Minimum Geriatrics Competencies for Internal Medicine and Family Medicine Residents
IM / FM Geriatrics Competencies Working Group1
In the fall of 2007 a group of geriatrics educators from General Internal Medicine, Family Medicine, and academic geriatrics designed a project to define minimum geriatrics competencies for Internal Medicine and Family Medicine residents. The project was designed to build on the success of a similar project to define competencies for medical students completed in the summer of 2007; and complement other ongoing curricular reform projects in Internal Medicine, the surgical specialties, and medical subspecialties. Previous residency geriatrics curricula have been developed within Family Medicine, the American Geriatrics Society, the Federated Council for Internal Medicine, and others; but are lengthy and have not been widely adopted by residencies.
The specific purposes of this project are to define geriatrics competencies for Internal Medicine and Family Medicine residents that: a) are unique to the care of older patients (i.e., not general competencies), b) are feasible within the structure of current residency programs, c) constitute a minimum but uniform expectation for all graduating residents, d) are behavioral and specific to enable assessment, and e) are approved and accepted by key stakeholder organizations and residency program directors.
Beginning in 2008, the 8-member working group obtained financial support for the project from the American Medical Association, the American Geriatrics Society, the American Board of Family Medicine Foundation, and the Society of General Internal Medicine. A multi-stage development process was implemented that included a literature review, creation and revision of initial competencies through small group meetings and a whole-group survey among over 100 field experts, detailed item review by 25 program directors and residency clinical educators recruited from key professional organizations, and final review for sensibility by 10 program directors. At each stage, the working group made revisions to incorporate new input and maintain consistency and compatibility within and among the competencies.
The outcome of this process is a set of 26 geriatrics competencies in 7 domains: Transitions of Care; Hospital Patient Safety; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illnesses; Medication Management; Ambulatory Care; and Palliative and End of Life Care. A paper describing the process was published in the Journal of Graduate Medical Education in September 20102.
1Listed in Appendix
2Williams B, et al. (2010). Medicine in the 21st century: Recommended essential geriatrics competencies for Internal Medicine and Family Medicine residents. Journal of Graduate Medical Education, 2(3), 373-383. Also available at https://www.jgme.org/doi/full/10.4300/JGME-D-10-00065.1.