INCREASE IN NUMBER OF GERIATRICS FACULTY

Accurate information on the historical and current supply of geriatrics faculty has been difficult to obtain. The results of an accreditation survey by the Liaison Committee on Medical Education (LCME) from 1991 to 1993 indicated that there were 621 faculty members nationwide with primary responsibility for teaching geriatric medicine (LCME, unpublished data, 1993). From 1969 through 1989, the Association of American Medical Colleges (AAMC) recorded 215 faculty appointed in geriatric medicine. During that same time period, 36 faculty in geriatric medicine were recorded as being deactivated (Brooke Whiting, AAMC personal communication, 1993). In 1992, the AAMC faculty roster listed 42 family physician faculty members as having geriatrics as a specialty, 169 internist faculty as having geriatrics or geropsychiatry as a specialty, and 20 psychiatrists as having geriatrics as a specialty (Association of American Medical Colleges, 1992). Because of poor response rates and other factors, these figures are regarded in the geriatrics community as being quite low.

Additional insight may be obtained from a 1988 survey of geriatrics training in residency programs in family practice and internal medicine (Reuben et al., 1990b). In that survey a 33 percent random sample of programs was employed, and the response rate was 100 percent. Internal medicine residency programs reported an average of 2.8 full-time geriatrics faculty available, and family practice programs reported an average of 2.3 geriatrics faculty available. When extrapolated to include all programs, estimates of the number of full-time geriatrics faculty might be as high as 869 in family practice and 1,176 in internal medicine. Although that study examined only physician faculty who were teaching at the residency level, it is likely that many of these faculty were also teaching at other levels of medical education (e.g., undergraduate and fellowship levels). These figures may also be high, because it is possible that faculty could be teaching in more than one residency program or across specialty disciplines.

As part of a contract to the Health Resources Services Administration, the University of California, Los Angeles (UCLA), School of Medicine and RAND conducted a study of the adequacy of geriatrics faculty and surveyed geriatrics faculty. Survey results were adjusted for sampling and for response rate to provide national projections of the number of geriatrics faculty in U.S. medical schools and residency programs. The number of faculty was multiplied by an adjustment factor that was the ratio of the number of students (or residents) nationwide to the number of students (or residents) in schools (or programs) responding to the survey. That study estimated the following numbers of current geriatrics physician faculty at U.S. medical schools ( Table 3): internal medicine, 909; family practice, 574; neurology, 267; psychiatry, 438; and physical rehabilitation and rehabilitation, 86 (Reuben et al., 1993a).



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