diversity in teaching and research and limiting the amount of clinical service. Although this is a problem for most faculty in clinical disciplines, it seems particularly important to the younger generation of academic geriatricians.
Further efforts need to be directed toward changing the attitudes of individuals in leadership positions, medical students, and residents concerning the importance of geriatrics and the major opportunities that exist of they were to embrace the area. Marketing professionals should be involved with professional organizations in highlighting the need, the value, and the opportunities that exist in geriatric medicine. The efforts might begin at the time of enrollment into medical school and be reinforced throughout the undergraduate curriculum. Students who are selecting their residency programs as well as residents who are making fellowship training decisions could also be targeted.
Nationally sponsored examinations throughout the medical educational continuum are often not considered to have any major effect on the course content of the undergraduate, graduate, or fellowship training curricula. The realities are that, from the potential examinees' perspective, they very much influence what students learn. There needs to be a systematic study of how the national examinations might contain questions that address the special content areas and, when applicable, the skills that are required for the care of elderly people by physicians.
Geriatrics and gerontology often appear to be underrepresented in the ongoing efforts at influencing national legislative and funding decisions. In all probability, several factors contribute to this lack of effectiveness, but one is clearly the large number of lobbying organizations involved but the lack of a coordinated lobbying effort. The Alliance for Aging Research has attempted to address this issue, but much more needs to be done. In a multi- and interdisciplinary activity, conflicting priorities understandably arise, and no effective mechanisms for their resolution exist at this time.