Exploring Motivations for a Career in Geriatrics: Perspectives from fellows and recent graduates

Abstract

Background: Recent literature reports declining numbers of medical trainees pursing a fellowship in geriatrics. The few qualitative studies that seek information as to why medical trainees choose geriatrics focus on what the subjects dislike about the field. The purpose of this study is to determine factors that motivated recent medical residency or fellowship graduates to pursue a career in geriatrics and gather information on the positive aspects of their career. Methods: 13 eligible participants were interviewed, either current geriatric fellows or graduates from an accredited geriatric fellowship in the U.S. within the last 6 years. Interviews were transcribed and coded by the research team. Results: There were 18 codes identified that were then divided into four themes: 1) personal experiences with older adults and geriatricians; 2) distinguishing characteristics of geriatrics as a specialty; 3) benefits and challenges of a career in geriatric medicine; and 4) expectations and recommendations for the future of geriatrics. Responses suggested close relationships with older adults, early clinical experiences in geriatrics, and having geriatrician mentors were common motivating factors. Benefits of a career in geriatrics, including good work-life integration, flexible career paths, supportive work environments, appreciative patients and caregivers, and making an impact, were met with challenges related to increased medical complexity and working in a system that does not value preventative care or the needs of older adults. Participants discussed the need for increased exposure to geriatrics in medical training and the need for geriatrics to further evolve as a specialty. Conclusions: Common motivating factors included personal relationships with older adults and early clinical exposure to geriatrics. Findings suggest that participants consider their work to be rewarding with many lifestyle benefits, and the declining number of medical trainees pursuing geriatrics should be met with efforts to increase exposure to the field early in medical training.