Are geriatricians born or made? Secondary analyses from the UK Medical Education Database, British Geriatrics Society teaching survey, and population data

Introduction

With the growing older population, too few doctors choose to specialise in geriatric medicine. Research has suggested that both demographic factors (e.g. gender) and educational factors (e.g. exposure to geriatrics) may influence choice of specialty career. We have examined associations between medical school-level exposures, such as teaching quality, over and above individual-level sociodemographic and academic performance measures with applications for higher specialty training in geriatric medicine. 

Methods

We used multi-level regression modelling to test for associations between individual-level exposures, from the UK Medical Education Database (2012-2022), medical school teaching exposure (BGS teaching survey data; 2013), and population data (ONS; 2013), with application into geriatric medicine higher specialty training. 

Results

Overall rate of application into geriatrics was low (866/54,409; 1.6%). Age ≥22 years at entry to medical school (0.63, 95%CI 0.50-0.80), male gender (0.51 95%CI 0.43-0.60), non-white UK ethnicity, and intercalation (0.57, 95%CI 0.43-0.76) showed reduced odds ratios whilst higher Foundation Programme Education Performance Measure score (1.52, 95%CI 1.23-1.65 per 5 points) increased the odds ratio. Parental educational attainment, secondary school type, IMD deprivation quintile, and ARCP performance were consistent with chance.  At a medical school-level, neither population demography, deprivation, or geriatric teaching score predicted application.

Conclusion

The proportion of qualified doctors choosing geriatric training remains low. We have found demographic factors and academic measures were associated with application into geriatric medicine training, whilst exposures acting at a medical school-level did not predict. Future work needs to better understand the reasons for specific career choices.