geriatric conditions (Moore et al., 2004). This section examines the education and training of all physicians in the care of older adults, with a focus on the path for geriatricians.

Geriatric Content

The geriatric curricula in medical schools has had notable improvements. The percent of medical schools with requirements for “geriatric exposure” has increased from 82 percent in 1985-1986 to 98 percent in 1996-1997 (Eleazer et al., 2005). Still, much of this exposure is inadequate or occurs too late in the educational process to influence which specialities the students select. As noted above, several major public and private initiatives support improvement in the geriatric education of physicians. In May 2001 the Donald W. Reynolds Foundation awarded $19.8 million in grants to 10 institutions in order to develop comprehensive training programs in geriatrics (Donald W. Reynolds Foundation, 2007). Because of the success of this effort, the Donald W. Reynolds Foundation repeated the grants in 2003 and 2005, distributing almost $20 million in each round, and in October 2007 the Donald W. Reynolds Foundation issued a request for proposals for a fourth series of grants. In addition to this effort, the Donald W. Reynolds Foundation has established two departments of geriatric medicine.

The Health Resources and Services Administration (HRSA) distributes grants to support Geriatric Education Centers (GECs), which educate and train individuals in the care of older patients. These centers are often collaborative efforts among several health-profession schools or health care facilities and have a special focus on interdisciplinary training.

In July 2007 the John A. Hartford Foundation and the Association of American Medical Colleges (AAMC) hosted the National Consensus Conference on Geriatric Education. There the participants developed a set of minimum standards for the knowledge, skills, and attitudes of graduating medical students with respect to the care of older patients (Leipzig, 2007). The standards covered a number of domains, including

  • cognitive and behavioral disorders;

  • medication management;

  • self-care capacity;

  • falls, balance, gait disorders;

  • atypical presentation of disease;

  • palliative care;

  • hospital care for older adults; and

  • health care planning and promotion.

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