adgap national survey of geriatric medicine fellowship

ADGAP National Survey of Geriatric Medicine Fellowship

Program Directors

April 30, 2008Updated 9/23/09

Gregg A. Warshaw, MD

Elizabeth “Libbie” Bragg, PhD, RN

Methodology

• 2007 Survey 102/143 = 71% response rate– Survey available online only

• 2001 Survey 96/126 = 76% response rate– Survey available both online and paper

• Secondary data from AMA/AAMC GME Survey

Program Directors

2007 2001 P value

Years director* 6.6 5.6 P=0.02

Years since formal training*

17.3 15.6 NS

Hours/week administration*

12.1 9.6 P=0.004

*Means

Program Directors

Certification 2007 2001Without fellowship training 29% 37%

With fellowship training 68% 59%

Not certified 3% 4%

Faculty Academic Rank (2007)

Rank Men Women Total

Assistant Professor 200 276 476

Associate Professor 119 81 200

Professor 105 36 141

Other 28 50 78

Total 452 443 895

Data presented as number of faculty

Fellowship Program Faculty Certified in Geriatrics (2007)

Number Mean ± sdMedian (range)

Certified without fellowship training 245 2.5 ± 3.0 2.0 (0-19)

Certified with fellowship training 727 7.1 ± 5.9 6.0 (0-34)

Application Trends*

2004-07 1999-02 P value

Applications 60 138 P=<0.0001

Interviews 23 19 P=0.0556

*Means over three years

Geriatric Medicine Fellowships: 1st year Positions, 1st year Fellows, and Programs

Source: AMA and AAMC data from the National Survey of GME Programs compiled by Geriatrics Workforce Policy Studies Center. Updated 10/10

Total GM Fellows, IMGs, and USMDs

Source: AMA and AAMC data from the National Survey of GME Programs compiled by Geriatrics Workforce Policy Studies Center. Data presented on fellows for all years of training. Osteopathic and Canadian medical school graduates are included in the total number of fellows but are not included in IMGs or USMDs. Updated 10/10.

Distribution of First Year Geriatric Medicine Fellows

Funding Sources: First Year Fellows(Percent of Programs Utilizing Source)

Sources 2007 2001

Medicare GME 86% 79%

VA 41% 48%

Institutional support* 41% 46%

Foundations/gifts 23% 27%

BHPr 12% 10%

Other 8% --

*Includes clinical revenue

ADGAP Survey Question Regarding

Advanced Fellows (2007)

Does your program offer additional training for any of your fellows beyond the ACGME accredited 12-month training program as advanced fellows or junior faculty? (In some programs advanced fellows beyond the 12 month clinical program are given junior faculty appointments. If these junior faculty are functioning in a role similar to advanced fellows, you would answer “yes” to this question.)

51% of program directors responded: Yes

Number of Advanced Fellows2007 Survey Data Compared with

GME CensusData Source 2006-07 2005-06 2004-05

GME Census

34 55 36

ADGAP Survey

65 73 72

Sources: GME Census: AMA and AAMC data from the National Survey of GME Programs compiled by ADGAP Status of Geriatrics Workforce Study; ADGAPstudy: 2007 Survey of Geriatric Medicine Fellowship Directors

Distribution of Second Year Geriatric Medicine Fellows

Funding Sources: Advanced Fellows (Percent of Programs Utilizing Source) Sources 2007 2001

Institutional support* 56% 56%

Foundations 46% 58%

Medicare GME 46% 46%

NIA Grants 35% 16%

VA SFPAG 28% --

VA Other 23% 43%

BHPr 21% 16%

*Includes clinical revenue

Selected Specialties

Percent USMDsPercent Filled 1st Year Positions Median Private Practice Salaries

Specialty % USMDs*% Filled First

Year Positions*Salary†

(median)

Urology 95% 88% 390,678

Dermatology 95% 93% 385,088

Emergency Medicine 82% 102% 262,475

Pediatrics 67% 98% 192,000

Gastroenterology 64% 95% 465,509

Psychiatry 58% 98% 191,267

Neurology 57% 98% 237,918

General Internal Medicine 49% 99% 197,080

Family Medicine 44% 96% 183,999

Geriatric Psychiatry 31% 45% 223,456

Geriatric Medicine 29% 56% 179,950 Sources *JAMA Education Issue, September 2010 †Medical Group Management Association. Physician Compensation and Production Survey 2010 report based on 2009 data Updated 10/10 Data compiled by Geriatrics Workforce Policy Studies Center.

Graduates of Geriatric Medicine and Geriatric Psychiatry Fellowship Programs

Source: AMA and AAMC data from the National Survey of GME Programs compiled by Geriatrics workforce Policy Studies Center. Updated 10/10.

Certification and Recertification in Geriatric Medicine (Initial Certification 1988-2000)

(as of 3/10)

Family Medicine Internal Medicine

Certified Re-certified Certified Re-certified

3,005 1,547 (51%) 6,696 2,756 (41%)

Family Medicine and Internal Medicine

Certified Re-certified

9,701 4,303 (44%)

Data updated 10/10. Data compiled by Geriatrics Workforce Policy Studies Center

Actual and Projected Ratio of Geriatricians/10,000 Population

Updated 9/09

Source: The Geriatrics Workforce Policy Studies Center staff projected the number of geriatricians/10,000 population using population data from the  Administration on Aging and data on geriatricians from the ABFM and ABIM and the GME National Census

Note: The 2000 data is from the 2000 Census. The figures for 2010 to 2050 are from Census Bureau International Data Base.

Summary (I)

• Program directors – now 2/3 with fellowship training

• Number of applications per program declining• Number of available 1st year positions more than

doubled over last decade

Summary (II)

• USMDs filling 1st year positions peaked at 167 in 2002-2003 and declined to 86 in 2009-2010

• The majority of programs have 2-4 first-year fellows

• AMA/AAMC GME data under-estimates the number of advanced fellows

• In the coming decades, based on current trends, the rapidly growing older population will overwhelm the supply of geriatricians.

Project Staff

• Dave Brewer

• Danielle Cornwall

• Tony Leonard

• Karthikeyan Meganathan

• Rob Witzke

Contact Information

Gregg Warshaw, MD

Email: Gregg.Warshaw@uc.edu

Elizabeth Bragg, PhD, RN

Email: Elizabeth.Bragg@uc.edu