Geriatric psychiatry education in Canada: the pathway to subspecialty recognition.
BACKGROUND
This paper outlines the evolution of the training of Canadian physicians and other professionals in the mental health care needs of older adults over the past 2 decades, which has culminated in long-awaited subspecialty recognition by the Royal College of Physicians and Surgeons of Canada (RCPSC). Despite the fact that Canada has more than 4000 psychiatrists officially recognized by RCPSC, and a national body of more than 200 members who practice primarily in geriatric psychiatry, the status of geriatric psychiatry as a subspecialty of psychiatry in Canada remained "unofficial" until 2009.


METHODS
Early along the pathway toward subspecialization, Canadian educational efforts focused on enhancing the capacity of primary care physicians and other mental health professionals to meet the mental health needs of older adults. Over the past decade, and with the encouragement of RCPSC, Canadian psychiatric educators have carefully and collaboratively defined the competencies necessary for general psychiatrists to practice across the life span, thereby influencing the psychiatry training programs to include dedicated time in geriatric psychiatry, and a more consistently defined training experience.


RESULTS
With these two important building blocks in place, Canadian psychiatry was truly ready to move ahead with subspecialization. Three new psychiatric subspecialties - geriatric, child and adolescent, and forensic - were approved at the RCPSC in September 2009.


CONCLUSIONS
The developments of the past 20 years have paved the way for a subspecialty geriatric psychiatry curriculum that will be well-aligned with a new general psychiatry curriculum, and ready to complement the existing mental health work force with subspecialized skills aimed at caring for the most complex elderly patients.
Andrew
Melissa H
MH
Division of Geriatric Psychiatry, Queen's University, Kingston, Ontario, Canada. andrewm@queensu.ca
Shea
Catherine
C
D000368:Aged; D002170:Canada; D002983:Clinical Competence / Q000592:standards; D003431:Cross-Cultural Comparison; D003479:Curriculum / Q000592:standards; D003695:Delivery of Health Care / Q000639:trends; D004503:Education, Medical, Graduate / Q000639:trends*; D005544:Forecasting; D005852:Geriatric Psychiatry / Q000193:education*; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D010348:Patient Care Team / Q000592:standards; D058007:Physicians, Primary Care / Q000193:education; D011157:Population Dynamics; D011570:Psychiatry / Q000193:education; D013038:Specialization / Q000639:trends*; D000078329:Workforce