By the year 2030, the number of individuals over age 65 is expected to reach 70 million. By 2050, those age 85 and over will climb to over 19 million. Despite this anticipated – and unprecedented -- growth, few physicians have the skills necessary to properly address the numerous medical challenges posed by many older patients.
A newly expanded geriatrics training program led by Harvard Medical School (HMS) faculty at Beth Israel Deaconess Medical Center (BIDMC) will address this educational shortcoming. Known as the Advancement of Geriatrics Education (AGE) Project, the program will integrate geriatrics into all four years of the existing HMS curriculum, and will also provide education to medical and surgical residents and to practicing physicians in the appropriate management of elderly patients.
The AGE Project is being funded by a four-year, $2 million grant from the Donald W. Reynolds Foundation, part of the Las Vegas-based philanthropic organization’s Aging and Quality of Life Program, which helps academic medical centers around the country to improve geriatric training.
“As medical advances enable individuals to live longer, it’s clear that doctors will have to be prepared to care for an increasingly older, sicker population,” says Lewis Lipsitz, MD, chief of gerontology at BIDMC and Professor of Medicine at HMS. “The AGE project aims to expose a greater number of physicians to the unique concerns of the elderly, and we’re extremely grateful to the Reynolds Foundation for recognizing and responding to this critically important need.”
Geriatricians are specially trained to handle the multiple interacting conditions, medications, social stresses and psychological problems often faced by older individuals. What makes the geriatrician unique among medical practitioners, says Lipsitz, is his or her focus on the elderly patient as a “whole person,” taking into consideration each individual’s special characteristics, medical conditions, medications, values and preferences, in order to develop an appropriate treatment plan.
“Unlike younger patients who are primarily concerned with preventing illness or treating one particular disease or condition, elderly patients may be simultaneously grappling with any number of issues – for example, risk of falling, urinary incontinence, confusion and memory loss, depression, osteoporosis and heart disease,” he adds. “In fact, the average 75-year-old has three chronic medical conditions and takes five different prescription medications.”
As part of the AGE project, HMS students will now be exposed to geriatric content in their core first- and second-year student courses, and will take an additional year-long course in the third year of medical school which includes longitudinal experiences with elderly patients in a variety of living situations. Novel teaching methods will include the use of computer-controlled patient “simulators” (which help students learn how to perform common medical procedures among various patient populations) and in this case, will instruct them in managing the multiple medical and psychosocial issues facing elderly patients.
In addition, according to Lipsitz, all residents in the departments of Medicine, Surgery and Emergency Medicine at BIDMC will learn to manage the unique medical problems of elderly patients through patient care rounds, case conferences and didactic seminars with preceptors specially trained in geriatrics. Using a “train-the-trainer” approach, hospitalists and faculty members from each of these disciplines will become knowledgeable teachers of geriatrics.
Lastly, in collaboration with the HMS Department of Continuing Medical Education (CME), the AGE program will also teach geriatrics to practicing physicians from around the world, offering web-based CME courses and embedding geriatrics lectures into existing live CME programs.
“Through the efforts and support of the Reynolds Foundation, HMS will now join 29 other Reynolds Center programs at medical schools around the country,” says Lipsitz. “This will ultimately help patients everywhere to enjoy better health and well-being as they grow older.”
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and ranks third among independent hospitals nationwide in National Institutes of Health (NIH) funding. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of the Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.harvard.edu.
The Donald W. Reynolds Foundation is a national philanthropic organization, founded in 1954 by the late media entrepreneur for whom it is named. Headquartered in Las Vegas, Nevada, it is one of the largest private foundations in the United States.