Why Geriatric Medicine?

Y4-ewZBYDr James Fisher is a final year Geriatric Medicine trainee working at Northumbria Healthcare NHS Foundation Trust; he tweets @drjimbofish. Here he describes an ongoing project that seeks to understand more about career choices and recruitment to Geriatric Medicine.

Geriatricians of tomorrow: We need you! As the number of people living with frailty grows, geriatricians are increasingly in demand. Already, in terms of consultant numbers, Geriatric Medicine is the biggest hospital medical specialty – but to meet the needs of the ageing population, further expansion in numbers will be needed.

Fortunately, it seems the popularity of the specialty amongst junior doctors is growing. There are increasing numbers of applicants for higher specialist training posts and the success of the Geriatrics for Juniors (G4J) events has revealed a huge appetite for older person-specific training amongst junior doctors.

Why do doctors ultimately choose a career in geriatric medicine? A 2006 BGS supported survey, in the aftermath of Modernising Medical Careers (MMC), asked this question to UK geriatric medicine consultants and registrars. Based on their findings, it seems that geriatricians take a while to germinate – trainees tended to opt for geriatric medicine at a relatively late stage in their training. Given this finding, how might the reforms introduced by MMC, where trainees are required to make earlier career choices, have impacted on recruitment to our specialty?

Notably, the most potent drivers towards a career in the specialty were identified as the clinical content of the job and the impact of positive role-modelling by senior colleagues.  But worryingly, 10% of registrars admitted that they regretted choosing geriatric medicine as a career. These regrets appeared to mainly relate to the pressures associated with contributing to the acute medicine rota, rather than negative attitudes towards their parent specialty. More recent work, emerging from the first G4J event, also identified negative perceptions about the role of the medical registrar role amongst junior doctors. The ‘med-reg’ role was cited as a strong deterrent to a career in geriatric medicine, but notably, attitudes towards the role were seen to improve after a focused teaching intervention.

A decade on from this original survey, the reforms to postgraduate training introduced by MMC are well established. Further change is on the horizon however, with Shape of Training mapping out another potential restructuring of postgraduate training.

Against this backdrop we wanted to ask current UK-based geriatric medicine registrars: why did you choose geriatrics? From October 2015 a short online survey went live: aeme.org.uk/whygeris/ and will remain open until the end of March 2016. As a token of our gratitude for completing the survey, all respondents will be entered into a prize draw to win one of twenty £20 Amazon vouchers.

We anticipate that the findings of our survey will enable us to better understand trainees’ motivations to undertaking a career in our specialty, as well as identifying any potential deterrents to geriatric medicine. We’re also seeking to crowd-source ideas for improvement, by asking registrars to tell us how they think the specialty can attract more people to work in it. The ultimate goal of this work is to use the lessons learnt to inform future initiatives to support recruitment.

We’d love to hear your thoughts about this blog article and our survey, or any personal reflections on career choices that you’d be willing to share – join the conversation on Twitter with the hashtag #whygeris

One thought on “Why Geriatric Medicine?

  1. I spent my working life both in Rheumatology (MRCP) and Geriatrics (DGM examiner for 6 years) and combining General Practice with in – patient Geriatrics (5 sessions at hospital practitioner looking after an acute/rehab ward in Cirencester sub-district hospital).

    I saw a shift from generalist geriatrics to geriatrics tagged with a special interest – cardiology and gastroenterology.

    My experience from 1974 to 2000 was that combination geriatrics pushed rehab and the generalist role to a lesser priority.

    I am curious about the present state of play. How many consultant posts are generalist geriatrics and how many geriatrics with a special interest?

    I think of general practice as the speciality of primary care general ism with special interests added for added interest but only at a minor level.

    Is this the present situation with geriatric medicine? Was this covered in your survey?

    David Beales FRCP MRCGP Retired GP.

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