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Correia RH, Dash D, Hogeveen S, Woo T, Kay K, Costa AP, Siu HYH. Applicant and Match Trends to Geriatric-Focused Postgraduate Medical Training in Canada: A Descriptive Analysis. Can J Aging 2023; 42:396-403. [PMID: 37066844 DOI: 10.1017/s071498082200054x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
Physicians with postgraduate training in caring for older adults-geriatricians, geriatric psychiatrists, and Care of the Elderly family physicians (FM-COE)-have expertise in managing complex care needs. Deficits in the geriatric-focused physician workforce coupled with the aging demographic necessitate an increase in training and clinical positions. Descriptive analyses of data from established matching systems have not occurred to understand the preferences and outcomes of applicants to geriatric-focused postgraduate training. This study describes applicant and match trends for geriatric-focused postgraduate training in Canada. In this retrospective cohort study, data from the Canadian Resident Matching Service and FM-COE program directors were analysed to examine program quotas, applicants' preferences, and match outcomes by medical school and over time. Based on their first-choice specialty ranking, applicants to geriatric medicine and FM-COE signalled a preference to pursue these programs and tended to match successfully. The proportion of unfilled training positions has increased in recent years, and the number of applicants has not increased consistently over time. There is a disparity between applicants to geriatric-focused training and the health human resources to meet population-level needs. Garnering interest among medical trainees is essential to address access and equity gaps.
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Affiliation(s)
- Rebecca H Correia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada
| | - Darly Dash
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada
| | - Sophie Hogeveen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Tricia Woo
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Kelly Kay
- Provincial Geriatrics Leadership Ontario, Kingston, ON, Canada
| | - Andrew P Costa
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Waterloo Regional Campus, Kitchener, ON, Canada
| | - Henry Yu-Hin Siu
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Cheung K, Tamura P, Malik Z, Lin J, Cyrus J, Alexander C, Hobgood S. Barriers and motivators to specializing in geriatrics and strategies for recruitment: scoping review. GERONTOLOGY & GERIATRICS EDUCATION 2022:1-17. [PMID: 35603812 DOI: 10.1080/02701960.2022.2078814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While the barriers to specializing in geriatrics are known, motivators behind why medical trainees choose geriatrics are not as well understood. It is also unknown if recruitment strategies in the literature address these barriers and motivators. The aim of this systematic scoping review is to examine the current literature on recruitment strategies alongside motivators and barriers for specializing in geriatrics. Eligible articles for this scoping review either focused on motivators or barriers among trainees (medical students, resident-physicians, fellows) or recruitment strategies. A scoping search was conducted in MEDLINE, Embase, CINAHL, and PsychINFO. Data was extracted on article characteristics and themes. 88 of 2064 articles were eligible and included. Personal fulfillment emerged as the most common theme for motivators, contrary to prior studies that cite positive role modeling. Financial disincentive remained the most common barrier, followed by limited exposure and "futile" practice. Promising interventions beyond financial compensation include defining geriatrics better, emphasizing the high job satisfaction rates, increasing clinical exposure for medical students, and additional funding for academic centers to recruit academic geriatricians. Policymakers and medical educators should consider multiple strategies that target the motivators, as well as the barriers to pursuing geriatrics.
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Affiliation(s)
- Kelly Cheung
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
| | - Peter Tamura
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
| | - Zeeshan Malik
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
| | - Jason Lin
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
| | - John Cyrus
- Department of Research and Education, Virginia Commonwealth University, Richmond, Virginia, US
| | - Chuck Alexander
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
| | - Sarah Hobgood
- Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US
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Correia RH, Jabbar A, Siu HYH, Hogeveen S, Dash D, Mowbray FI, Costa AP, Vanstone M. Comparing the scopes of practice of geriatric-focused physicians in Canada: a qualitative study of core competencies. CMAJ Open 2022; 10:E563-E569. [PMID: 35728839 PMCID: PMC9343128 DOI: 10.9778/cmajo.20210193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Given long-standing deficits of medical expertise to care for a growing population of older adults, it is important to understand the geriatric medical workforce. We aimed to describe and compare the scopes of practice of the 3 geriatric-focused physician providers in Canada (i.e., family physicians with certification in Care of the Elderly [FM-COE], geriatricians and geriatric psychiatrists). METHODS We conducted a qualitative study to compare competencies across geriatric-focused physician provider types in Canada, using a directed content analysis approach. We identified and obtained relevant publicly available documents that described the competencies required for certification by searching the websites of The College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada between June 2 and July 31, 2020. An inductive content analysis was used to compare content within each CanMEDS Role according to the CanMEDS Framework. RESULTS We identified and obtained 4 relevant publicly available documents describing the competencies required for geriatric-focused certification for the 3 geriatric-focused physician provider types. We found substantial overlaps in the expected medical expertise of FM-COE and geriatricians. The few substantive differences across providers may result from different priorities about which competencies were made explicit for providers. The focused nature of mental health care is apparent in several competencies unique to geriatric psychiatry. INTERPRETATION This work highlights substantial overlaps in the scopes of practice for FM-COE and geriatricians. Our findings may encourage efforts to develop more robust delineations between the scopes of practice of these related professionals to facilitate inter-specialty collaboration to lead to more equitable and accessible medical care for older adults.
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Affiliation(s)
- Rebecca H Correia
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont.
| | - Amina Jabbar
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Henry Yu-Hin Siu
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Sophie Hogeveen
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Darly Dash
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Fabrice I Mowbray
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Andrew P Costa
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
| | - Meredith Vanstone
- Department of Health Research Methods, Evidence and Impact (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa), and Big Data and Geriatric Models of Care Cluster (Correia, Jabbar, Hogeveen, Dash, Mowbray, Costa) and Department of Family Medicine (Siu, Vanstone), McMaster University, Hamilton, Ont
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Chiavaroli N. Knowing how we know: an epistemological rationale for the medical humanities. MEDICAL EDUCATION 2017; 51:13-21. [PMID: 27981654 DOI: 10.1111/medu.13147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/21/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT Although their inclusion in medical curricula internationally is increasing, the medical humanities still face challenges to their role and place in the curriculum. Justifications supporting the inclusion of humanities content, methods and perspectives in medical curricula have generally been proposed along instrumental, intrinsic and critical lines. However, recent literature in the field has turned to 'ways of knowing' as representing an alternative, essentially epistemological, perspective on the matter. This involves the claim that the medical humanities align with and promote characteristic ways of understanding and practising medicine, which are not adequately represented in traditional disciplinary frameworks. DISCUSSION Such epistemological arguments aim to move beyond generic claims of medicine as both an 'art' and a 'science' to explore the way in which the humanities support the ultimate objectives of a medical education, particularly in relation to claims about requisite knowledge and typical reasoning. Not only can this help focus attempts to identify and document relevant learning or clinical outcomes, but it can potentially uncover evidence from education outcomes research which may not have been the focus of previous inquiry in the medical humanities and which may in fact be associated, at least in part, with curricular activities formally associated with humanities disciplines. CONCLUSIONS An epistemological view of the humanities in medical education offers a significant new way of conceptualising and communicating the potential role of the humanities in medical training. If clinical practice can be characterised as rational but interpretive, partly predictable yet fundamentally uncertain, and logical but also intuitive, it follows that educational training should facilitate such ways of knowing and thinking. An epistemological perspective enables the argument that the medical humanities are valuable not because they are more 'humane', but because they help constitute what it means to think like a doctor.
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Affiliation(s)
- Neville Chiavaroli
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
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