Abstract
Background: Aging populations require physicians skilled in competencies essential for the care of older adults. The extent to which such geriatric competencies are included in non-geriatric postgraduate medical training programs is not known. Therefore this study examined the inclusion of 13 geriatric competencies in postgraduate training programs in Australia and New Zealand, the United Kingdom, and the United States.
Methods: Thirteen core geriatric competencies were identified and defined: aging physiology; health equity and sociodemography in aging; geriatric assessment and management; individualized care and decision-making; multidisciplinary team collaboration; effective communication; cognition and mental health; common geriatric syndromes and presentations; medication prescribing and pharmacology; ethical and legal issues; coordination of care; end-of-life care and advance care planning; and older adults in research. Curricula of programs accredited by the Australian Medical Council, General Medical Council, and Accreditation Council for Graduate Medical Education were reviewed for inclusion of these competencies. Subspecialty programs pursued after initial training, and specialties without direct clinical care of older adults were excluded.
Results: Twenty-four of 52 programs (46%) included no core geriatric competencies. Among curricula that did include them, coverage ranged from 1 to 12 competencies. The most frequently included were ethical and legal issues (18 programs [35%]), cognition and mental health (15 programs [29%]), and geriatric syndromes (14 programs [27%]).
Conclusions: Significant gaps exist in the integration of geriatric competencies across postgraduate medical training programs. Coordinated efforts are needed to integrate and assess these competencies to prepare physicians to care for aging populations.