BERKELEY, CA (UroToday Inc.) - In 1994, the American Geriatrics Society (AGS), with funding from the John A. Hartford Foundation, created the Geriatrics for Specialists Project. The goal of this project is to expand geriatric expertise in surgical and medical specialties. The following specialties were chosen: general surgery, emergency medicine, gynecology, orthopedic surgery, urology, anesthesiology, ophthalmology, otolaryngology, physical medicine and rehabilitation and thoracic surgery. In the March 2005 edition of The Journal of the American Geriatrics Society (JAGS), J. Potter and colleagues describe the Geriatric Education for Specialty Residents (GESR) Program, which is part of the larger project, and express some of the lessons learned from this program.

29 GESR awards had been made to specialty resident training programs to develop project models of how geriatrics can be incorporated into subspecialty training. The GESR leaders convened at the end of the first year of the project to discuss their strategies and outcomes.

Five common strategies were identified as necessary for a successful program: 1) a designated faculty leader, 2) working with the existing geriatrics program, 3) creating a "buy in" by the residents, 4) a structured curriculum, and 5) use of technology.

First, a designated faculty leader was needed to drive the program. The reasons for participating varied, but there was a common belief that an improved understanding of geriatrics would translate into better medical care and outcomes. Secondly, collaboration with the geriatrics training program at the institution such as interaction with designated faculty and performance of various activities such as joint conferences and rounds was helpful in integrating geriatrics into the subspecialties. Third, the residents had to "buy in" to the idea that geriatrics was relevant to their training. This was accomplished by having them understand the prevalence of the older population in their specialty, as well as through education and collaboration. Creating a structured curriculum proved to be important. Various methods were employed including block rotations, or programs aimed at certain level residents, geriatric lecture series, and the use of teaching tools. Technology, including the use of videos and CD-ROMs also played an important role in allowing residents to review information on a flexible schedule, as well as allowing other programs to review the same materials.

Barriers to success that were identified included: 1) too little time to convey increasing content in a specialty, 2) faculty members who have decreased time to mentor and teach residents, and 3) little opportunity to exchange information and educational methods.

Despite existing barriers, the effectiveness of the project has reached beyond the programs that were given grants. The GESR projects have resulted in numerous presentations and publications through regional as well as national forums.

The authors conclude that the GESR project provides lessons on how geriatrics education can be integrated into specialty training. Although barriers do exist, they can be overcome, as has been exhibited by the programs involved. This experience will help other programs initiate, develop, and foster geriatric education into their subspecialty.

J Am Geriatr Soc 2005; 53: 511-5