Abstract
Introduction
Despite the UK’s increasing life expectancy, and increase in the elderly population, there is an overwhelming lack of Geriatricians in the UK; as of 2022, there is only 1 consultant Geriatrician per 8,031 individuals over the age of 65 (BGS, 2023). To meet the complex care needs of this population, there must be a focus on increasing the interest that doctors have towards Geriatric Medicine, with the overall aim being to recruit more doctors into the speciality.
Method
The aim of this review was to investigate what factors medical students perceive as barriers to pursuing a career in Geriatric Medicine and then, from identifying these, generate a set of comprehensive suggestions as to how to tackle these barriers at a medical school level to increase the interest and ultimately uptake of Geriatric Medicine. The qualitative review contains literature published between 2003 and 2023 accessed using MedLine.
Results
Six themes were identified in answering our question: (a) high emotional burden, (b) caring for patients with complex needs, (c) negative preconceptions of non-clinical factors (prestige, salary, career progression), (d) negative influence of clinical educators, (e) lack of intellectual stimulation and (f) lack of exposure to the speciality and the elderly.
Conclusion
The barriers perceived by medical students when considering Geriatrics as a speciality are complex and multifaceted; these barriers must be tackled promptly in order to secure the next generation of Geriatricians. We suggest that this work can be used as a foundation for further qualitative studies with UK medical students to investigate barriers that are specific to UK students. From this, interventional courses designed to increase Geriatric Medicine uptake could be developed to strengthen the UK Geriatric Medicine workforce.
Comments
Good work. Very important to…
Good work. Very important to keep a strong pipeline of future geriatricians. As you note, many different settings. Would be interesting to know if there are different trends between countries as I suspect UK would differ quite a bit to US etc.
I think this is so important…
I think this is so important. As an F2 currently, I also understand this negative preconception towards geriatrics as a career. I think the cause is definitely mutli- faceted but would be interesting to compare the views of medical students and foundation doctors to understand whether a rotation in geriatrics influences their perception of the society.
I believe that medical…
I believe that medical school is not good at conveying the concept of a geriatrics as a specialty. Students are often taught using a systems based approach, which lends it self to specific single organ specialties (be it medicine or surgery). So their understanding of what geriatricians actually do is quite poor, and this is apparent when they start working in the speciality during their foundation years.
Geriatrics training posts uptake
If there is a shortage of geriatricians, how does this correlate with geriatric medicine st4 competition ratios? Are all posts filled every year? Are there certain areas in the UK which do not often fill up their training posts? Could it be worth considering a monetary supplement to be given to those training in these under-subscribed areas, as is the case with GP training?
Interesting themes
I thought the key themes found were interesting, especially the non-clinical factors, negative influence of educators and intellectual stimulation. As you've discussed that these papers cover common factors worldwide, I wonder how much the different cultures/healthcare systems in other nations also have an influence in this as well compared to UK specifically.
Very interesting themes
I wonder whether part of the motivation is the perception of overwhelming social care considerations. As Foundation doctors, our experience of geriatrics is often maintenance of frailty wards where the majority of patients have social rather than medical issues and who are being managed mainly by social care teams, not by us. I have seen this contribute to people's motivation, as it gives a wrong impression to young doctors that geriatrics is mainly about taking care of patients with social care needs. From my experience, participating in geriatrics clinics in F1 can change this perception.
Really important work
Great presentation with really important themes! As a medical student keen to pursue geriatric medicine,I have came across these topics when discussing the specialty with other students, so really great that these topics have been reflected in your research
Really Interesting!
Great job