Preparing medical graduates to care for geriatric patients: A case study of the undergraduate medical curriculum at a South African university

Abstract

BackgroundHealth care professionals in South Africa are facing a rapidly ageing population with increased demands for age-related health care services. 1 Old age is associated with chronic illnesses and functional impairments that result in an increased burden of disease among older adults. 2 The high prevalence of multi-morbidities and sensory impairments in older adults requires an integrated approach from health care professionals with a focus on function and quality of life. 3 The National Health Insurance Bill, which aims to provide Universal Health Coverage (UHC) to all South African citizens, is dependent on health professionals' ability to deliver comprehensive health services to all at primary care level. 4 It is thus essential that all medical students receive training in the core competencies of geriatric care to ensure the delivery of quality primary care services to elderly patients. 5 The World Health Organization (WHO) highlighted the necessity of including geriatric training in undergraduate (UG) medical curricula almost two decades ago, but medical schools have been slow to implement this recommendation. 6 Geriatric medicine, the field of medicine that deals with ageing and health conditions associated with advancing age, is a relatively new and neglected area in health professions education. 7 A global survey conducted by the WHO in 2002 revealed a lack of attention to geriatrics in UG medical curricula. 5 It was also disconcerting that data from only one sub-Saharan African (SSA) country, namely Ghana, had been included in that study. A 2015 survey of 25 medical schools across 11 countries in Africa reported on inclusion of geriatric topics at UG level in only 60% of the participating institutions. 8 Dedicated teaching time for geriatrics was very limited, consisting Background: Medical schools in South Africa must be responsive to the health needs of the rapidly ageing population. Reports of the poor quality of care received by elderly patients raises concerns about the training of medical students. A review of the curriculum can help to assess current geriatric care training and identify the areas in need of improvement. This study was conducted to describe the nature and scope of undergraduate medical education in geriatric care at a South African university.Methods: An exploratory, descriptive case study was conducted to analyse the learning objectives, opportunities and outcomes of the 6-year undergraduate medical program. Data included an electronic curriculum supported by student and teacher guides. Semi-structured interviews were conducted with health professions educators. Results:The curriculum covered key geriatric competencies that included addressing geriatric syndromes and conducting a comprehensive geriatric assessment. Teaching on geriatric competencies occurred mainly in the clinical years, was integrated and no sub-minima was applied in its assessment. Teaching occurred in disciplinary silos with little involvement of the multidisciplinary team. Learning objectives and assess...

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