Warshaw Gregg A, Thomas David C, Callahan Eileen H, Bragg Elizabeth J, Shaull Ruth W, Lindsell Christopher J, Goldenhar Linda M
Office of Geriatric Medicine and Institute for Health Policy and Health Services Research, University of Cincinnati, 231 Albert Sabin Way, PO Box 670504, Cincinnati, OH 45267-0504, USA.
J Gen Intern Med. 2003 Sep;18(9):679-84. doi: 10.1046/j.1525-1497.2003.20906.x.
The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In this study, we document the current and future trends in geriatric education in GIM residency programs.
DESIGN, SETTING, PARTICIPANTS: An original survey was mailed to all the GIM residency directors in the United States (N = 390).
A 53% response rate was achieved (n = 206). Ninety-three percent of GIM residencies had a required geriatrics curriculum. Seventy one percent of the programs required 13 to 36 half days of geriatric medicine clinical training during the 3-year residency, and 29% required 12 half days or less of clinical training. Nursing homes, outpatient geriatric assessment centers, and nongeriatric ambulatory settings were the predominant training sites for geriatrics in GIM. Training was most often offered in a block format. The average number of physician faculty available to teach geriatrics was 6.4 per program (2.8 full-time equivalents). Conflicting time demands with other curricula was ranked as the most significant barrier to geriatric education.
A required geriatric medicine curriculum is now included in most GIM residency programs. Variability in the amount of time devoted to geriatrics exists across GIM residencies. Residents in some programs spend very little time in specific, required geriatric medicine clinical experiences. The results of this survey can guide the development of future curricular content and structure. Emphasizing geriatrics in GIM residencies helps ensure that these residents are equipped to care for the expanding aging population.
预计在未来几十年，美国老年人口将急剧增加，这将给当前的医疗保健系统带来沉重压力。普通内科（GIM）住院医师需要做好照顾这一人群的准备。在本研究中，我们记录了GIM住院医师培训项目中老年医学教育的现状和未来趋势。
设计、地点、参与者：向美国所有GIM住院医师培训项目主任邮寄了一份原始调查问卷（N = 390）。
回复率为53%（n = 206）。93%的GIM住院医师培训项目设有老年医学必修课程。71%的项目要求在3年住院医师培训期间提供13至36个半天的老年医学临床培训，29%的项目要求提供12个半天或更少的临床培训。养老院、门诊老年评估中心和非老年门诊环境是GIM住院医师培训项目中老年医学的主要培训地点。培训通常以集中授课的形式进行。每个项目可用于教授老年医学的医师教员平均人数为6.4人（相当于2.8名全职教员）。与其他课程的时间需求冲突被列为老年医学教育的最大障碍。
现在大多数GIM住院医师培训项目都设有老年医学必修课程。不同GIM住院医师培训项目在老年医学教学时间上存在差异。一些项目的住院医师在特定的、必修的老年医学临床实践中花费的时间很少。本次调查结果可为未来课程内容和结构的制定提供指导。在GIM住院医师培训项目中强调老年医学有助于确保这些住院医师有能力照顾不断增加的老年人口。
