For example, as discussed above, some geriatric professions have existing opportunities for advanced training, but practitioners do not pursue the positions (e.g., only 54 percent of available first-year positions in geriatric medicine were filled in 2006-2007). If financial support was available, it might encourage professionals to pursue such advanced training. The availability of scholarships could also get students interested in geriatrics earlier in their careers, which in turn would create a need for the development of more robust geriatric curricula and more advanced training options.

Recommendation 4-3c: States and the federal government should institute programs for loan forgiveness, scholarships, and direct financial incentives for professionals who become geriatric specialists. One such mechanism should include the development of a National Geriatric Service Corps, modeled after the National Health Service Corps.

One mechanism to create incentives for students to enter geriatric specialties is a National Geriatric Health Service Corps which would offer loan repayment for newly graduating professionals in geriatrics. There are many mechanisms for achieving this increased recruitment and retention; loan repayment is one example. For example, the committee estimated the costs required to institute loan repayment for graduating fellows of geriatric medicine. As in Tables 4-6 and 4-7, the committee presents costs for a loan repayment program associated with two hypothetical goals: to either double the number of geriatricians over 10 years, or to triple their numbers over 20 years. Under these scenarios, the costs for loan repayment for physicians is estimated at $35,000 per year for 4 years (or $140,000 per physician). Tables 4-9 and 4-10 demonstrate rough estimates for loan repayment to graduating fellows of geriatric medicine based on 2008 dollars assuming, as in Tables 4-6 and 4-7, either a 20 percent or 10 percent annual increase in the number of geriatric fellows.

CONCLUSION

This chapter addressed the education, training, recruitment, and retention of the professional health care workforce. Overall, there is an inadequate supply of professionals in general for meeting the health care needs of the future older adults and also an inadequate number of geriatric specialists both to care for these patients and to teach other professionals about geriatric care. Although the situation is improving, most professional education programs still do not have sufficient geriatric content in their curricula or adequate experiences in clinical settings. When the opportunity exists, most professionals are not choosing to receive specialized training in geriatrics, and some professions lack the opportunity for advanced geriatric



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