The Development of Academic Geriatric Medicine: Progress Toward Preparing the Nation's Physicians to Care for an Aging Population

Abstract

Academic geriatric medicine programs are critical for training the physician workforce to care effectively for aging Americans. This article describes the progress made by medical schools in developing these programs. Academic leaders in geriatrics at all 145 accredited allopathic and osteopathic medical schools in the United States were surveyed in the winter of 2005 (68% response rate) and results compared with findings from a similar 2001 survey. Physician faculty in geriatrics at U.S. medical schools increased from 7.5 (mean) full-time equivalents (FTEs) in 2001 to 9.6 FTEs in 2005. Faculty and staff effort is mostly devoted to clinical practice (mean 36.9%) and education (mean 34.6%). A small number of programs focus on research; only six responding schools devote more than 40% of faculty effort to research. Seventy-one percent reported that their medical school required a geriatrics medical student clerkship or that their geriatric training was integrated into a required clinical rotation. In summary, from 2001 to 2005, more fellows and faculty have been recruited and trained, and some academic programs have emerged with strong education, research, and clinical initiatives. Medical student exposure to geriatrics curriculum has increased, although few academic geriatricians are pursuing research careers, and the number of practicing geriatricians is declining. An expanded investment in training the physician workforce to care for older adults will be required to ensure adequate care for aging Americans.

The Urgency Of Preparing Primary Care Physicians To Care For Older People With Chronic Illnesses

“…In total, there are only 920 full-time equivalents in the United States devoted to teaching geriatrics to medical students and residents. [13][14][15][16] This is far fewer than the number needed to train those who will care for most older Americans during the coming decades.…”

“…1 In total, there are only 920 full-time equivalents in the United States devoted to teaching geriatrics to medical students and residents. [13][14][15][16] This is far fewer than the number needed to train those who will care for most older Americans during the coming decades. 17 Clearly, whatever strategy the nation has pursued to date to train enough geriatricians to teach and provide chronic care for an aging population has not succeeded and does not show promise.…”

“…18 Consequently, 77 percent of medical schools do not require students to take a course in geriatrics. 15 Residents in internal medicine and family medicine receive little training in the comprehensive management of patients with multiple conditions. And two-thirds of America's internists report being undertrained in chronic care.…”

Interprofessional Geriatrics Education Program: Train the Trainer Pilot Model

“…As of 2003, there were only about 5.5 geriatricians per 10,000 patients, 75 years and older [1]. The trend in the number of physicians certified in geriatric medicine in the last 10 years has been relatively stagnant, if not on a decline [2]. This figure is just as small in other health professions.…”

“…In 2011, US adults age 65 years and above made up almost 13% of the total population and were over 39 million in number .With life expectancy increasing, this number is projected to double by the year 2040, when all 'baby boomers' will be at least 65 years of age [4]. Within the same time frame, the number of geriatricians currently just over 7000, is not expected to increase significantly given the falling entry rates of new doctors into the geriatric field [2]. This situation makes the geriatric work force shortage critical and dire.…”