Geriatrics residents must:

• Know the most prevalent diseases in elderly people, their symptoms, the diagnostic processes and the interdisciplinary pharmacological and non-pharmacological therapeutic approaches.
• Know and be able to identify geriatric syndromes: delirium, falls, immobility, malnutrition or pressure ulcers. -ç
• Know and be able to identify frail patients in routine clinical practice.
• Know and be able to use geriatric assessment tools. These are tools specific to the field of geriatrics.
• Be aware of the proper use of drugs, taking into account the pharmacokinetic and pharmacodynamic changes that occur in elderly patients, the proper prescription of drugs, possible adverse events, polypharmacy and drug interactions.

Residents are thus trained to offer a high quality service whereby a strong focus on the patient, with the help of the interdisciplinary team (medicine, nursing, social work, physiotherapy, psychology, etc.) and coordination with other primary care specialists, the intermediate care hospital and acute care hospital are vital.

This 4-year specialisation programme is split into two training periods:

• Basic training period over the first two years of the residency, including general rotations in the Internal Medicine, Neurology, Cardiology, Psychiatry, Radiology and A&E departments in addition to various elective rotations.
• Specific geriatrics training period over the next two years, in which the geriatrics resident will rotate between intermediate and acute care facilities.
  • Intermediate care (third year): Parc Sanitari Pere Virgili Intermediate Care Hospital. Rotations in sub-acute, palliative, convalescent and long-stay hospitalisations. Specific outpatient appointments and home care services. Casernes-Vall d’Hebron Complex Care Support Team. Consultations and day hospital.
  • Acute care (fourth year). Functional Geriatrics Unit (consultation team). Acute Fragile Patient Hospitalisation Unit (acute medical hospitalisation). Orthogeriatrics Unit (acute traumatic hospitalisation). Cardiogeriatrics (external consultations). Oncogeriatrics (external consultations).

Both the basic and specialised formative periods offer ample opportunities for elective rotations, including an external rotation during the final year.

The Geriatrics Teaching Unit encourages research, and offers the opportunity to do a doctoral thesis at the Autonomous University of Barcelona (UAB). Attendance at national and international geriatrics congresses, as well as that of the Catalan Geriatrics and Gerontology Society (SCGiG), is always encouraged.

Why practise this speciality at Vall d'Hebron?

• Because our residents receive training in a tertiary hospital that is considered world-leading in many areas.
• Because the volume of patients at our hospital offers great potential for teaching and gaining experience.
• Because the hospital covers most medical specialities, and you'll have the chance to study complex pathologies and apply cutting-edge diagnostic and treatment methods.
• Because you’ll have the opportunity to do rotations in other centres that specialise in geriatrics, palliative care and psychogeriatrics.
• Because in this unit we place an emphasis on the functional recovery of patients, allowing them to carry out their day-to-day activities with confidence.
• Because we understand the importance of the doctor-patient relationship and other recurring aspects in the field of geriatrics, such as the appropriate treatment of patients suffering from chronic pathologies.

Pneumology deals with the physiology and pathology of the respiratory system. Its principle purpose is the study of the aetiology, epidemiology, physiopathology, diagnosis, treatment, prevention and rehabilitation of respiratory diseases. The therapeutic and diagnostic principles of respiratory medicine are similar to those of internal medicine, although there are differences that clearly distinguish each of the specialisations. The most important difference is their reliance on and mastery of specific techniques. Diagnostic techniques include lung function analysis, respiratory or thoracic endoscopy, polysomnography and cardiorespiratory polygraphy; while mechanical rehabilitation and ventilation are used therapeutically.

Why specialise at Vall d’Hebron?

• Because as a participant on the Pneumology training programme you will observe, study and treat patients (hospital admissions and outpatients) with a wide range of respiratory diseases.
• Because at the end of the residency you will be able to show competency and technical expertise in the diagnosis and treatment of a broad spectrum of acute and chronic respiratory conditions, both within and outside the hospital environment.
• Because you will be able to implement programmes related to prevention, healthcare promotion and education with patients, their families and their communities.
• Because you will have come into contact with experimental and/or epidemiological clinical research that will help you approach scientific literature with a critical mindset and develop the foundation for continuous self-learning.

Internal medicine is a core medical speciality that is practised primarily in hospital settings, providing comprehensive care to sick adults. It uses a medical approach in the prevention, diagnosis, therapeutic indication and follow-up of diseases in adults, including during their rehabilitation and palliative care. Internists are the backbone of the hospital, offering their versatility in acute and emergency hospitalisation; carrying out consultancy roles in primary care; and offering innovation in areas other than conventional hospitalisation and in the socio-health field. 

The teaching unit is made up of 3 different departments. These include the Internal Medicine Department, which is broken down into the Systemic Autoimmune Disease Department, the Internal Medicine - Hepatology Department and the Infectious Disease Department. The Internal Medicine department is made up of different units which independently treat patients suffering from complex pathologies (Pleural Unit, Thromboembolic Diseases Unit, Autoinflammatory Diseases Unit and the Autoimmune Diseases unit). 

