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

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Table 5.10 Allocation of Faculty and Staff Time (Percent) Area Allopathic Osteopathic All Schools Schools Schools (n=100) (n=16) (n=116) Mean SD Mean SD Mean SD Medical Student education in geriatrics 10.0 11.4 36.0 27.1 13.6 17.0 Residency Education in geriatrics 13.4 10.8 7.3 9.7 12.6 10.8 Fellowship training in geriatrics 11.9 11.6 3.0 5.4 10.7 11.3 Continuing education in geriatrics 4.0 4.5 3.3 4.3 3.9 4.4 Clinical practice in geriatrics 36.0 20.5 40.8 20.7 36.6 20.5 Research/Scholarship in geriatrics 20.0 17.7 6.9 6.8 18.2 17.2 Other 4.7 11.5 2.7 9.5 4.4 11.2 Source: IHPHSR ADGAP Database Project, 2001 Table 5.13 Obstacles to Achieving Goals of Geriatrics Programs 1 Possible Obstacles to % of Schools Achieving Goals Ranking Obstacles 5 or > Lack of senior research faculty 70.7 Poor clinical reimbursement for patient care 65.2 Lack of research fellows 61.4 Lack of junior research faculty 57.8 Lack of institutional financial support 53.4 Lack of access to medical students’ curricular time 38.6 Lack of clinical fellows 32.6 Lack of clinical educators 28.4 Lack of access to residents’ curricular time 23.7 1 Measured on a 1 – 7 Likert scale from ‘not an obstacle’ to ‘major obstacle’. Source: IHPHSR ADGAP Database Project, 2001 academic programs with the faculty and resources needed to implement clinical, education and research activities. However, many other academic centers lag far behind in ensuring the adequate training of future physicians. There is a continuing need for new resource investment to train faculty for roles as teachers and researchers, and to develop medical school geriatrics programs of the size and scope comparable to those of other academic disciplines. Although much has been accomplished, there are complex challenges ahead for academic geriatric medicine. 50
Table 5.7 Sources of Geriatric Program Revenues for AY 2000-2001, Allopathic Schools (Percent) (n=103) State Medical School 1 2 3 4 5 6 7 8 9 AL University of Alabama at Birmingham 0 20 1 0 16 10 43 10 0 AL University of South Alabama College of Medicine 35 0 0 0 65 0 0 0 0 AR University of Arkansas College of Medicine 12 0 11 5 15 15 26 21 0 AZ University of Arizona College of Medicine 15 0 0 2 10 71 2 0 0 CA Loma Linda University School of Medicine 0 0 0 0 50 50 0 0 0 CA Stanford University School of Medicine 0 0 30 0 30 30 0 10 0 CA University of California Davis 0 0 0 0 0 0 0 100 0 CA University of California Irvine College of Medicine 0 2 0 5 0 0 20 73 0 CA University of California Los Angeles 2 0 7 1 3 15 70 2 0 CA University of California San Francisco 10 5 1 0 1 50 20 13 0 CO University of Colorado 0 0 20 5 20 15 35 5 0 CT University of Connecticut School of Medicine 5 5 10 20 30 0 30 0 0 CT Yale University School of Medicine 0 0 20 15 15 20 30 0 0 DC George Washington University 0 0 0 0 60 30 5 5 0 FL University of South Florida College of Medicine 20 0 0 1 37 37 5 0 0 GA Emory University School of Medicine 0 7 7 0 34 32 15 5 0 GA Mercer University School of Medicine 0 0 50 0 50 0 0 0 0 HI University of Hawaii 16 4 34 0 0 27 10 9 0 IA University of Iowa College of Medicine 0 15 15 0 53 10 2 5 0 IL Finch University of Health Sciences 0 0 0 0 0 100 0 0 0 IL Loyola University, Stritch School of Medicine 0 0 0 0 100 0 0 0 0 IL Northwestern University Medical School 0 0 60 10 0 0 30 0 0 IL Rush Medical College . . . . . . . . . IL University of Chicago 0 0 0 0 0 0 0 0 0 IL University of Illinois College of Medicine 0 0 5 5 35 50 5 0 0 IN Indiana University School of Medicine 0 9 32 4 18 7 30 0 0 KS University of Kansas School of Medicine 37 0 0 5 1 2 40 15 0 KY University of Kentucky College of Medicine 0 45 0 0 30 20 5 0 0 KY University of Louisville School of Medicine 30 25 0 30 15 0 0 0 0 LA Louisiana State University School of Medicine 0 0 0 0 60 0 40 0 0 LA Louisiana State University Shreveport 0 50 0 0 40 0 0 10 0 LA Tulane University School of Medicine 10 20 0 0 20 50 0 0 0 MA Boston University School of Medicine 7 0 50 0 17 0* 16 10 0 MA Harvard Medical School 0 20 20 0 0 0* 50 10 0 MA University of Massachusetts Medical School 0 0 25 0 50 0 0 25 0 MD Johns Hopkins University School of Medicine 0 0 30 5 30 0 35 0 0 MD University of Maryland School of Medicine 0 5 0 0 0 5 90 0 0 MI University of Michigan Medical School 0 14 19 16 0 19 30 2 0 MI Wayne State University School of Medicine 0 0 0 0 90 0 10 0 0 MN Mayo Medical School 0 0 0 0 80 0 10 10 0 MN University of Minnesota Duluth 0 0 0 0 0 0 0 100 0 MN University of Minnesota Medical School Minneapolis 0 80 0 0 0 0* 10 0 10 MO Saint Louis University School of