Generation Geriatrician?

Felicity Jones is a final year medical student at King’s College London and current Junior Members Representative for the BGS: representing Junior Doctors and Medical Students on the Trainees Council. Reblogged from the British Geriatrics Society blogGG

Caring for an ageing population is a major challenge of our time. Across the world, societies are ageing, with wide-ranging impacts. Many overlook the huge contributions the over-65s make to our labour workforce, running the third sector, and as carers for friends and relatives. It’s easy for these contributions to be ignored in a narrative which at a societal level tends to focus the challenges of providing a comprehensive health and social care to an ever-increasing proportion of our society.

At only twenty-three, it’s unusual for me to be interested in these issues. Most of my fellow medical students struggle to comprehend what draws me to geriatrics. I tell them it’s because I’m interested in health systems, quality improvement and leadership, because I’m intrigued by the complexities of how to flourish in our society once you hit retirement age, because I care about each and every older person I meet and want to see them supported holistically… but most of all because I’m young.

Our generation will be caring for an unprecedented number of older people, and managing an ageing challenge on a scale that today’s consultant geriatricians, healthcare managers and government have never experienced. As we become consultants, we will inherit systems which are already failing to cope, and we will have to manage any chaos resulting from a continued failure to radically re-design policies. Therefore, as healthcare professionals of the future, do we not have a duty to not only learn about but also get involved in leading these developments?

‘But I don’t want to be a geriatrician, I want to be a neurologist, a dermatologist, or specialise in some medical specialty…’ I hear you cry. Do not kid yourself. Each and every one of us is going to be affected by this demographic shift, and we will all (ok, with the possible exception of paediatricians!) see increasing numbers of elderly patients, who are taking multiple drugs and have multiple comorbidities. Even you budding surgeons should sit up and take note – services such as POPS at St Thomas’ demonstrate we can expect increasing numbers of older patients to undergo surgery with successful outcomes if given the right support.  We all need to learn from the experience of existing geriatricians, and gain expertise in how to care for the complex elderly patient of today, who will become the commonplace patient tomorrow. As one of my friends at King’s said after our elderly care placement, ‘I just didn’t expect geriatrics to be so difficult – I thought it was just talking to people!’ He’s right that caring for this population is academically rigorous, but he is also right that communication skills are critical: working with the elderly means thinking holistically about social, psychological and spiritual circumstances. Therefore, what better place to gain the skills and expertise you are going to need whatever you choose to specialise in?