Autumn 2021

Training to care for older patients


Aging Issue

  • by George Q. Daley
  • 2 minute read

Among the initiatives our students launched this past year, the COVID curriculum, adopted by medical schools worldwide, was a point of pride. This initiative also had an extracurricular component: COVID Community Voices, which paired our students with older adults in the Boston area who, by staying home to avoid the risk of infection, were separated from family and friends and therefore at increased risk for social isolation. Students who took part in this program would regularly call their “phone pals” to check in, talk, and listen. In addition to helping stave off loneliness and fear in members of a vulnerable population, the project gave joy and purpose to our students. COVID Community Voices is still going strong.

The percentage of older adults in the United States is growing. In its 2019 American Community Survey, the U.S. Census Bureau reported that an estimated 54 million people, approximately 16.5 percent of our nation’s population, were over the age of 65. That percentage is expected to climb to 20 percent by 2030, with many individuals experiencing multiple medical conditions and complex psychosocial circumstances. Workforce projections, such as those produced by the American Geriatrics Society, indicate that by 2025, there will be approximately 6,000 certified geriatricians in the United States, about fivefold short of the anticipated need.

Producing more geriatric specialists is a goal we are working toward through the HMS Multicampus Geriatric Medicine Fellowship Program and other Harvard geriatrics training programs. In addition, we have launched a curricular effort that will ensure that all our medical students, no matter their specialty, will be prepared to provide sensitive and competent care to address the unique needs of their older patients.

In 2019, our Educational Policy and Curriculum Committee selected aging population/end-of-life care as a required curricular theme, which, together with health equity and disparities, trauma-informed care, substance abuse and pain, and sexual and gender minority medicine, integrate pressing societal issues into our MD curriculum. Co-directors Andrea Wershof Schwartz, an HMS assistant professor of medicine at the VA Medical Center and Brigham and Women’s Hospital, and Kristen Schaefer, MD ’94, an HMS assistant professor of medicine, part-time, at Dana-Farber Cancer Institute, have worked with HMS faculty to integrate geriatric competencies across the pre-clerkship, Principal Clinical Experience, and post-PCE phases of our curriculum. During the pandemic, the curriculum theme co-directors collaborated with students, trainees, and colleagues on research that produced peer-reviewed publications on several topics including clinical geriatrics and our trainees’ adaptation of the “My Life, My Story” program, a tool for getting to know seriously ill and aging patients as people.

Our recognition of the need to prepare our students to provide informed care to older adults reflects our tradition for pedagogic leadership and compassionate care. Our students are passionate about becoming skilled caregivers, and our faculty are dedicated to educating them to become physicians who are leaders in medicine.

George Q. Daley is the dean of Harvard Medical School.