Simon Steven R, Fabiny Anne R, Kotch Jamie
Department of Ambulatory Care and Prevention, Harvard Medical School, Harvard Pilgrim Health Care, and Hebrew Rehabilitation Center for Aged, Boston, Massachusetts 02215, USA.
Ann Intern Med. 2003 Oct 7;139(7):621-7. doi: 10.7326/0003-4819-139-7-200310070-00036.
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.
为确保其发展与繁荣，普通内科需要将老年护理、衰老研究和老年医学教育纳入其核心使命。专家们一致认为，普通内科住院医师可从更多衰老研究和老年医学教育机会中受益；然而，一些重要障碍将阻碍把老年医学培训融入普通内科住院医师培训项目的努力。本文回顾了整合过程中的障碍，并提出克服这些障碍的解决方案。通过与普通内科医生、老年医学专家、资助机构和政策制定者的广泛代表进行访谈和会议，我们提出了两项干预措施：1）设立机构项目资助，以促进普通内科和老年医学教员在培训普通内科住院医师方面的合作；2）创建一个为期三年的将普通内科和老年医学相结合的住院医师培训项目。本文讨论了评估这些以及其他旨在增加普通内科住院医师老年医学经验的项目的重要性，并描述了这些变化对众多利益相关机构的潜在影响。
