AMA Wire

Wednesday, Feb. 6, 2013

For Residents

Fewer trainees choosing geriatrics, numbers show

The number of doctors enrolling in the nation's fellowship programs to become geriatricians has again dropped, to 251 this year from 279 last year, according to annual graduate medical education statistics published in the Journal of the American Medical Association.

In comments made on a New York Times' blog, Christopher Langston, MD, program director at the Hartford Foundation, said he found the decrease particularly disappointing considering that geriatricians already have begun receiving 10 percent bonuses in reimbursement for evaluation and management under the Affordable Care Act.

"Maybe it's not enough, maybe it's too time-limited. Maybe the problem isn't financial," he said.

The Institute of Medicine's 2008 report on health care for the aging provided some possible causes for the declining rate of geriatricians. For one, residents thinking about medical specialties often consider geriatrics depressing despite surveys showing that geriatricians generally find their work to be very satisfying.

The shortage has prompted Dr. Langston and others to move from training new geriatricians to using existing geriatricians as educators and consultants for the generalists who will actually treat older patients. Despite the seemingly bleak statistics, Dr. Langston expressed some optimism that perhaps the pay increase hadn't become effective in enough time to influence residents who enrolled in fellowships and were included in this year's statistics.

Med schools offering shorter training, for less tuition

New York University (NYU) and a handful of other medical schools are among the first to begin shortening medical school and, ultimately, the cost of training, according to a recent report in the New York Times.

Administrators at NYU say they can make the change without compromising quality by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer, the Times reports. And all while saving a quarter of the cost of tuition, which at NYU comes to $49,560. This could mean substantially less debt as medical students move into their residency training.

"We're confident that our three-year students are going to get the same depth and core knowledge, that we're not going to turn it into a trade school," Steven Abramson, MD, vice dean for education, faculty and academic affairs at NYU School of Medicine, told the Times.

The movement is not without critics, the Times reports. Some say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

The AMA is also doing its part to change medical education for the better, recently announcing a $10 million initiative to change the way future physicians are trained. The fund will support about 10 projects that support a significant redesign of undergraduate medical education.

The initiative supports the AMA's work to accelerate change in medical education, one of its three strategic focus areas.