Geriatrics for Residents in the Surgical and Medical Specialties: Implementation of Curricula and Training Experiences

Abstract

In 1994, under the leadership of the late Dennis Jahnigen, the American Geriatrics Society, with support of the John A. Hartford Foundation, began a project to improve the amount and quality of geriatrics education that surgical and related medical specialty residents receive. The targeted disciplines initially were general surgery, emergency medicine, gynecology, orthopedic surgery, and urology and, later, anesthesiology, ophthalmology, otolaryngology, physical medicine and rehabilitation, and thoracic surgery. A key element of this project was to develop model programs within surgical and related specialty residency education. The Geriatrics Education for Specialty Residents (GESR) program has supported 29 residencies to pilot methods for integration of geriatrics within residency programs, encouraged and inspired development of curricular content, and helped to develop faculty leaders to support these efforts in the long term and at a national level. This paper describes the GESR program, the status of curriculum development, steps for other programs to use in developing a geriatrics education program, and some of the common barriers likely to be encountered during implementation along with solutions to those barriers.

Postoperative Delirium in Older Adults: Best Practice Statement from the American Geriatrics Society

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Geriatrics for Surgeons: Infusing Life into an Aging Subject

“…2 Elderly patients account for only 12% of the population, but they undergo nearly 40% of surgical procedures and constitute one third of hospital admissions for traumatic injury. 3 Elderly patients have a disproportionately greater rate of complications and death because of a decline in physiologic reserve and comorbid disease. Emergency surgery in the elderly population has been shown to increase morbidity 10 to 15 times that of elective surgery, and it increases mortality by 3 to 5 times that of elective procedures.…”

Medicine in the 21st Century: Recommended Essential Geriatrics Competencies for Internal Medicine and Family Medicine Residents

“…In recent years, influenced by a series of grants from the Donald W. Reynolds Foundation 7 and the John A. Hartford Foundation, [8][9][10] geriatrics training has been substantially expanded among medical students and residents at many academic institutions 11 in a variety of surgical and related specialties 12 and medical subspecialties. 7,13 In the context of the IOM recommendations, in May 2009, the American Geriatrics Society (AGS), American Medical Association (AMA), and the Council of Medical Specialty Societies convened a conference that brought together representatives of 13 certifying boards, 21 specialty or subspecialty societies, and members of 6 Residency Review Committees.…”