Improving geriatrics training in internal medicine residency programs: best practices and sustainable solutions
Article Abstract:
National surveys indicate a need for additional training in geriatrics during internal medicine residencies. This paper describes 1) "best practices" for integrating geriatrics education into internal medicine residency programs, 2) barriers to implementation of these practices, and 3) possible ways to improve geriatrics training for internal medicine residents. These best practices were determined by a systematic review of the literature and through interviews with leaders of 26 residency and geriatrics programs concerned with geriatrics training for residents. The most successful programs have clinical experiences with 3 key elements: model geriatric care in 1 or more settings (for example, in the hospital or in ambulatory practice), patient care across sites or transitions of care, and interdisciplinary teamwork. Barriers include attitudes, few faculty, need for relationships with nontraditional training sites, and lack of funding. Local solutions include engaging the internal medicine program director to accomplish a mutual goal -- for example, by creating a model geriatrics training experience in which residents demonstrate their skill in a new Accreditation Council of Graduate Medical Education competency (such as systems-based practice). National solutions include reaching consensus on the competencies in geriatrics that should be achieved by board-eligible internists. This may mean increasing the number of questions that test geriatrics competency in the certifying and in-training examinations, increasing numbers of faculty members able to teach and model geriatric care, developing "effective medical resident teaching" courses for nonphysician faculty, and lobbying for improved systems of care.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
User Contributions:
Comment about this article or add new information about this topic:
General internal medicine and geriatrics: collaboration to address the aging imperative can't wait
Article Abstract:
All medical interns and residents who specialize in internal medicine should also receive training in the care of the elderly. This specialty is called geriatrics, and in 2003, less than one percent of all internal medicine residents pursued geriatrics training. The October 7, 2003 issue of the Annals of Internal Medicine includes a supplement that addresses this issue.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Cervical ripening in humans: potential roles of estrogen, progesterone, and insulin-like growth factor-I. Changes in 17-beta,20-alpha-hydroxysteroid dehydrogenase activity supporting an increase in the estrogen/progesterone ratio of human fetal membranes at parturition
- Abstracts: New mind/body tactics target medically unexplained physical symptoms and fears. Programs target youth violence prevention
- Abstracts: Development of geriatrics-oriented faculty in general internal medicine. General internal medicine and geriatrics: building a foundation to improve the training of general internists in the care of older adults