Medicine 0 10 0 8 30 20 30 2 0 MO University of Missouri Columbia School of Medicine 25 10 0 0 25 20 15 5 0 MO University of Missouri, Kansas City 0 0 40 0 50 0 0 10 0 MO Washington University School of Medicine 0 10 0 5 25 0 60 0 0 MS University of Mississippi School of Medicine 60 0 0 0 40 0 0 0 0 NC Duke University School of Medicine 0 10 0 5 10 20 50 5 0 NC East Carolina University 0 0 0 0 75 0 0 25 0 NC University of North Carolina 38 0 0 0 0 0 31 31 0 NC Wake Forest University School of Medicine 5 4 5 1 30 0 55 0 0 ND University of North Dakota 100 0 0 0 0 0 0 0 0 NE Creighton University School of Medicine . . . . . . . . . NE University of Nebraska College of Medicine 0 58 0 5 20 0 15 2 0 NJ University of Medicine and Dentistry of New Jersey 70 0 30 0 0 0 0 0 0 NM University of New Mexico 10 3 25 0 25 20 7 10 0 NY Albany Medical College . . . . . . . . . NY Albert Einstein College of Medicine 0 15 20 10 50 0 5 0 0 NY Cornell University 0 40 26 0 17 0 8.5 8.5 0 NY Mount Sinai School of Medicine 0 11 11 8 5 0* 43 22 0 NY New York Medical College 10 0 0 0 90 0 0 0 0 NY New York University School of Medicine 0 0 60 20 0 10 10 0 0 NY State University of New York Syracuse 30 0 0 0 40 0 0 30 0 NY State University of New York Stony Brook 0 15 20 15 50 0 0 0 0 NY State University of New York Buffalo 5 0 50 0 30 0 15 0 0 NY State University of New York Brooklyn 100 0 0 0 0 0 0 0 0 NY University of Rochester 0 5 8 2 50 0 25 10 0 * Program Director did not report VHA funding at these GRECC affiliated sites. 1=College of Medicine, Required Support; 2=College of Medicine, Discretionary Support; 3= Direct Hospital Support; 4=Endowment Income; 5=Clinical Practice; 6=Veterans Health Administration; 7=Research Grants; 8=Educational Grants; 9=Other 51
Page 1 and 2: The Association of Directors of Ger
Page 3 and 4: The Association of Directors of Ger
Page 5 and 6: National Oversight Panel M. Brownel
Page 7 and 8: The American Geriatrics Society . .
Page 9 and 10: List of Tables and Figures Chapter
Page 11 and 12: Figure 7.4 Figure 7.5 Figure 7.6 Fi
Page 13 and 14: the fastest acceleration in 12 year
Page 15 and 16: esidency review committee provide a
Page 17 and 18: Project Methodology National Oversi
Page 19 and 20: Table 2.2 Secondary Data and their
Page 21 and 22: 3 Historical Development of Geriatr
Page 23 and 24: $195.9 million NIA extramural suppo
Page 25 and 26: important political decision by the
Page 27 and 28: 4 The Practice Of Geriatric Medicin
Page 29 and 30: participants. Geriatricians have be
Page 31 and 32: Table 4.8 Medicaid Recipients and P
Page 33 and 34: Figure 4.1 Distribution of Certifie
Page 35 and 36: Figure 4.3 Geriatric Caseload for P
Page 37 and 38: Table 4.19 Total Annual Compensatio
Page 39 and 40: panel felt were most important for
Page 41 and 42: 5 Academic Geriatrics Programs in U
Page 43 and 44: Table 5.1 Academic Geriatric Progra
Page 45 and 46: Table 5.1 Academic Geriatric Progra
Page 47 and 48: Figure 5.1 Number of Years as Acade
Page 49 and 50: Table 5.4 Women and Minority Facult
Page 51: Figure 5.6 Physician Faculty Vacanc
Page 55 and 56: Table 5.9 Allopathic Medical School
Page 57 and 58: Table 5.11 Allocation of Faculty an
Page 59 and 60: Table 5.12 Allocation of Faculty an
Page 61 and 62: Table 6.1 Geriatric Medicine and Ge
Page 63 and 64: Table 6.4 Sources of Financial Supp
Page 65 and 66: investigators receive $60,000 of su
Page 67 and 68: Table 6.7 Program Directors Reporte
Page 69 and 70: Table 6.10 Program Directors Report
Page 71 and 72: Fellowship Training Activities for
Page 73 and 74: Table 6.16 Fellowship-Trained Geria
Page 75 and 76: 7 Preparing All Physicians To Care
Page 77 and 78: General Internal Medicine The 1999
Page 79 and 80: Trends in GIM Residency Programs Re
Page 81 and 82: Nursing homes and home care experie
Page 83 and 84: Geriatric Education Retreats (GERs)
Page 85 and 86: and GIM programs a mean of 2.8 avai
Page 87 and 88: chapter. The goals of these student
Page 89 and 90: This program awarded 20 two-year, $
Page 91 and 92: Conclusion This report summarizes r
Page 93 and 94: Bureau of Health Professions, HRSA,
Page 95 and 96: U.S. Centers for Medicare & Medicai
Page 97 and 98: APPENDIX A. Research Focus of Curre
Page 99 and 100: APPENDIX C. RESEARCH FOCUS OF NATIO
Page 101 and 102: APPENDIX E. SELECTED GERIATRIC MEDI
Page 103 and 104:
Appendix F. Geriatric Medicine and
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Helen Hoenig, M.D., M.P.H., Duke Un
Page 111 and 112:
APPENDIX H. RESIDENCY REVIEW COMMIT
Page 113 and 114:
Appendix H. Residency Review Commit
Page 115:
Association of Directors of Geriatr
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