The Geriatrics Specialist must have gained theoretical, scientific and professional knowledge: of the care of the elderly patient in all its aspects; normal and pathological aging processes and the condition of frailty and disability of the elderly; demography and epidemiology of ageing; the pathophysiology, clinic and treatment of acute and chronic diseases of the elderly and major geriatric syndromes; preventive medicine, rehabilitation and palliative care for the elderly patient; assessment methods and multidimensional intervention in the elderly in all nodes of the service network, also acquiring the ability to coordinate interdisciplinary intervention within the geriatric evaluation unit.

Basic learning objectives: knowledge of the biological basis and physiology of ageing; notions of demography and epidemiology of ageing; notions of statistics necessary to interpret epidemiological data and scientific literature in clinical and experimental fields; knowledge of quality of life assessment methods;

Objectives of the general training: knowledge of computer science adequate for the creation and analysis of databases, with the particular aim of computerizing the geriatric record for the evaluation of the quality of care: and for the multidimensional evaluation of the patient;

Educational objectives of the type of School: in-depth knowledge of the relationships between aging, frailty and geriatric diseases, the physiology of aging and its effects on the function of organs and systems, on the homeostasis of the organism and on the global functional status:

• knowledge of the changes in pharmacokinetics and pharmacodynamics in the elderly subject and of the problem of polypharmacotherapy; knowledge of the methods of prevention and non-pharmacological therapy of the main diseases and syndromes of the elderly: clinical nutrition, physical exercise, lifestyle habits, behavioral techniques;
• acquisition of integrated skills to develop the ability to clinically approach the geriatric patient;
• knowledge of the peculiar ways in which diseases present in old age;
• knowledge of the major geriatric syndromes: cognitive impairment, incontinence, falls, malnutrition, immobilization syndrome, pressure sores;
• mastery of multidimensional assessment techniques: clinical, functional, cognitive, psycho-affective, socio-economic (including the ability to detect any abuse of the elderly), environmental;
• ability to coordinate the interdisciplinary intervention and the integrated treatment plan of the geriatric patient;
• knowledge of the principles of care for the elderly in different care situations;
• Management of the elderly with acute pathology: objectives and risks of hospitalization; methodologies for the care of the hospitalized elderly; planned discharges;
• knowledge of the territorial network of services, of the treatment methodologies to avoid repeated hospitalization, and of the methods of operation and objectives of the main services for the elderly: Acute hospital; Health Care Residence; Day Centre; integrated home care;
• ability to coordinate the Geriatric Evaluation Unit with the aim of global care of the elderly patient;
• knowledge of selection criteria, objectives, principles and methods of rehabilitation in the elderly, with particular reference to the orthopedic, cardiology, neurological and cognitive sectors;
• knowledge of the objectives, principles and methods of palliative care for the elderly, the methodological bases of research on the elderly, the planning of controlled research and the implementation, also for the geriatric patient, of "evidence based medicine".

Integrated training objectives (i.e. common trunk): the student must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, even in emergency-urgency conditions, of the most common internal pathologies. The student must acquire the fundamental knowledge of the pathophysiology of the various organs and systems, the theoretical and practical knowledge necessary for the recognition of diseases affecting the different systems of the body, the theoretical and practical knowledge of the main sectors of instrumental and laboratory diagnostics related to the aforementioned diseases, the acquisition of the ability to evaluate internal and specialist connections and influences. He must therefore be able to recognize the symptoms and clinical-functional signs with which diseases of various organs and systems manifest themselves, having acquired the fundamental diagnostic, therapeutic, psychological and ethical knowledge necessary for a global vision of the patient. To this end, the ability to clinically frame the patient on the basis of the anamnesis and physical examination must mature; develop critical and analytical diagnostic skills; become familiar with the main diagnostic procedures and laboratory-instrumental investigations; recognise and be able to deal with major medical emergencies; familiarize themselves with therapeutic resources in order to plan their optimal use and recognize their indications and contraindications, as well as the effects of interaction and possible iatrogenic accidents; acquire the fundamental notions relating to clinical research methodologies and pharmacological trials; know the fundamental problems related to prevention, public health and social medicine. The resident must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency-urgency conditions, of the most common pathologies. Finally, the resident must also know, from a clinical and therapeutic point of view, the most common pathologies of competence of the other types of the class.

The following are compulsory professionalizing activities for the achievement of the educational purposes of the type:

• having drawn up and signed 100 medical records of inpatients or outpatients;
• have personally performed the following medical acts: 20 rectal examinations; placement of 20 peripheral venous lines, 10 nasogastric tubes and 10 bladder catheters; 20 invasive maneuvers (execution of 10 thoracentesis and 10 paracentesis);
• having performed cleansing and dressing of at least 40 pressure sores, trophic ulcers, lesions in the "diabetic foot";
• have performed the hydro-electrolyte and nutritional balance of at least 20 patients;
• have acquired experience in the clinical, instrumental and laboratory evaluation of caloric-protein malnutrition and clinical nutrition interventions
• know how to use practical diagnostic tools such as the electrocardiograph, the pulse oximeter, the reflexometer, the dynamometer;
• have performed and countersigned at least 50 electrocardiographic examinations and 30 arterial blood gas tests;
• have acquired competence in basic and advanced cardiopulmonary resuscitation techniques (BLS and ACLS) and have participated in or performed at least 10 resuscitation maneuvers on a patient or dummy;
• have discussed with an expert at least 20 echocardiographic examinations and 10 angiographic examinations;
• have discussed with an expert at least 20 brain CT or MRI;
• have discussed with an expert at least 50 chest x-rays and 50 spine x-rays, chest and abdomen CT scans;
• have participated in at least 50 multidimensional assessment procedures in different nodes of the service network (District, RSA, Day Center), learning to manage the continuity of care for the geriatric patient;
• have performed at least 20 geriatric consultations in other departments;
• have discussed at least 20 spirometry;
• have participated in the conduct of at least 2 controlled clinical trials;
• have acquired experience in the use of educational programs related to telemedicine;
• have worked for at least 2 weeks at each of the following clinics/services: dementia; Parkinson's/movement disorders; diabetology; urodynamics; functional rehabilitation, with particular reference to balance disorders and fall prevention; osteoporosis; vascular and internal ultrasound; respiratory pathophysiology; pain therapy and palliative therapy.

The student will be able to compete for the diploma after completing the professionalizing activities.

As part of the training course, the student will have to learn the scientific bases of the type of School in order to achieve full maturity and professional competence that includes an adequate ability to interpret scientific innovations and critical knowledge that allows him to consciously manage both assistance and his own updating; In this context, participation in meetings, congresses and the production of scientific publications and periods of attendance in qualified Italian and foreign institutions useful for his/her training may be envisaged.