Print this page.
The following information is based on data from the Association of Directors of Geriatric Academic Programs' "Status of Geriatric Workforce Study".
Q: What is a Geriatrician?
A: A geriatrician is a medical doctor who is specially trained to meet the unique healthcare needs of older adults. Illnesses, diseases and medications may affect older people differently than younger adults and older patients often have multiple health problems and take multiple medications. Geriatricians prevent, manage and develop care plans that address the special health problems of the elderly.
Generally, geriatricians are primary care physicians who are board-certified in either family medicine or internal medicine and have completed the additional training necessary to become board certified in Geriatric Medicine.
Geriatricians often work as part of a team with other healthcare providers, including nurses, pharmacists and physical therapists -- who may also have advanced training and hold special certifications in geriatrics. A geropsychiatrist is a psychiatrist trained to meet older adults' mental health needs and address specific syndromes seen in the elderly.
Back to top
Q: How many board certified geriatricians and geropsychiatrists are there in the US?
A: As of April 2008, there were 7,590 board certified geriatricians and 1,657 board certified geriatric psychiatrists in the US.
Back to top
Q: What special training do geriatricians receive?
A: After earning their medical degrees, geriatricians complete a three-year residency program in either internal medicine or family medicine before entering a geriatric medicine fellowship program.
Through this training, geriatricians develop clinical competence in: the physiology of aging; illnesses common among older persons; atypical presentations of illnesses in older adults; the functional assessment of older people; the treatment and management of older adults in acute care, long-term care, community-based, and home-care settings; and the assessment of cognitive status and mood in the elderly. Geriatricians also have clinical training and experience providing care for persons who are generally healthy and require primarily preventive healthcare. In addition, their training highlights behavioral aspects of illness, socioeconomic factors, health literacy issues and ethical and legal considerations that may affect the medical management of older patients.
Geropsychiatrists complete a four-year residency program in psychiatry before entering a fellowship program in geriatric psychiatry.
Back to top
Q: How many geriatrics training slots are there? How many are filled?
A: For academic year 2006-2007, there were 468 geriatric medicine first-year fellowship training slots, and 253, or 54%, were filled. For the same year, there were 142 geriatric psychiatry fellowship first-year training slots, and 68, or 48%, were filled.
Back to top
Q: How many students are going into geriatrics training this year? How does this compare with previous years?
A: In 2007, 91 medical doctors who graduated from US medical schools (USMDs) entered geriatric medicine fellowship programs (slightly more than 0.5% of all medical students in that graduating class). The number of USMDs entering geriatric medicine fellowship programs decreased from 167 in 2003 to 91 in 2007.
In 2007, 24 USMDs entered geriatric psychiatry fellowship programs (less than 0.2 % of all medical students in that graduating class). The number of USMDs entering geriatric psychiatry fellowship programs decreased from 30 in 2003 to 24 in 2007.
The majority of physicians who enter geriatric fellowship programs attended medical school outside of the United States. Of the 287 physicians who entered geriatric medicine fellowship programs in 2007, 184 were international medical school graduates (IMGs). The same trend held for geriatric psychiatry fellowship programs -- with 44 of the 72 fellows being IMGs.
Back to top
Q: What are the current and projected future doctor to patient ratios in geriatrics?
A: There are currently 7,590 certified geriatricians in the US -- one geriatrician for every 2,500 Americans 75 or older. Due to the projected increase in the number of older Americans, this ratio is expected to drop to one geriatrician for every 4,254 older Americans in 2030.
There are far fewer geriatric psychiatrists. Currently there are 1,657 - one for every 11,451 older Americans. That ratio is projected to decrease by 2030 to one geropsychiatrist for every 20,195 Americans 75 and older.
Back to top
Q: What's the average salary for a geriatrician?
A: The median salary for a geriatrician in private practice in 2006 was $161,888. This was $2,133 less than the average family physician's salary, and 15,171 less than the average general internist's. Geriatricians train at least one year longer than their primary care colleagues, and yet they are compensated at a lower level. Overall, geriatricians' compensation is significantly lower than that of most other medical and surgical specialists.
Back to top
Q: What factors are contributing to - or are expected to contribute to - the shortage of geriatricians?
A: Over the last 5 years, a declining number of US medical school graduates have been choosing careers in internal medicine and family medicine -- the two fields that are the source of applicants for geriatric fellowship programs. Physicians in internal medicine, family medicine -- and geriatrics -- earn significantly less and have less predictable work schedules than those in other medical and surgical specialties, especially popular disciplines such as dermatology, plastic surgery, otolaryngology, radiation oncology, and emergency medicine.
A career focused on caring for older adults can be particularly financially unattractive for physicians with increasingly large medical school loan debts. Physicians graduating from U.S. medical schools in 2007 owed an average of $138,608 for their education. Fifty one percent of these graduates said that salary expectations were a moderate or strong influence in determining their specialty.
In many parts of the U.S., Medicare payment rates for physicians are lower than commercial insurance rates. Medicare reimbursement rates for mental health services are discounted even further than rates for geriatric medical services. Medicare reimbursement is the major source of income for most geriatricians and, as a result, community-based geriatricians have lower incomes than most other physician specialists.
Back to top
Q: Are there any sub-specialties within geriatrics that are able to recruit more candidates than others?
A: Geriatricians providing hospital-based care for older adults and hospital-based palliative for older people care have been in increasing demand and are earning more competitive salaries. These important career paths are benefiting from a new trend -- increasingly, U.S. hospitals are recruiting and subsidizing the practices of physicians caring for the hospitalized elderly.
Back to top
Q: Where can I find more information about the status of the geriatrics workforce?
A: The ADGAP Status of Geriatrics Workforce Study tracks trends in geriatrics faculty development, medical school-based academic programs, and teaching programs for medical students, residents, and fellows, as well as the practice of geriatrics. The ADGAP study is funded by grants from the Donald W. Reynolds Foundation of Las Vegas and the John A. Hartford Foundation of New York City.
Back to top
|
