In a heartwrenching hypothetical narrative in today’s Times, Mount Sinai School of Medicine Professor Rosanne M. Leipzig argues that all medical schools should require clinical training in geriatrics. As the population ages and treatments become progressively more sophisticated, more and more patients and their families will face later-life and end-of-life diseases and decisions, and doctors will need to be equipped to provide care for these patients.
Most medical schools do offer geriatric medicine electives, but it’s not one of the required clerkships. Leipzig’s argument that this training should be required makes a lot of sense: elderly people deserve competent treatment, and not enough med school graduates are able to provide it. Moreover, required training could have the added benefit of inspiring some students to devote their careers primarily or entirely to geriatric care.
But when you add something, you usually have to take something else away.
Leipzig disparagingly notes that few doctors will care for children or pregnant women after med school if they don’t go into pediatrics or OB/GYN, but it’s hard to imagine either of those clerkships being taken out of the curriculum or even downgraded to elective status.
Another possible solution would be to integrate geriatrics into an existing course: at Mount Sinai, the Medicine clerkship is titled Internal Medicine-Geriatrics and emphasizes geriatric care more strongly than other schools do. Folding geriatric training into existing required courses will probably meet with less resistance than creating a new required class that would cut into elective/residency prep time in the 4th year. And since Americans are getting old much faster than the glacial pace of curriculum change, that’s a probably a good thing.
