Why choose a career in geriatric medicine?

Abstract

In this issue, Briggs et al examine why doctors choose a career in geriatric medicine. 1 Their large survey of current consultants and trainees provides a useful insight into the factors which motivate (and demotivate) doctors from deciding to work in this specialty. Recent problems with recruitmentThe disappearance of senior registrars with the Calman reforms meant that many new specialist registrar (SpR) posts were created on the basis of 'history or equity' rather than on their capacity as good training slots. As a result, some registrar posts, previously not considered suitable for training, were incorporated into SpR rotations, exposing several deficiencies:• the lack of research opportunities or a need to rotate to a research oriented department• the inadequacy of services to offer exposure to the specialty elements now required for accreditation, and the new service elements emphasised in the National Service Framework for Older People (NSFOP) such as falls, stroke care, acute assessment and geriatric specialisation within acute services.The demands of acute medicine compounded by the dramatic effects of the European Working Time Directive (EWTD) are widely believed to be detrimental to the quality of specialty training and hence may adversely affect recruitment to the specialty. Most obviously, the majority of SpRs in geriatric medicine (and other specialties involved in emergency medicine) have been forced into partial or complete shift work in the service of acute emergency medicine, with a detrimental effect on specialty training and continuity of medical care. These changes are deeply unpopular with trainees. 2 Modernising Medical Careers (MMC), designed to accelerate postgraduate medical training, is to be fully implemented by the summer of 2007. Concerns have been expressed about its principles as well as the rapidity of its introduction. 3 As Briggs and colleagues point out, 1 with the implementation of MMC, the requirement to choose a specialty at an earlier career stage may well reduce the potential market for geriatric medicine which previously relied heavily on 'late converts' .The strictures imposed by the EWTD have led to consultant expansion in other acute medicine specialties, for example cardiology, gastroenterology and respiratory medicine, so geriatric medicine faces competition for trainees with other specialties which are expanding as fast or faster than itself. A recent survey of recruitment of SpRs in geriatrics gives cause for concern. 4 In 2005, certain areas of England (Yorkshire, Mersey and North West Thames) noted a sharp rise in the number of unfilled SpR posts although in Scotland, Northern Ireland and Wales there appeared little difficulty in recruitment.Academic opportunities are an attractive feature in career choice and this aspect has been an issue for geriatric medicine. In its recent submissions to the Royal College of Physicians (RCP) Workforce Unit, 5 the British Geriatrics Society (BGS) Workforce Committee noted that only 91 out of 965 posts were academic appointmen...

Factors Determining the Choice of a Career in Geriatrics among Students in Geriatric in-Hospital Training: A Prospective Study of 74 Medical Students

“…Despite the obvious need for qualified personnel, hospitals struggle to recruit geriatricians and particularly to attract young physicians to this specialty [ 4 ]. It appears that medical students (MS) have little interest in pursuing a career in geriatrics (CIG).…”

Factors determining the choice of a career in geriatrics among students in geriatric in-hospital training: a single-center prospective study of 74 students

“…Despite signi cant needs in personnel, hospitals are struggling to recruit geriatricians and particularly to attract young physicians to this specialty [3]. Indeed, medical students seem to have little interest in geriatrics.…”