In daily practice, resident medical staff visit patients together alongside specialist physicians. During these visits, medical records are drawn up and physical examinations are carried out. Visits can also entail clinical ultrasounds, diagnostic-therapeutic examinations (thoracentesis, paracentesis, arthrocentesis, liver biopsy, etc.) as well as differential diagnoses and the provision of diagnostic guidance. The pertinent examinations are requested and the treatment is duly adjusted. 

During the IMR training, internal medicine residents learn how to diagnose and manage the most commonly found diseases on hospital wards and in internal medicine consultations. They will also learn about the most commonly treated pathology in other medical fields, obtaining a comprehensive and multi-disciplinary training that will allow them, upon the completion of their residency programme, to tackle a wide range of clinical scenarios with complete independence.  

Moreover, in terms of specific areas of interest, residents will learn how to manage immunosuppressive therapies and patients suffering from cirrhosis, HIV and nosocomial infections, amongst other pathologies.  

On-duty shifts are carried out in the A&E department in combination with inpatient care, preparing the Internal Medicine resident to treat critically ill patients in a fully independent manner upon the completion of their IMR training. It should be noted that residents treat patients suffering from a broad range of medical pathologies, meaning experience is gained in the management of patients suffering from conditions such as shock, respiratory failure (intubation and mechanical ventilation) and cardiac arrest.

Healthcare, teaching (sessions) and research tasks are carried out on a daily basis in all Internal Medicine departments. The Internal Medicine IMR will be progressively incorporated into these sessions, and will also participate in the research groups of his/her interest. 

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with cutting-edge services. The volume of patients at the site offers great potential for teaching and acquiring experience through a multi-disciplinary comprehensive training programme. 
• Because, unlike other sites, we offer specific training programmes: general internal medicine, autoimmune diseases, hepatology and infectious diseases. 
• Because we cover most medical specialities, and you will have the chance to study complex pathologies and apply cutting-edge diagnostic and treatment methods.
• Because we have a Rapid Diagnosis Unit in which you can participate, as well as a multi-purpose day hospital which is coordinated by our department. 
• Because we perform the most cutting-edge diagnostic procedures (capillaroscopies, ultrasounds, PET/CT scans) in the Autoimmune Disease Unit; because we have more than 50 years’ experience in the treatment of patients with these kinds of complex diseases; and because we are a reference CSUR (Sites, Departments and Units of Reference) for this pathology. 
• Because in the Hepatology Unit you will have the most modern diagnostic procedures at your disposal and you will be able to participate in the treatment of portal hypertension-related complications, liver transplants and the use of the pioneering drugs.
• Because in the Infectious Diseases department you will have the most pioneering diagnostic procedures at your disposal, and you will also receive an introduction to imported pathologies, HIV monograph consultations, the management of diseases in organ transplant and immunosuppressed patients, etc.
• Because in the Pleural Unit you will be taught how to carry out a clinical diagnosis while learning how to detect pleural effusion in scans (ultrasound, x-ray and PET/CT). You will also collaborate with the thoracic surgery department throughout the entire diagnostic and therapeutic process. 
• Because you will learn how to manage venous thromboembolism, including the indication of acute and chronic invasive therapies. 
• Because you will carry out a differential diagnosis of multiple pathologies, including constitutional syndrome, study tumours and fevers without a focus. 
• Because you will receive training in the A&E department, carrying out on-duty shifts in the “pool” system. On-duty shifts in the A&E department and the hospitalisation ward.
• Because the Department is made up of specific national and international reference units. 
• Because we treat patients who have been admitted to surgical departments (Traumatology, General Surgery, Vascular Surgery, Neurosurgery) and the Obstetrics-Gynaecology Department in a collaborative manner, learning to assess pathologies related to these specialities.
• Because we offer you the chance to participate in peer to peer education. We feel that we learn how to communicate by teaching. 
• Because the resident collaborates in clinical studies during the final years of their specialist training. He/she will then present their results at a national congress and, if possible, publish them.
• Because the different departments are in contact with national and international scientific reference groups, which means ample opportunities for periods abroad at the end of the residency programme.
• Because you will participate in theoretical and practical courses with local, national and international certification.
• Because you will present clinical sessions under the supervision of the responsible physicians. During these sessions, open cases will be reviewed and closed cases will be discussed. You will also have the chance to attend clinical-pathological and bibliographical conferences. 
• Because you will have the chance to do rotation placements away from the site, depending on your areas of interest.
• Because we facilitate the training and scientific methodology for the various research lines, thus helping you obtain pre-doctoral grants for your doctoral thesis.
• Because during your residency, we offer you the chance to collaborate on tasks in some of your preferred research lines. This will allow you to focus your doctoral thesis on the topic that is of greatest interest to you.
• Because our teaching adapts to the initiative and vocation of each resident, with options ranging from the most care-oriented to the most research-oriented programmes.