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Geriatric Psychiatry Fellowship Programs in the United States

Findings from the Association of Directors of Geriatric Academic Programs' Longitudinal Study of Training and Practice

Received November 1, 2002; revised January 31, 2003; accepted February 3, 2003. From the University of Toronto, Toronto, Ontario (SL), the Office of Geriatric Medicine, University of Cincinnati, Cincinnati, OH (GAW), and the Institute for Health Policy and Health Services Research, University of Cincinnati, Cincinnati, OH (EJB,RWS,CJL,LMG). Address correspondence to Dr. Susan Lieff, Baycrest Centre for Geriatric Care, Department of Psychiatry, 3560 Bathurst Street, North York, ON M6A 2E1. e-mail: s.lieff{at}utoronto.ca
©2003 American Association for Geriatric Psychiatry

Objective: The authors document the development and growth of geriatric psychiatry fellowship training in the United States (U.S.) through 2002. Methods: A cross-sectional survey of the 62 U.S. geriatric psychiatry fellowship programs was conducted in Fall 2001. They also analyzed longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, along with data from the Accreditation Council for Graduate Medical Education (ACGME). Results: Forty-six (74%) of 62 training directors (TDs) responded. The number of fellowship programs has slowly increased over the past 7 years. During 2001–2002, a total of 94 fellows were in training (all years of training). Seventy-eight percent (N=36) of responding programs offered only 1-year fellowship training experiences. TDs reported that application rates for fellowship positions were stable during the academic years 1999–2002, with a median number of eight applications per program for first-year positions in 2001–2002. The fill-rate for first-year geriatric psychiatry fellowship positions dropped from 84% in 1999–2000 to 61% in 2001–2002. During 2001–2002, 73% of programs reported having two or fewer first-year fellows, and 16% had no first-year fellows. Seventeen programs reported having no U.S. medical school graduates (USMGs) as first-year fellows. Conclusion: Recruiting high-quality USMGs into geriatric psychiatry fellowship programs remains a challenge. Furthermore, retaining first-year fellows for additional years of academic training has been difficult. Findings indicate that specific strategies need to be developed to stimulate undergraduate and graduate interest in careers in clinical and academic geriatric psychiatry.

Key Words: geriatric psychiatry fellowships • specialty training • recruitment

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