Perceived barriers and facilitators for an academic career in geriatrics: medical students' perspectives.

Abstract

There is a growing concern about a shortage of physician scientists. This problem is particularly severe in certain subspecialties such as geriatrics in general and geriatric psychiatry in particular. This study sought to obtain medical students' perspectives on barriers and facilitators toward pursuing a career in academics and/or in geriatric psychiatry or geriatic medicine. The study surveyed 27 first-year medical students from six US medical schools, who had demonstrated a clear interest in academic geriatrics by completing a mentored summer research training program in geriatric medicine or geriatric psychiatry, funded by the National Institute on Aging. The survey included open-ended and close-ended questions about likely career choice and factors affecting it. Sixty percent of students reported they were likely to pursue an academic career, 44 % a career in geriatric psychiatry or geriatic medicine, and only 36 % a career in academic geriatrics. The most frequently perceived barriers were a lack of knowledge about academic careers and lack of exposure to geriatrics, financial concerns due to loan debts and low compensation, and negative impressions of research and of working with older adults. Facilitators included positive experiences with or positive impressions of research and research mentors and of older adults, and the growing demand for geriatric care. Attracting capable and motivated medical students to academic careers in fields such as geriatric psychiatry or geriatic medicine should be a priority in seeking to expand the number of physician scientists and to add to the health-care workforce in underserved subspecialty areas. Necessary approaches should include opportunities to work in academic settings; availability of sustained and dedicated mentorship; early, consistent, and positive exposure to older adults; and financial incentives.