Geriatric Medicine (IM)

Geriatric Medicine Subspecialty/Fellowship Training

The education and training requirements for geriatrics are set by the American Board of Family Medicine, the American Board of Internal Medicine, the American Board of Psychiatry and Neurology (geriatric psychiatry), the American Osteopathic Board of Family Physicians, and the American Osteopathic Board of Internal Medicine. The minimum training requirement to be eligible for board certification as a geriatrics specialist is a one- year fellowship. Many physicians who specialize in geriatrics complete additional years of fellowship training, depending upon their areas of interest and whether they wish to pursue a career in academic medicine.

No matter what specialty you choose, your clinical practice will likely include older adults given the projected growth of the US population aged 65 and older. In July 2007, the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation of New York hosted a National Consensus Conference on Competencies in Geriatrics Education, where a consensus was reached on minimum competencies (learning outcomes) that graduating medical students should possess to ensure competent care by new interns/residents to older patients. In addition, a project was also designed to define minimum geriatrics competencies for internal medicine (IM) and family medicine (FM) residents. The result of this three-year initiative is a set of 26 geriatrics competencies for IM/FM residents. 

The Geriatric Fellowship Curriculum Milestones, released in December 2012, build on the geriatrics competencies developed for medical students and residents and delineate 76 competencies that are designed to direct curriculum development and training for geriatrics fellowship. They were created by a working group of geriatricians, reviewed and commented on by more than 400 geriatricians, and revised and then approved by the boards of the American Geriatrics Society (AGS) and the Association of directors of Geriatric Academic Programs (ADGAP). 

Released in April 2013, Geriatrics End-of-Training Entrustable Professional Activities (EPAs) are the critical activities that define a specialty. These are written from the perspective of an end‐of‐ training geriatrics fellow who is ready to enter into unsupervised practice. They are not intended to capture every entrustment decision that occurs over the course of fellowship training. To present a manageable list and allow flexibility in how programs assess fellow competence for the ACGME Next Accreditation System (NAS), these EPAs are intentionally broad. This list was developed and refined over two years by geriatrics educators. 

To help strengthen geriatrics training for all physicians, the American Geriatrics Society has spearheaded the Geriatrics-for-Specialists Initiative (GSI), a longstanding collaboration with leaders from the major medical societies representing:

• Anesthesiology

• Emergency medicine

• General surgery

• Gynecology

• Ophthalmology

• Orthopaedic surgery

• Otolaryngology

• Physical medicine and rehabilitation

• Thoracic surgery

• Urology