Medina-Walpole Annette, Barker William H, Katz Paul R, Karuza Jurgis, Williams T Franklin, Hall William J
Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
J Am Geriatr Soc. 2002 May;50(5):949-55. doi: 10.1046/j.1532-5415.2002.50225.x.
The rapid growth of the older population has focused national attention on the need for physicians trained in geriatric medicine. To gain insight into the evolving status of the field, with particular focus on career decision-making and academic career development of trainees, we conducted a survey of physicians recently completing geriatric fellowships. The 107 accredited extant geriatric fellowship programs in the United States and Puerto Rico were contacted to identify trainees from 1990 to 1998. A mailed survey addressed relevant career development and training issues. Four hundred ninety out of 787 (62%) physicians responded; 20% completed 1 year and 80% 2 or more years of training. Half made the decision to pursue a career in geriatrics during residency, 27% decided before/during medical school, and a mentor influenced 48%. Currently, 80% have a Certificate of Added Qualifications in geriatric medicine, 69% hold academic appointments, 78% teach, 39% participate in research, and 44% author publications. Most are doing predominantly clinical work in multiple settings. Further analysis of the 1996-to-1998 cohort revealed that those completing fellowships of 2 or more years are more likely to identify all geriatrics as their professional focus, conduct and author research, work with multidisciplinary teams, and participate in professional geriatric societies. This national survey documents career decision-making and the academic and clinical profiles of physicians completing geriatric fellowship training in the past decade. Longer fellowship training is associated with academic career development. Although there is a national need to train clinical geriatricians, the additional need to train and fund future geriatric academic leaders requires increased attention.
老年人口的迅速增长使全国关注对老年医学方面受过培训的医生的需求。为了深入了解该领域不断变化的状况，特别是关注学员的职业决策和学术职业发展，我们对最近完成老年医学 fellowship 培训的医生进行了一项调查。我们联系了美国和波多黎各现存的 107 个经认可的老年医学 fellowship 项目，以确定 1990 年至 1998 年期间的学员。通过邮寄调查询问了相关的职业发展和培训问题。787 名医生中有 490 名（62%）回复；20% 完成了 1 年培训，80% 完成了 2 年或更长时间的培训。一半人在住院医师培训期间决定从事老年医学职业，27% 在医学院学习前/期间做出决定，48% 受导师影响。目前，80% 的人拥有老年医学附加资格证书，69% 担任学术职务，78% 从事教学，39% 参与研究，44% 发表过著作。大多数人主要在多种环境中从事临床工作。对 1996 年至 1998 年这一批学员的进一步分析显示，完成 2 年或更长时间 fellowship 培训的人更有可能将整个老年医学领域作为其专业重点、开展并撰写研究、与多学科团队合作以及参与专业老年医学协会。这项全国性调查记录了过去十年中完成老年医学 fellowship 培训的医生的职业决策以及学术和临床概况。更长时间的 fellowship 培训与学术职业发展相关。尽管全国需要培训临床老年医学医生，但培训和资助未来老年医学学术带头人的额外需求需要更多关注。
