The aging of Quebec’s population is forcing physicians to adapt their practices, as caring for an elderly person is very different from caring for a young adult.
University geriatric programs are struggling to fill available positions, but medical departments are working to better equip future physicians with the specific needs of older adults.
Seniors constitute the primary clientele of most medical specialists, including family medicine.
Marc Bouchard, director of the doctoral program in medicine at Université Laval, recalls that in the 1990s, he was already hearing about a “grey tsunami” that was about to hit Quebec. He believes the tsunami has arrived.
“With the aging of the population, there are more and more elderly people. These elderly people have more and more comorbidities. It’s becoming the bread and butter of everyone’s medical practice,” he says.
The academic path of physicians is therefore called upon to adapt to the elderly because these patients have specific characteristics that are absent in younger patients.
Also an orthopedic surgeon, Dr. Bouchard gives the example of an anti-inflammatory drug he would like to prescribe to his elderly patient.
“It’s not the same as prescribing it to an athlete who has just sprained their knee. The dosages will be different, the types of molecules will be different,” he explains.
Family physicians are doing well
Universities are aware that medical programs must adapt to the aging population.
Many have already modified their curricula to include more courses—practical, theoretical, and clinical—focused on caring for the elderly. Some faculties have also added mandatory rotations in geriatric practice.
In addition, emphasis is placed on clinical situations that particularly affect older adults, such as hip fractures, cognitive impairment, delirium, polypharmacy, and other geriatric syndromes.
Medical schools must cover all Canadian programs. The Medical Council of Canada establishes the basics that must be covered within the programs, but each university can then adjust them to suit its own preferences.
In Quebec, the medical program is offered by four university faculties. At the Université de Montréal, McGill University, Université Laval, and Université de Sherbrooke, a program in care of the elderly can be completed after completing a residency in family medicine.
Dr. Julia Chabot, geriatrician and vice-president of the Association des médecins gériatres du Québec (AMGQ), praises the work of general practitioners. According to her, the basic training in geriatrics they receive allows them to effectively treat common syndromes in older adults. “Where the geriatrician’s role becomes much more important is in more specific situations,” she says.
For example, if a patient’s cognitive assessment seems to reveal something, but it’s not a typical case.
“I think there’s always room for more training in geriatrics, given the aging population, but that being said, I’m always extremely impressed by the care provided by my family physician colleagues,” says Dr. Chabot.
Difficult recruitment
The Université de Montréal offers a two-year geriatrics program. It has managed to fill all the spots in this program only three times in the last six years. Laval University has achieved the same result with its program, as has McGill University.
The Faculty of Medicine and Health Sciences at the Université de Sherbrooke also offers a postdoctoral program in geriatrics. It has never filled all the available positions in this program over the past six years.
The difficulty recruiting medical students into geriatrics programs is not unique to Quebec. Across Canada, medical schools are struggling to fill all the positions in these programs, according to Dr. Josée Filion, director of the geriatrics program at the Université de Montréal.
Her duties lead her to speak several times a year with other program directors at Canadian universities that offer medical courses.
Dr. Filion reported that in Toronto, this year, approximately 50 per cent of the available positions in geriatrics programs have been filled, and in British Columbia, none of the four positions have been filled. “We’re trying to implement strategies to increase the appeal of geriatrics.” This often involves elective internships fairly quickly,” she says.
She also believes that potential breakthroughs in research, particularly in the cognitive health, could encourage an interest in elder care.
Furthermore, the Association of Geriatric Physicians of Quebec would like to improve training outside of university curricula by better equipping various professionals, whether family physicians, nurses, or other front-line professionals. The AMGQ states that it is ready to offer more training.
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–This report by La Presse Canadienne was translated by CityNews
The Canadian Press’s health content receives funding through a partnership with the Canadian Medical Association. Editorial choices are solely the responsibility of The Canadian Press.
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