In the recent past, most physician visits by older adults were with a primary care physician, with less than 40% of ambulatory visits to other specialists. Since 1991, that trend has reversed. In 2001, 53% of ambulatory visits by patients aged 65 years or older were to nonprimary care specialists. Demographic trends and an expanding geriatrics medicine knowledge base require that every physician develop skills specific to the care of older adults. There are concerns that physicians-in-training are not learning adequate specific geriatrics medicine content to prepare them for the rapidly expanding numbers of older adults who will be seeking medical care. Training standards to prepare residents and fellows for practicing medicine are established by experts in the various medical specialties serving on individual residency review committees (RRCs) of the Accreditation Council for Graduate Medical Education. In 2002 (with a follow-up in 2003), the Association of Directors of Geriatric Academic Programs' team at the University of Cincinnati School of Medicine's Institute for Health Policy and Health Services Research reviewed all 91 nonpediatric specialties' RRC program requirements to identify the specific curriculum requirements related to geriatrics medicine training. As of 2003, 27 of the 91 RRC-accredited specialties have specific geriatrics training requirements; the other 70% of these specialties did not specifically mention geriatrics training. Even among the specialties with specific geriatrics training requirements, curriculum expectations are modest. The geriatrics-specific descriptions within the program requirements of the 27 specialties are presented in this article. The authors encourage the RRCs for all nonpediatric specialties to update their program requirements to ensure that future physicians graduating from their graduate medical education programs are adequately prepared to care for older adults.

译文

:最近,大多数老年人的医师就诊都是由初级保健医师进行的,不到40%的其他专科就诊者就诊。自1991年以来,这种趋势已经逆转。在2001年,年龄在65岁或65岁以上的患者的非卧床就诊中有53%是非初级保健专家进行的。人口趋势和不断扩展的老年医学知识基础要求每位医师都应发展专门针对老年人的护理技能。令人担忧的是,接受培训的医生没有学习到足够的特定老年医学药物含量,无法为将要寻求医疗服务的迅速增长的老年人做准备。由研究生医学教育认可委员会的个人住院医师审查委员会(RRC)中服务的各个医学专业的专家制定了为居民和医学从业人员做准备的培训标准。 2002年(2003年进行了跟进),辛辛那提大学医学院健康政策与健康服务研究所的老年医学项目主管小组审查了所有91个非儿科专业的RRC计划要求,以确定与老年医学培训有关的具体课程要求。截至2003年,在91个获得RRC认可的专业中,有27个具有特定的老年医学培训要求。这些专业中的其他70%没有专门提及老年医学培训。即使在具有特定老年医学培训要求的专业中,对课程的期望也很低。本文介绍了27个专业的计划要求内的老年医学特定描述。作者鼓励所有非儿科专业的RRC更新其计划要求,以确保从其研究生医学教育计划毕业的未来医生有足够的准备来照顾老年人。

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