Geriatric Psychiatry Fellowship Programs

Comparison of 2001 and 2007

Elizabeth “Libbie” Bragg, PhD, RN

College of Nursing

September 2012

Methods

• Cross sectional surveys of GP fellowship program directors

2001 76% response rate (N=47/62)

2007 66% response rate (N=37/56)

• Longitudinal data from multiple sources National GME Census

Main Points

• GP Fellowship Slots are not filling

• USMDs not choosing GP

• Few GP fellows train beyond year one

• Many GP do not recertify

Geriatric Psychiatry: Number of Programs, First Year Positions Available and Filled

Source: AMA and AAMC data from the National survey of GME programs, JAMA 1995-2011.

Geriatric Psychiatry: Total Number of Fellows, IMGs and USMDs

Source: AMA and AAMC data from the National survey of GME programs, JAMA 1995-2011.

Distribution of First Year Geriatric Psychiatry Fellows for Academic Years 2001-2002 and 2006-

2007

Source: Geriatrics Workforce Policy Studies Center. Surveys of Directors of Geriatric Psychiatry Fellowship Programs. (Fall 2001, N=47/62, 76% response rate.) (Winter 2007, N=37/58, 66% response rate.)

Conclusions so far

• GP Fellowship Slots are not filling– Less than half of the slots have been filled

in past 4 years– From 2001/02 to 2006/07 a 23% ↓ fellows– From 2001/02 to 2010/11 a 56% ↓ fellows

• USMDs not choosing GP– Since 1996/97 majority of fellows are IMGs

Fellowship Training Beyond Year 1

Advanced Fellows are prepared to:

• Conduct basic, clinical, or health services research

• Educate others

• Be leaders in the field

Geriatric Psychiatry: Total Number of Fellows, First Year & Advanced Fellows

Source: AMA and AAMC data from the National survey of GME programs, JAMA 1995-2010.

Faculty at 37 GP ProgramsAcademic Rank (2007)

Rank Men Women Total

Assistant Professor 88 (60%) 59 (40%) 147 (50%)

Associate Professor 52 (69%) 23 (31%) 75 (25.5%)

Professor 58 (87%) 9 (13%) 67 (22.8%)

Other 4(80%) 1 (20%) 5 (1.7%)

Total 202(69%) 92 (31%) 294

Data presented as number of faculty. Median total faculty 7. IQR 5 – 10.5

228 are certified in GP: 126 by fellowship training

2007 GP Program Directors Years director

7 years

(< 1 to 22 years)

Years since formal training16 years

(4 to 40)

Hours/week administration6 hours

(1 to 25)

Institutional support for salary* N=28 (76%)

Certified via fellowship training* N=19 (51%)

Certified via practice pathway* N=18 (49%)

*Data presented as number and %. All other data median and ranges

Source: AMA and AAMC data from the National Survey of GME Programs compiled by Geriatrics Workforce Policy Studies Center. Does not include osteopathic programs.

Specialty% of First Year

Filled Positions1 % USMDs1 Private Practice Salary2

Hematology/Oncology 102.3% 53.6% 381,992Physical Medicine & Rehabilitation 102.2% 55.0% 241,182

Gastroenterology 100.2% 64.7% 463,955Emergency Medicine 99.4% 81.0% 277,297

Psychiatry 98.9% 57.2% 199,996Family Medicine 98.3% 44.2% 189,402

General Internal Medicine 97.9% 48.9% 205,379Dermatology 97.6% 94.9% 392,885

Pediatrics 97.2% 66.5% 192,423Neurology 96.3% 55.3% 249,867

Rheumatology 96.1% 50.6% 225,521Nephrology 92.9% 36.3% 306,046

Infectious Disease 91.6% 51.9% 219,556Endocrinology 91.5% 48.5% 211,400

Urology 84.2% 95.2% 372,455Hospice/Palliative Care* 62.1% 58.3% 196,262

Geriatrics (FM+IM) 57.2% 24.4% 183,523Geriatric Psychiatry 30.0% 36.6% 211,071

Sources: 1AMA and AAMC data from the National Survey of GME programs, JAMA, September 2011. 2Medical Group Management Association. Physician Compensation and Production Survey 2011 report based on 2010 data. Data compiled by Geriatrics Workforce Policy Studies Center.*Hospice and palliative medicine is a subspecialty of anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, physical medicine and rehabilitation, psychiatry, radiology, or surgery.USMD = Graduates of US medical schools

Comparison of Percent of Filled First Year Positions, Percent of USMDs, and Private Practice Salaries for Selected Specialties 2011

Comparison of Number of Certificates Awarded toNumber of Active Certificates in Geriatric Psychiatry

As of December 31, 2011

Source: Jenny Vollmer, ABPN & ABPN 2011 Annual Report .

Compiled by AGS/ADGAP Geriatrics Workforce Policy Studies Center

September 2012

Certification and Recertification Year Number

CertifiedN (%) Currently Certified

1991 490 232 (47%)*

1992 359 216 (60%)*

1994 422 219 (52%)

1995 376 161 (43%)

1996 713 275 (39%)

1998 65 37 (57%)

2000 83 47 (57%)

*Second recertification

• Few GP fellows train beyond year one– 13 advanced fellows in 2001/02– 4 advanced fellows in 2006/07– 2 advanced fellows in 2010/11

• Many GP do not recertify – Only 47% have recertified 1187/2508

More Conclusions

Contact Informationhttp://

www.americangeriatrics.org/advocacy_public_policy/gwps

Libbie Bragg, PhD, RNThe University of CincinnatiElizabeth.Bragg@uc.edu513-558-5241