Geriatrics Training in General Internal Medicine Fellowship Programs: Current Practice, Barriers, and Strategies for Improvement

7 October 2003 | Volume 139 Issue 7 | Pages 621-627

To ensure its growth and prosperity, general internal medicine will need to embrace care of the elderly, research on aging, and geriatrics education as components of its core mission. Experts agree that general internal medicine fellows could benefit from increased opportunities in research on aging and geriatrics education; however, important barriers will hamper efforts to integrate geriatrics training into general internal medicine fellowship programs.

This article reviews the barriers to integration and proposes solutions for overcoming those barriers. As a result of interviews and meetings with a broad representation of general internists, geriatricians, funding agencies, and policymakers, we propose 2 interventions: 1) the development of institutional program grants to foster collaboration between general internal medicine and geriatrics faculty in the training of general internal medicine fellows and 2) the creation of a 3-year fellowship program combining general internal medicine and geriatrics.

This article discusses the importance of evaluating these and other programs intended to increase the geriatrics experience of general internal medicine fellows, and it describes the potential implications of these changes for a broad array of stakeholder institutions.

Author and Article Information

From Harvard Medical School, Harvard Pilgrim Health Care, and Hebrew Rehabilitation Center for Aged, Boston, Massachusetts.

Acknowledgments: The authors thank the key informants and summit conference participants for their contributions.

Grant Support: In part by a grant from the Society of General Internal Medicine and the John A. Hartford Foundation, Inc.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Steven R. Simon, MD, MPH, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA 02215; e-mail, steven_simon{at}hms.harvard.edu.

Current Author Addresses: Dr. Simon and Ms. Kotch: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, Sixth Floor, Boston, MA 02215.

Dr. Fabiny: Hebrew Rehabilitation Center for Aged, 1200 Centre Street, Boston, MA 02131.