OBJECTIVES: The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current
health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In this
study, we document the current and future trends in geriatric education in GIM residency programs.
DESIGN, SETTING, PARTICIPANTS: An original survey was mailed to all the GIM residency directors in the United States (N=390).
RESULTS: A 53% response rate was achieved (n=206). Ninety-three percent of GIM residencies had a required geriatrics curriculum. Seventy one percent of the programs required
13 to 36 half days of geriatric medicine clinical training during the 3-year residency, and 29% required 12 half days or less
of clinical training. Nursing homes, outpatient geriatric assessment centers, and nongeriatric ambulatory settings were the
predominant training sites for geriatrics in GIM. Training was most often offered in a block format. The average number of
physician faculty available to teach geriatrics was 6.4 per program (2.8 full-time equivalents). Conflicting time demands
with other curricula was ranked as the most significant barrier to geriatric education.
CONCLUSIONS: A required geriatric medicine curriculum is now included in most GIM residency programs. Variability in the amount of time
devoted to geriatrics exists across GIM residencies. Residents in some programs spend very little time in specific, required
geriatric medicine clinical experiences. The results of this survey can guide the development of future curricular content
and structure. Emphasizing geriatrics in GIM residencies helps ensure that these residents are equipped to care for the expanding
aging population.
Key words geriatric medicine education - general internal medicine - graduate medical education
This work was supported by a grant from the Donald W. Reynolds Foundation, Las Vegas, Nevada.
This report is a part of the Association of Directors of Geriatric Academic Programs’ Longitudinal Study of Training and Practice
in Geriatric Medicine. We thank Rosanne M. Leipzig, MD, PhD, and Seth Landefeld, MD, for their help in developing the survey.