Big ‘G’ and Little ‘g’ Geriatrics Education for Physicians

Abstract

In the July 2016 issue of this journal, Dr. Mary Tinetti proposed that geriatric medicine abandon attempts to increase the numbers of board‐certified geriatricians and change focus to the development of a “small elite workforce.” What would be gained and what sacrificed by accepting this challenge? We agree that the best clinical use of a scarce resource, specialty trained geriatricians, is to care for frail, complex, severely ill elderly adults and to help design and study novel interventions in research, education, and care models to improve the care of all older adults, but for this to happen, all other providers must attain specific competency in the care of older adults. This article responds and discusses alternative pathways for teaching geriatrics care, training specialists, and geriatrics fellows.

Project ECHO-Geriatrics: Training Future Primary Care Providers to Meet the Needs of Older Adults

“…The primary care workforce for the rapidly growing population of older adults cannot be derived solely from the dwindling numbers of board-certified geriatricians. [1][2][3][4][5] Integrating geriatrics telementoring and telehealth into primary care training may mitigate the scarcity of geriatricians and support trainees and clinicians who are caring for medically complex older adults in underserved communities.…”

Why Geriatric Medicine Is Important for Korea: Lessons Learned in the United States

“… 23 There are also now many well-trained medical educators with access to turn-key educational products, as well as specialty and subspecialty geriatrics champions. 31 However, these efforts and resources have not translated into an increase in U.S. board-certified geriatricians, as previously cited in this paper.…”

“…As a discipline, geriatric medicine in the U.S. has been fortunate to have received significant philanthropic and governmental funding over the last 4 decades, resulting in career development for clinician — educators, incorporation of geriatrics training into undergraduate and graduate medical education, and development of curricula and geriatric subgroups within many medical specialties. 31 As a result, many educational materials have been produced and are freely available on curriculum websites such as the Portal of Geriatrics Online Education ( www.pogoe.org ). 27 Nearly all U.S. medical students are now exposed, if not well grounded, in geriatric topics based on the twenty-six Minimum Geriatric Competencies.…”

Trends in Geriatrics Graduate Medical Education Programs and Positions, 2001 to 2018

“…the number of older adults that clinicians care for using geriatric principles” (p. 1401) ( Tinetti, 2016 ). Some professionals believe that the specialty will not meet demands by recruiting more young Geriatricians; rather, they believe Geriatricians should ensure that primary care, specialty care, and surgical professionals are equipped to treat older adults as well ( Callahan, Tumosa, & Leipzig, 2017 ). In this paradigm, specialty Geriatricians would be responsible for the most complex and frail patients.…”