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

in geriatrics as demonstrated through original research or reviews.
The awardee receives a $500 travel stipend to attend the annual
meeting of the American Geriatrics Society.
The American Geriatrics Society and Boston University, with
funding from the NIA, has sponsored a Summer Institute in Geriatrics
for medical students since 1986. This week-long conference, generally
held each year during July, provides medical students entering their
third or fourth years exposure to academia and geriatric medicine
research. Activities include lectures, seminars, and case discussions
as well as site visits to research and clinical programs. Faculty include
nationally recognized academic geriatricians and other individuals
pursuing research in geriatrics and gerontology. Approximately 250
medical students have attended the Institute. No Institute will be held
the summer of 2002 as the curricula is being revised and updated
since students are coming to the Institute with more background in
geriatrics. (Personal communication, Laura Anastasi, Boston University,
March 22, 2002).
In 1998, the AGS developed Areas of Basic Competency for the
Care of Older Patients for Medical and Osteopathic Schools
(www.americangeriatrics.org). This curriculum guide addressed
attitudes, knowledge and skills that medical students should achieve.
The AGS education committee conducted a mail survey of medical
schools’ pre-doctoral curricula in 1999-2000 (Eleazer, 2001). Ninetythree
schools responded. Eighty-nine percent of responders indicated
they had a geriatrics curriculum, but only 64% reported having
developed learning objectives for medical students in the care of older
persons. The mean number of hours of geriatric medicine lectures for
all 4 years of training was 13.79 hours. Sixty-eight percent of the
responding schools offered elective experiences in the home or
nursing home settings.
For this project, we surveyed, in the spring of 2001, U.S. allopathic
and osteopathic directors of geriatric medicine programs. They were
asked to report on their required geriatric medicine training settings.
Each setting was utilized more commonly in the osteopathic schools.
Nearly one-third of allopathic schools required nursing home and
home visits. Besides nursing home and home visits, settings included
inpatient geriatric consultation, geriatric acute care unit, outpatient
geriatric assessment center, geriatric primary care clinic, hospice
care, and assisted living. Fifty-eight medical schools (56.3%) indicated
they did not have any required setting.
AAMC/Hartford Foundation
Initiative
In 2000, utilizing the AGS’s Areas of Competency as a guide, the
AAMC, with a series of grants totaling five million dollars over a
four-year period from the John A Hartford Foundation, initiated the
Geriatrics Curriculum Grants Initiative. This program is led by M.
Brownell Anderson, Associate Vice President of the AAMC’s Division of
Medical Education. The purpose of this program is to enhance medical
student education related to gerontology and geriatrics by:
• Catalyzing in a small group of medical schools the
development and implementation of innovative curricula on
these topics, and
• Disseminating widely to all medical schools the results of the
development, implementation, and evaluation of these curricula.
Figure 8.2 2001 AAMC Expanded Medical Student Graduation Questionnaire: AAMC/Hartford Geriatric
80
70
75.5
67.7
68.1
69.3
64.1
63.6
79.7
73.1
73.2
62.9
Round 1 Schools Funded in 2000
Round 2 Schools Funded in 2001
Non-funded
60
50
40
30
55
46.7
48.6
54.9
51.6
37.6
29.4
29.2
46.1
30.8
31.9
53.1
38.9
40.7
20
10
0
Curriculum Grants Initiative Analysis 1 86
I learned about
the health care
needs of healthy
older adults
during my
medical training.
I am well
prepared to
care for older
adult patients
in acute
settings.
I am well
prepared to
care for older
adult patients
in ambulatory
settings.
I am well
prepared to
care for older
adult patients
in long-term
health care
settings.
I was exposed
to expert
geriatric care
by the attending
faculty of
my medical
program.
Geriatric/
gerontology
education was
part of all
four years of
my medical
education.
Small group
exercises were
used to
increase my
knowledge
of geriatrics.
Interdisciplinary
approaches
were used
to increase
my knowledge
of geriatrics.
1 In 2000 and 2001, a total of 40 medical schools received funding from the AAMC/Hartford Geriatrics Grants Initiative.
Medical schools were to implement a required experience for all students in each of their four years of training.
Source: AAMC Medical School Graduation Questionnaire, All School Report, 2001