Geriatric psychiatry fellowship programs in the United States: findings from the Association of Directors of Geriatric Academic Programs' longitudinal study of training and practice.
OBJECTIVE
The authors document the development and growth of geriatric psychiatry fellowship training in the United States (U.S.) through 2002.


METHODS
A cross-sectional survey of the 62 U.S. geriatric psychiatry fellowship programs was conducted in Fall 2001. They also analyzed longitudinal data from the American Medical Association (AMA) and the Association of American Medical Colleges' (AAMC) National Graduate Medical Education (GME) Census, along with data from the Accreditation Council for Graduate Medical Education (ACGME).


RESULTS
Forty-six (74%) of 62 training directors (TDs) responded. The number of fellowship programs has slowly increased over the past 7 years. During 2001-2002, a total of 94 fellows were in training (all years of training). Seventy-eight percent (N=36) of responding programs offered only 1-year fellowship training experiences. TDs reported that application rates for fellowship positions were stable during the academic years 1999-2002, with a median number of eight applications per program for first-year positions in 2001-2002. The fill-rate for first-year geriatric psychiatry fellowship positions dropped from 84% in 1999-2000 to 61% in 2001-2002. During 2001-2002, 73% of programs reported having two or fewer first-year fellows, and 16% had no first-year fellows. Seventeen programs reported having no U.S. medical school graduates (USMGs) as first-year fellows.


CONCLUSIONS
Recruiting high-quality USMGs into geriatric psychiatry fellowship programs remains a challenge. Furthermore, retaining first-year fellows for additional years of academic training has been difficult. Findings indicate that specific strategies need to be developed to stimulate undergraduate and graduate interest in careers in clinical and academic geriatric psychiatry.
Baycrest Centre for Geriatric Care, Department of Psychiatry, University of Toronto, 3560 Bathurst Street, North York, Ontario M6A 2E1, Canada. s.lieff@utoronto.ca
Susan J
SJ
Lieff
Gregg A
GA
Warshaw
Elizabeth J
EJ
Bragg
Ruth W
RW
Shaull
Christopher J
CJ
Lindsell
Linda M
LM
Goldenhar
D000368:Aged; D000375:Aging; D003430:Cross-Sectional Studies; D003479:Curriculum; D004493:Education / Q000706:statistics & numerical data; D005257:Fellowships and Scholarships / Q000458:organization & administration* / Q000706:statistics & numerical data; D005852:Geriatric Psychiatry / Q000193:education*; D006801:Humans; D008137:Longitudinal Studies; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014481:United States