Fourth Year Medical Student Rotation

The next four weeks will be an exciting time for you. We understand that the fourth year is a busy time and hope that this rotation rounds out your education in a positive way. The majority of your time will be spent in the Nix Senior Health Center. We hope that you enjoy your time with us. We are constantly attempting to improve, so if you have any suggestions, please let the faculty know.


**Prior to your first day:

  • Review the Sevocity EMR and Nix Clinic Orientations listed in the Orientation Info area of this page.
  • Familiarize yourself with the various Geriatric Assessment Instruments listed on the Geri Resources Page.
  • Review the various articles on geriatric syndromes listed on the Geri Resources Page.
  • Download the PDA and electronic versions of the "Geriatrics at Your Fingertips" handbook, available online:

If you have further questions, contact the course coordinator, Dr. Cynthia Alford at 358-3200 or If you have a special interest in spending time on our geriatrics inpatient service or the long term care service during your time with us, please check with Dr. Alford on the first day of orientation to develop a personalized schedule.


GETTING STARTED image_parking

On Monday morning, report at 8am to the Nix Senior Health Center located on the 11th floor at 414 Navarro, Ste. 1111 in downtown San Antonio. See Map for more details.


Please park at Mid-City Garage across the street from the Nix. Have your parking ticket validated at the Nix garage on the first floor. Let them know that you a physician working with the Nix geriatrics group.


Cafeteria - 6th floor. There is a 25% physician discount with jacket and UHS id. The cafeteria is cash only. SACU ATM available on the first floor in valet parking. Lunch is provided free during the Monday Geriatrics Grand Rounds, but not at any other time.

Further Information on the Nix Hospital can be found on their website, .


Medical Team Support

The Nix Senior Health Care Center is busiest between 8am and 3:30pm due to patient appointments. Medical students may be asked to assist the office faculty and staff with medication refills, computer lab result searches and other activities as assigned. Please check with the office staff daily.


Student Medical Record Keeping
Order sheets are filled out by the student on consultation with the attending (please read the clinic orientation section for further information). The order sheet should be filled out and delivered at the nurses station ASAP to allow for prompt processing of the patients and their family members who are waiting. All sheets should be signed by the medical student.

**Electronic Medical Record Charting. Per Medicare policy, students may only document the Review of Systems (ROS), Past Family, Social, Medical, Surgical history, and update the Medications list. Students MAY NOT document the HPI, Assessment or Plan.

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Resident evaluation will be weighed towards three (3) distinct areas: Attitude & Behavior, Medical Records Review, and Didactic Participation.


Attitude & Behavior

Absences - Two or more absences, excused or unexcused, may result in you needing to provide make up time. In the past this usually involves after hours call support. Excused absences due to an illness must be accompanied by an practicing physician (not colleague) note. Absences due to interviewing will be consistent with Family & Community Medicine department policies.

Tardiness - Students will have no tardiness. Office hours start promptly at 8am and 1pm. Call the office at 568-5600 or the geriatrics coordinating office at 358-3200 if you anticipate that you are going to be tardy. Tardiness of more than 30 minutes will be treated as an absence.

Dress - Dress appropriately. As our patients represent a unique cohort with preconceived notions of how physicians should interact with them it is requested that students dress respectfully. Men should wear ties and women dress modestly. No open toes sandals. Failure to dress appropriately, in and of itself, is a basis for a sub par evaluation.

Problem List Completion

The student is responsible for the completion of the new patients problem list in a responsible and complete manner. It is expected that the student will review the attendings problem list in a responsible and complete manner. It is expected that the student will review with the attending at least three (3) electronic charts in which the student documented. Students who get honors for this content area will have been expected to have all elements of the problem list document complete and documented as being in progress on ALL three new patient charts reviewed.


Students who fail will either: (1) not have presented the three charts for review to an attending or (2) will have missed basic elements such as the medical problem list or the geriatrics instrumentation list on at least one of the charts. Completion of one or more flow sheets in the Sevocity EMR will fulfill this requirement.


Monday Geriatric Grand Rounds

Lunch is provided on Mondays at noon. Attendance is required. Student participation in grand rounds lectures will count towards the final evaluation. This will be done in an honors, pass, fail format with students who participate actively scoring higher than those who are not attentive.

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