Objectives: Participants will become familiar with the current status of:
(a) Required training in geriatric psychiatry in general psychiatry residency programs in Canada and the US
(b) Fellowship training in Canada and the US.
In Canada, there has been a requirement for geriatric training as part of general psychiatry training since 1987. This defined as "Supervised experience, not necessarily in a dedicated clinical rotation, sufficient to assure competence in geriatric psychiatry"(1). The Canadian Academy of Geriatric Psychiatry (CAGP) recommends a minimum three-month FTE experience supervised by a geriatric psychiatrist. In 1991, 13/16 medical schools were complying with this recommendation (2). A more recent update of the current status of training to meet this requirement will be reported on. Additionally, most residents have the opportunity to do an additional full year of geriatric training during their residency if they desire. Currently, geriatric psychiatry is not a recognized subspecialty of the Royal College of Physicians and Surgeons of Canada (RCPSC). After a 4-year moratorium on any new specialty or subspecialty requests, the RCPSC has recently reopened this discussion. Although not all medical schools offer fellowship training opportunities, there are a variety and diversity of fellowship training experiences throughout the country ranging, from clinical, research, education and administrative. The CAGP has recommended training requirements for these fellowships. The adherence to these requirements is unknown.
In the US, as of July 2001 there is now a required geriatric experience as part of the general psychiatry residency program. It is described as "One-month FTE supervised clinical management of geriatric patients with a variety of psychiatric disorders, including familiarity with long-term care in a variety of settings. This may be fulfilled as part of the inpatient or outpatient requirement". Supervision by a geriatric psychiatrist is not required (3). In 1991, the ABPN administered the first certification exam in geriatric psychiatry (4). The certification in geriatric psychiatry by the ABPN resulted in the formal accreditation of one-year geriatric psychiatry training programs by the ACGME. There are currently 62 accredited geriatric psychiatry fellowship programs in the US. Although numbers of programs and positions available continue to grow, numbers of applicants have been relatively stable resulting in a 61% fill rate in 2001-2002 (5).
1. Objectives of Training and Specialty Training Requirements in Psychiatry. April 12, 2001. http://rcpsc.medical.org/english/residency/certification/index.php3
2. Thorpe L, LeClair K, Donnelly M, MacBeath L: Geriatric psychiatry: training guidelines and their application. Can J Psychiatry 1993; 38:90-95.
3. Program Requirements for Residency Training in Psychiatry. http://www.acgme.org/
4. Shore, JR: Order and Chaos, Subspecialisation and American Psychiatry Acad Psych 1993;17(1): 12-20
5. Lieff, SJ, Warshaw, GA, Bragg, EJ, et al: Geriatric Psychiatry Fellowship Programs in the United States: Findings from the Association of Directors of Geriatric Academic Programs' Longitudinal Study of Training and Practice. Accepted Am J Ger Psych 2003; May/June
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