vascular dementia, Lewy body dementia, and frontotemporal dementia by onset, cognitive profile, motor and behavioral features, and expected imaging.

Outline a stepwise workup for new cognitive decline (medication review, thyroid function, B12, depression screen, when neuroimaging is indicated) and identify which tests are low-yield.

Differentiate delirium, dementia, and depression using CAM, Mini-Cog, and PHQ-2/9, writing the discriminating bedside features for each.

Answer 30 board-style questions on cognitive disorders and log every miss with a one-sentence reason and corrected concept.

Perform and interpret the Timed Up and Go, 30-second chair stand, and 4-stage balance test, stating the cutoffs that flag increased fall risk.

Build a gait-disorder differential (parkinsonian, ataxic, spastic, neuropathic, antalgic, fear-of-falling) with the key exam finding for each.

Rank fall-prevention interventions by strength of evidence: multicomponent exercise, medication review, vitamin D, vision correction, home safety, orthostatic blood pressure management.

Explain which patients need post-fall imaging, when to refer for physical therapy or vestibular rehabilitation, and how to reduce restraints and bed alarms.

Answer 30 board-style questions and write a five-step post-fall evaluation checklist from memory, then verify it against a reference.

Identify 25 medications to avoid or use cautiously in older adults using Beers Criteria (anticholinergics, benzodiazepines, long-acting sulfonylureas, NSAIDs, proton pump inhibitors, antipsychotics) and name a safer alternative for each.

Apply STOPP/START criteria to five medication lists and record at least two deprescribing targets per list with justification.

Explain age-related pharmacokinetic and pharmacodynamic changes and calculate creatinine clearance by Cockcroft-Gault to adjust renally cleared drug doses in three cases.

Write a stepwise deprescribing plan (indication check, harm versus benefit, taper schedule, monitoring) for a benzodiazepine and for a proton pump inhibitor.

Answer 30 board-style questions on polypharmacy and complete a full medication review on one real or simulated patient with 10 or more medications.

Classify urinary incontinence (stress, urge, overflow, functional, mixed) by bedside findings and write first-line management for each, including behavioral therapy and referral triggers.

Describe pressure injury staging, Braden risk scoring, offloading, and nutrition support, and identify the wounds that require specialty referral.

Outline screening and management of hearing and vision loss in older adults, including the link between sensory loss, isolation, and cognitive decline.

Distinguish major depression from dementia-related apathy and from bipolar disorder, apply PHQ-9 and Geriatric Depression Scale, and justify antidepressant selection by interaction and fall risk.

Describe nonpharmacologic first-line management of behavioral and psychological symptoms of dementia and state the specific risks of antipsychotics in this population.

Justify individualized glycemic and blood pressure targets for multimorbid older adults (for example A1c 7.5 to 8.0 percent in those with limited life expectancy or functional impairment) in written case notes.

Write two multimorbidity care plans that prioritize patient-stated goals and explicitly state which treatments are being de-intensified and why.

Compare post-stroke, post-hip-fracture, and cardiac rehabilitation pathways by setting, intensity, duration, and outcome measures such as the Functional Independence Measure and 6-minute walk test.

Analyze tertiary-prevention trade-offs in five vignettes: hypoglycemia from tight control, orthostasis and falls from intensive blood pressure lowering, and polypharmacy from single-disease guidelines.

Answer 25 board-style questions on chronic illness and rehabilitation and record the domain-level accuracy.

Compare hospice eligibility criteria for dementia, heart failure, COPD, and cancer, naming the functional and prognostic tools used (FAST, NYHA class, MMRC or FEV1, PPS).

Outline end-of-life symptom management with starting doses and titration principles for pain, dyspnea, terminal secretions, and agitation.

Apply a capacity-determination framework and work through five ethics vignettes covering informed consent, advance directives, POLST, and surrogate decision making.

Describe the long-term care continuum (home and community-based services, PACE, assisted living, SNF, CCRC) and explain Medicare skilled versus custodial coverage rules.

Explain two care-coordination models that reduce readmissions and list the components of an effective care transition.

Complete two 60-question timed practice exams under exam conditions and log accuracy by domain.

Rewrite condensed one-page review sheets for the three lowest-scoring domains from those exams.

Re-answer every previously missed question and state the corrected concept in one sentence each.

Teach back aloud, in five minutes or less each, the highest-yield algorithms: fall evaluation, post-fall imaging, delirium workup, dementia workup, deprescribing, incontinence subtyping, pressure injury staging, hospice eligibility, and capacity assessment.

Verify logistics: test-day timing, break strategy, and a one-page final review sheet limited to your 20 weakest facts.