TABLE 1 Numbers of Certified Geriatriciansa

 

No. Certified in:

 
 

1988

1990

1991

1992

Total

Internal medicine

1,645

1,204

 

1,254

4,103

Formal training

183

178

 

123

484

Family medicine

753

473

 

597

1,823

Formal training

43

25

 

65

133

Psychiatry

   

490

359

849

Total

2,398

1,677

490

2,210

6,775

a The first examination was given in 1988, but none was administered in 1989 or 1993. No examination was given in internal medicine or family medicine in 1991. The first examination was given in psychiatry in 1991.

Federal support has come from the National Institute on Aging (NIA), the National Institute of Mental Health (NIMH), the Bureau of Health Professions, and the U.S. Department of Veterans Affairs (DVA). NIA invested approximately $58.8 million in research training during that time period. NIMH has had two programs; the first supports pre-and postdoctoral research training on aging and has supported approximately 25 to 30 trainees per year, and the second is the Career Development Award mechanism for physicians. NIMH estimates that approximately $19 million has been spent on training since 1982. The Bureau of Health Professions has supported the training of 57 two-year fellows between 1989 and 1992 and the 1-year retraining of nine physicians in geriatric medicine during the same time period. The investment was approximately $14.6 million.

DVA has supported training through the Geriatric Research Education and Clinical Centers (GRECCs) and by supporting non-GRECC fellows. Approximately 284 geriatric medicine fellows have been supported since 1982, and total estimated support has been $27.7 million. In 1991, DVA began training geriatric psychiatry fellows at nine sites, and 12 psychiatrists had graduated as of June 1993. In 1993, DVA began training geriatric neurology fellows at four sites; seven neurologists have enrolled, but none has yet graduated from these programs (W. F. Dube, DVA, personal communication, 1993).

The John A. Hartford Foundation began its Aging and Health program in 1983, initially with a strategy to train midcareer faculty to become leaders in academic geriatrics. The program supported 29 scholars over 5 years. Following



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