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A Young Field of Medicine

New initiative to fill critical gaps in geriatric health training

Carmel B. Dyer, MD
Few physicians choose to practice geriatric medicine like Carmel B. Dyer, MD (left), creating an urgent need for health professionals who understand the unique needs of a growing older population.
Holly M. Holmes, MD (right), delivers the personalized, age-specific care that will feature prominently in the new education program.
Holly M. Holmes, MD
Director of the Division of Geriatric and Palliative Medicine
McGovern Medical School
“There is a lot of practical knowledge about dealing with the health issues of people in old age that you’re not going to get from a textbook. There’s certainly a lack of formal instruction, but there is also a lack of hands-on modeling of what you do in certain situations.”

After examining the older person, emergency room doctors diagnosed an infection and sent him home with antibiotics. He fell repeatedly during the next few days and wound up back in the hospital—this time with acute kidney and liver failure.

“They treated him with an antibiotic that was probably four times the dose they should have given someone his age,” says Carmel B. Dyer, MD, Executive Director of UTHealth Consortium on Aging.

Only two percent of practicing physicians in the United States qualify as geriatricians. Dyer, one of these select physicians, knows that older adults react to medication differently than younger patients. Yet fewer than three percent of medical students choose the courses in geriatric medicine that could help them spot similar hazards. More than half of all medical and nursing schools have no structured geriatric curriculum at all.

Dyer and her colleagues at the consortium—a collaboration of UTHealth experts focused on the health of older adults—are laying the groundwork for an initiative to help close these training gaps among current health professionals.

The Consortium on Aging is now developing the Geriatric Interprofessional Education Program, an 18-month certificate program administered by the consortium that will provide essential geriatric health training to professionals from across disciplines, including doctors, nurses, dentists, pharmacists, and social workers.

The program will incorporate online and in-person learning, delivering hands-on experiences that show participants how to care for the complex needs of older adults. Dyer explains that if she went to the hospital today for a stomach bleed, doctors may simply find an ulcer and treat it. But she wants to prepare health professionals for the same symptoms in her 90-year-old self.

“It could be an ulcer, or it could be all the medications I’m taking,” she says. “I might come in confused with hypertension and several other diseases, and I might have dementia and not be able to clearly explain everything. Then, once you discharge me from the hospital, I can’t walk because I have a bad knee that stiffened up while lying in the bed all day.”

Dyer and her team have begun meeting with faculty across UTHealth to develop the curriculum for the program, which will include topics such as proper medication prescribing, recognizing the difference between illness and normal aging, and managing multiple chronic conditions. Thanks to a generous gift from the Wyatt Foundation, they plan to begin training approximately 140 health professionals each year with the first cohort starting in 2019.

The older man recovered fully after the treatment was stopped. Dyer and the members of the Consortium on Aging are working to better equip the health care workforce with the skills needed to meet the needs of an emerging population of patients.

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