Physician training should include general geriatric medicine principles and specialty specific topics related to ageing

Since the Institute of Medicine published its report Strengthening Training in Geriatrics in 1993, it is widely recognized that all physician training should include general geriatric medicine principles and specialty-specific topics related to aging.

According to a study contracted by the Association of Directors of Geriatric Academic Programs (ADGAP) and published in the February 2004 issue of ADGAP’s Training and Practice Update, a gap exists between geriatric requirements in training programs for physicians and the growing aging population.

The study, called “ACGME Residency Review Committees’ Requirements for Geriatric Medicine Curriculum,” reports that an increasing proportion of patient care provided by medical specialists is for adults age 65 and over.

In spite of the rapidly growing number of older adults seeking medical care, the ADGAP study found that at the end of 2003, only 27 of the more than 100 non-pediatric residency and fellowship training programs have specific geriatrics curriculum requirements. Yet once these physicians establish their clinical practices, many adults over the age of 65 will become their patients.

Although the ADGAP researchers did confirm that three medical disciplines added new geriatrics training requirements during the past year, the integration of specific geriatrics content into the curriculum of all primary care and other specialty training programs is essential to achieve a well-trained physician workforce to care for older adults.

Formal geriatric training for virtually all physicians ends with their primary care or specialty residency training. For example, in 2002, 9,558 physicians graduated from allopathic family practice and general internal medicine residency programs, but only 292 entered geriatric medicine fellowships. Likewise, 997 physicians completed allopathic psychiatry residencies, but only 73 enrolled in geriatric psychiatry fellowships. In that same year, 14,161 physicians graduated from other residency and fellowship programs (these figures do not include pediatrics).

The ADGAP study was conducted by researchers at the University of Cincinnati Medical Center, led by Gregg Warshaw, M.D, (ADGAP member and Professor of Geriatric Medicine) and Elizabeth Bragg, PhD, RN. The full report is available from ADGAP at https://adgap.americangeriatrics.org/. This work was funded by a grant from the Donald W. Reynolds Foundation.

The Association of Directors of Geriatric Academic Programs (ADGAP) was founded in the early 1990s by a group of twenty leaders from the American Geriatrics Society (AGS). ADGAP is dedicated to providing support to education and research programs in geriatric medicine within U.S. medical schools, and to directors of academic geriatric programs in order to improve patient care and research. ADGAP is an integrated group within the AGS that works both independently and along side the society in pursuit of its mission.