Choosing Your Medical Specialty: Geriatric Medicine

With an aging population and not enough people going into the specialty, Geriatric Medicine becomes a dynamic field with loads of opportunity.

There are many possibilities when it comes to choosing your medical specialization and there's a lot to consider. This “Choosing Your Medical Specialty" series will help you learn more about each specialty and help you explore which one best matches your values, interests, and abilities.

"It's an exciting time to be within the geriatric field," says Dr. Lindy Romanovsky, a Staff Geriatrician and Clinical Associate at Sinai Health and the University Health Network in Toronto. "We have captured people's attention during the pandemic and people are realizing that the care older adults require is very different."

The COVID-19 pandemic has had an impact on the health system in many ways, including placing a spotlight on the importance of doctors who specialize in the health needs of the elderly. If you're considering geriatrics as your medical specialty, here are some things to keep in mind.

What is a typical day like for a geriatrician?

According to the Canadian Medical Association, 72% of geriatricians work in a hospital-based practice although you can also work in a solo, group or interprofessional practice. No two days as a geriatrician are alike. For example, in any given week, Dr. Romanovsky sees elderly patients with broken hips, cancer patients, people with dementia, Parkinson's disease and multiple sclerosis as well as patients in the geriatric rehab centre. "I wear a lot of hats," she says. "The exciting part of the job is that we do a variety of different things, and every day can be different."

What are the opportunities in geriatric medicine?

With an aging population in Canada and not enough people going into geriatric medicine, geriatric doctors are in high demand. "We currently have a year waitlist for our outpatient clinic which is really sad, and really not sustainable," says Dr. Romanovsky. She points to the fact that if you have interests in other areas, like endocrinology or surgery, you still can have the opportunity within geriatrics to co-manage patients in things like diabetes clinics or doing pre-surgical assessment. "There are just endless opportunities to create programs that interest anyone within geriatrics," says Dr. Romanovsky.

What are the misperceptions of specializing in geriatric medicine?

Geriatric medicine includes all aspects of the health, illnesses and complaints of older adults. You may think that when you work in geriatrics you have little impact on your patients' lives because of their age, but Dr. Romanovsky says that's far from the truth. "If someone's life expectancy is six months or a year, any small changes that improve their quality of life are important."

What are the rewards of specializing in geriatric medicine?

There are many rewards in the field of geriatrics:

Get to be creative: While in some areas of medicine you are often treating similar problems in similar ways, in geriatrics, you are taking care of complex older adults whose illnesses don't always follow set patterns. "You have to really analyze the problems, get to be creative and think outside the box," says Dr. Romanovsky.
Collaborating with other medical professionals: "A huge part of what we do is co-management," says Dr. Romanovsky. "For example, in rehab medicine, you may be working with a hospitalist, a physiotherapist, an occupational therapist, a social worker, a speech-language pathologist, and a dietitian. You'll be learning from all these different experts within their own fields, and it is often exciting to see how they approach problems."
Caring for a whole family: When you're taking care of an older adult you're often making changes that may improve the lives of the whole family. "It's really rewarding to see someone who had a really poor quality of life prior to seeing you make a small adjustment, and it having a significant positive change in their lives," says Romanovsky.

How is the work / life balance in geriatrics?

According to the Canadian Medical Association, 57% of geriatricians are satisfied with the balance of their personal and professional commitments while 81% are satisfied with their current professional life. Dr. Romanovsky, for one, thinks that compared to other medical specialties the work / life balance in geriatrics is fairly good. "There are fewer emergencies and there's more time to like think about problems and see patients," she says. Also, there is ample opportunity to be involved in research and policy-making, which can help with work / life balance because it breaks up the day.

You're interested in geriatric medicine: now what?

It's important to shadow a geriatrician to really get a feel for what they do and consider if you could spend the rest of your career in the role. "Getting involved in research with a geriatrician is also very helpful," says Dr. Romanovsky, to gain experience in the field before applying to the specialty.

To become a geriatrician you'll need to do you do four years of medical school followed by a three-year residency in internal medicine and then two years of residency in geriatric medicine.

Bottom line: There is a shortage of doctors in this challenging and rewarding specialty. "The sky's the limit," says Dr. Romanovsky. "Our population is aging, and there are not enough people going into geriatrics, so there's a huge need."

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This article originally appeared on the RBC Healthcare - Advice & Learning

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