More training needed to care for growing geriatric population

The changing medical needs of the growing 65-and-over population in the United States are not being met by current medical education, University of Cincinnati (UC) researchers warn.

What is required, they say, is more standardized geriatric training across all medical specialties. An article in the March 2005 issue of Academic Medicine says older adults are making more visits to nonprimary-care specialists and suggests faculty development and curriculum changes be made to better prepare future physicians to handle this growing patient base.

In 2001, 53 percent of ambulatory (outpatient) visits by patients 65 and older were to nonprimary-care specialists, an increase of 13 percent from 1980. “Until recently, most physician visits by geriatric patients were to primary-care providers,” says lead author Elizabeth Bragg, PhD, of UC’s Institute for the Study of Health. “The changing needs of the geriatric population have shifted that trend. Now, more than 50 percent of all outpatient visits by geriatric patients are to nonprimary-care specialists.”

The authors reviewed program requirements of 91 specialties accredited by the residency review committees of the Accreditation Council for Graduate Medical Education (ACGME). They found, as of 2003, that only 27 of the 91 specialties had specific geriatric training requirements. And these requirements, say the authors, have very modest expectations. “In other words,” they say, “70 percent of the graduate medical education specialties training non-pediatric physicians do not have specific geriatrics curriculum requirements. Yet once these physicians establish their clinical practices, many adults over the age of 65 will become their patients.”

It is estimated that by the year 2030, there will be more than 70 million people over the age of 65 in the United States. “We know there’s a shortage of trained geriatric specialists in the United States,” says co-author Gregg Warshaw, MD, professor of geriatric medicine and family medicine at UC’s Academic Health Center. “It only makes sense that we improve geriatric education within medical specialties in order to achieve a well-trained physician workforce prepared to handle the medical needs of this population.”