Under Construction: Phase 2 - Interviews

IM Subspecialities:

    Allergy and Immunology

    Cardiology

    Endocrinology

    Gastroenterology

    Geriatrics

    Hematology

    Oncology

    Infectious Diseases

    Nephrology

    Respirology

    Rheumatology

Useful Links:

Geriatrics

Introduction

Geriatric medicine is a subspecialty that centers on the healthcare of elderly individuals (commonly over the age of 75). The major goals of geriatric practice are ensuring the highest quality of life and maintaining independence. This is done through the optimal management of their age-related disabilities and chronic illnesses. It also aims to promote healthy elder years by focusing on disease prevention and lifestyle modifications. Training requires completion of a 3 year internal medicine program, followed by an additional 2 years of residency specific to geriatrics.

The physiology of the body changes as we age, thus the hallmark role of geriatricians is to differentiate normal age-related changes from pathologic conditions. There is a large focus on previous health issues and lifestyle choices, as these will determine the severity and spectrum of issues that patients face as they age. Geriatric patients tend to have very complex and overlapping conditions, thus their management requires an immense knowledge base and exemplary problem-solving skills. Another important aspect of their practice is considering their patient’s culture and how they view aging, as this will guide a geriatrician’s care goals. Often the goals of care are to maximize independence, which requires the use of comprehensive functional assessments to better understand a patient’s abilities. Geriatricians are therefore highly skilled at assessing, managing and preventing age-related disorders and complications from chronic illness. With an aging population, this specialty is becoming increasingly sought after, which is also no surprise given that geriatricians report some of the highest job satisfaction of all medical specialties!

Common Disease and Disorders

Polypharmacy
Geriatric patients are usually on numerous medications to manage their age-related disabilities and chronic illnesses. Being on multiple prescription drugs predisposes patients to adverse drug reactions and decreases their medication compliance. Geriatricians specialize in optimizing a patient’s prescriptions down to the essential drugs, which reduces the risk of adverse reactions and increases compliance.

Geriatric Giants
Many elders will experience similar symptoms of impairment as they age. These symptoms are commonly referred to as the “Geriatric Giants” and include; immobility, instability, incontinence and impaired intellect/memory. Managing these conditions is paramount within geriatrics.

Functional assessments
In order to determine one’s capabilities and potential for independence, geriatricians utilize a variety of assessment tools in their practice. Evidence-based assessment tools can accurately quantify a patient’s activities of daily which include: bathing, dressing, ambulating, toileting and eating. Performing these assessments over time can be useful in charting a patient’s progress or decline.

Further Advanced Training Opportunities

Geriatricians have the opportunity to pursue further education and advanced training in areas such as palliative care, geriatric psychiatry, acute elderly care and gerontological research.

Gender Breakdown
39 responses (2014 National Survey Results)

Age Breakdown
39 responses (2014 National Survey Results)
Hours Breakdown (Excluding on-call activities)
38 responses (2014 National Survey Results)

Activity Hours Worked (mean)
Direct patient care without a teaching component 16.76
Direct patient care with a teaching component 10.58
Teaching/ educating without direct patient care 3.67
Indirect patient care 7.46
Health facility committees 1.36
Administration 2.43
Research 2.40
Managing your practice .74
CME/ CPD (Continuing Professional Development) 2.94
Other actvities 2.35
Total Hours 50.70

Average number of on-call work hours per month: 103.56
32 responses; reported as mean (2014 National Survey Results)


Geriatric Medicine Programs in Canada

Contact information for Program Directors can be accessed on the Royal College’s website here: Open in new tab

University of British Columbia
Vancouver, British Columbia

University of Calgary
Calgary, Alberta

University of Ottawa
Ottawa, Ontario

University of Alberta
Edmonton, Alberta

University of Manitoba
Manitoba, Winnipeg

Western University
London, Ontario

Dalhousie University
Halifax, Nova Scotia

McMaster University
Hamilton, Ontario

University of Toronto
Toronto, Ontario

Quebec Provincial Network Program is also available and is joint between Université de Montréal McGill Université, Université Laval, Université de Sherbrooke.

Page Author(s): Jake Yeoman (2018)
© 2017 Internal Medicine Interest Group (IMIG) - Schulich School of Medicine and Dentistry