How many geriatricians in the uk

The majority of geriatricians see GIM as a key part of their workload, and the specialty is second only to acute internal medicine in the proportion of consultants who take part in unselected on calls. Around one-third partake in specialty on call only, with one-fifth providing on-call work to both geriatric and GIM rotas. Geriatric medicine clinics may follow a traditional outpatient model. A new patient in a geriatric medicine clinic could require an appointment ranging from 30 minutes to over 2 hours, depending on the degree of comprehensive geriatric assessment CGA that occurs, where the clinic takes place, and the involvement of the multidisciplinary team.

Follow-up appointments should range from 15 to 30 minutes, again depending on the clinic environment and MDT involvement. Where a clinic involves multiple healthcare professionals, time must be built in for interdisciplinary discussions and care planning. Geriatric medicine Workforce and job planning Education and training Research and innovation. Geriatric medicine Workforce and job planning.

Atul Gawande predict a system of training for all primary care providers in some geriatric medicine, and leaving truly complicated cases to specialist geriatricians due to the sheer rate of change of number of older adults in the U. What am I going to do? My research mentor was an emergency physician whose research interests primarily concerned older adults, and he invested a lot of time in allowing undergraduates like myself to shadow, to interview older adults for our research papers, to get involved in the research process, and even to graduate university with publications in geriatric emergency medicine.

As any pre-medical student in the U. While shadowing is an excellent opportunity, it can be rather passive compared to what medical schools somehow expect you to have done by the time you apply. Having attentive, inspiring mentors in geriatric medicine or research is perhaps one way to invigorate a future generation to take on the responsibilities of caring for the older adult population. Perhaps, in fact, the future of geriatric medicine is not an army of geriatricians, but a team of consultants or specialists working together to provide integrated, specialized care for older adults.

Regardless of the format, however, the medical field will undoubtedly have to get creative to improve the health and lives of older adults. Geriatric medicine workforce planning: a giant geriatric problem or has the tide turned?.

Clinical Medicine , 14 2 , We welcome your comments on this or any of the Institute's blog posts. These sections also often contribute to collaboration with other bodies and to consultation and development of national policies and guidelines. The society also administers a number of charitable funding streams for research and study. Finally, because performance frameworks and funding of health and social care now differ in each of the jurisdictions, we have separate councils for Wales, Scotland, England and Northern Ireland.

We are also increasingly involved in helping fellow geriatricians in countries where the speciality is emerging. For instance, for the past two years a number of our members have been delivering a fellowship training programme for the first wave of trainee doctors in Taiwan, with several of the Taiwanese visiting the UK. At the RCP, we have a clinical effectiveness unit which has recently performed large national audits on continence falls and bone health highlighting deficiencies in care provision and securing wide publicity.

To reiterate, the population is ageing, illnesses of old age are increasing in prevalence and an increasing amount of health and social care is taken up by the care of older people, often with multiple long term conditions and frailty.

And getting the care of older people right will have dividends for access and capacity across the whole health system. In parallel, other physicians are becoming ever more specialised and do not necessarily have the relevant interest, skills or training to care for older people.

If only it were that simple! All the current policy imperatives centre on reducing acute beds and shifting the care of older people to primary care.

In the UK, geriatrics has become a largely hospital-based speciality. Despite the evidence that consultant-led comprehensive specialist geriatric assessment works, there is a zeitgeist towards devolving care to GPs or specialist nurses. We will therefore need to be far more proactive in working with primary care and becoming more involved in the community if older people are not to be denied our specialist skills and our role is not to be marginalised.

As we will not have the capacity to care for all older people, it is important that we spread the word to doctors and nurses in other fields. Many health professionals still have very little specialist training in the assessment and care of older people with complex needs [26, 27].

Another potential threat is to academic Geriatric Medicine. Research Assessment metrics and the policy push to centre research in a small number of centres of excellence [53], combined with the fact that a speciality such as geriatrics does not generally have the capacity to raise major income streams, poses a problem.

There are several vacant chairs or closed academic departments in the Medical Schools. Universities must appoint non-geriatricians to some chairs on the grounds of potential to generate income.

Our speciality has often attracted doctors from diverse professional backgrounds who have chosen us a little later in their career. We know for instance that incontinence [15], delirium [16], falls and osteoporosis [13] are still under-recognised and under-treated. Even for a condition such as stroke [17] where there has been more of a policy push, many patients still never get to a specialised stroke unit.

And outcomes for older people outside specialist areas e. We know that there are still routine problems with dignity or communication which are not easy to solve. This leads us onto whether we should have a more proactive and campaigning role. One could argue that the whole history of the speciality has been about campaigning — highlighting deficiencies in care and suggesting solutions, pushing forward new directions for policy rather than merely responding to them.

The society is still approached for advice and consultation in many areas. However, should we be far more pro-active and militant, without going so far that we antagonise government and are marginalised. For any predominantly medical organisation, there is always a risk that however hard we bang the drum on behalf of patients, we will be portrayed as a priesthood; a self-interest group. One way to combat this of course would be to be much more interdisciplinary.

Our speciality is par excellence an interdisciplinary one and the membership should perhaps begin to reflect this more. Again, there is an issue about how proactive we should be in seeking wider membership. Finally, the issue of our name is a perennial one. It could be that our name is a hindrance — but what to change it to which reflects our particular mission and role?

An estimate had been made previously, and was widely published, but has long been passed with no doubt that we still need more geriatricians. Diversity within local arrangements and system organisations mean that there is no one size fits all model within the healthcare of older people, unlike for example specialties such as gastroenterology who can calculate numbers needed based on procedural demand.

Much thought and consideration has been given within the BGS to answering this question. Attempts have been made previously to commission an organisation such as the CfWI to carry out such a piece of workforce planning, however even they were unable to proceed.

These events are positive for the speciality in the long term, but can cause short term inconvenience to departments who are reliant on registrars to deliver service in addition to receiving training. LAT posts have been abolished centrally, so Trusts have to recruit individually to short term contracts in order to fill rota gaps.

Calculations carried out for the Future Hospital Commission report concluded that to have one WTE male doctor it is necessary to train 1.

Therefore to minimise rota gaps within geriatric medicine we should look to over-recruit by a factor of 1. Ability to influence these is variable, but BGS centrally and the individual councils as well as colleagues with a remit for education and training constantly attempt to make an impact. TPDs and the SAC in geriatric medicine consistently give out the message that we have capacity to deliver high-quality training to many more junior doctors, but need to have more training numbers within the speciality.

There is increasing demand for geriatricians and the skills we have to offer. Expansion of our work into areas such as POPS, the continuing growth of orthogeriatrics and front-door geriatrics means we are being spread more thinly. Of all posts advertised at each time of advertising only one third are filled at interview. This is due to a combination of lack of applicants, or poor quality applicants. Anecdotally, we know that doctors are more likely to take up a consultant post in a hospital or unit they have worked in or have experience of while training.

There is no ready pool of geriatricians to recruit from elsewhere in the world. Some specialities have had success with the IMT programme, recruiting specialists to work at registrar level within the NHS to gain their higher training.

However, because geriatric medicine is not developed in many countries the standard of those recruited via this route is often at SHO level rather than that required and so additional experience and supervision is needed before commencing a higher level post.

Recruitment levels to training posts in the speciality are the highest they have ever been, with sustained year-on-year improvement. We have high numbers working LTWT and taking additional experience during their training programmes, and therefore need to be able to over-recruit to the programme, or mortgage training numbers.