Geriatric Medicine Training and Practice in the United States at the ...

Figure 4.1 Distribution of Certified Geriatricians in the United States, 2001
11 (8.3)
The number of certified geriatricians 1 per state.
The national mean of geriatricians
per 10,000 population age >75 2 is 5.5
(state ratios in parentheses).
Above national mean
Below national mean
194 (6.0)
29 (5.0)
75 (3.4)
26 (3.7)
16 (6.1)
22 (2.5)
27 (3.0)
103 (5.4)
967 (5.7)
120 (4.0) 60 (6.4)
37 (7.6)
22 (4.0)
48 (4.1)
95 (5.3)
358 (3.9)
249
(8.3)
100 (4.5)
162 (4.5)
229
(6.6)
562
(7.7)
47 (2.2)
59
123 (3.8)
(3.4)
46
(2.9)
148
(4.1)
92
(3.5)
313
(5.4)
321
(4.5)
114
(3.3)
89 (4.1)
857 (9.0)
73
(5.7)
74 (3.2) 215 (6.0)
191 (4.4)
979 (8.4)
16 (3.5)
30 (8.2)
172 (7.2)
368 (6.8)
240 (8.6)
54 (15.9)
54 (6.2)
47 (6.8)
297 (6.9)
41 (5.2)
79(3.4)
463 (3.4)
47 (6.2)
1 American Board of Medical Specialities, 2002
2 Census 2000 as compiled by the Administration on Aging
Source: IHPHSR ADGAP Database Project, 2002
before 1996 do not have to re-certify, while those certified after 1996
must re-certify (Personal communication, Carol Thoma, AOBFP, May
2002).
The American Board of Internal
Medicine (ABIM) Study of
Re-Certification
In 2001 the ABIM conducted a review of re-certification in
geriatric and critical care medicine (the latter began re-certification
examinations one year before geriatrics in 1997) (Wiley and Grosso,
2001). Four cohorts were followed: critical care medicine in 1987 and
1989 and geriatric medicine in 1988 and 1990. Diplomates were
tracked to determine how many returned to seek re-certification.
For this study, diplomates were considered to have returned
for re-certification if they sat for the final proctored re-certification
examination. These diplomates were compared across several
variables with those who did not re-certify (i.e., type of medical school
attended, type of training received, age, and initial certification
examination score).
31
Approximately 50% of diplomates in critical care medicine and
42% of those in geriatric medicine have returned for re-certification.
The type of medical school attended was not related to the percent
of returnees: USMSGs and IMGs were evenly divided in critical care
medicine diplomates, for geriatric medicine 45% were USMSGs and
42% were IMGs. A higher percentage of diplomates who were
formally trained returned for re-certification: 58% versus 47% for
critical care and 59% versus 43% for geriatric medicine. Those who
returned had scored slightly higher on their initial certification exam
(567.5 compared to 548.5 for critical care and 554.5 compared to
544.5 for geriatric medicine) and were slightly younger than those
who did not return (37.5 compared to 38.5 years for critical care and
39.5 compared to 42.5 for geriatric medicine). (These are the mean
ages at the time of the initial added qualification exam.)
Preliminary analysis of the ABFP diplomates found a 50%
re-certification rate for the 1988 cohort. Although ABIM/ABFP
diplomates from the 1988 and 1990 examinations may still apply
for re-certification, it appears that a significant decrease in the
number of certified geriatricians will occur over the coming decade,