Combating Ageism in Medical Education

Combating Ageism in Medical Education

It’s becoming more and more evident that medical professionals’ biases tend to affect the kind of treatment patients of different backgrounds receive. For instance, patients may be at a disadvantage if they have less in common with their doctors in terms of race, religion, or economic background. However, a less commonly discussed bias includes ageism.  At Weill Cornell Medical, geriatrics co-chief Dr. Ronald Adelman created “Introduction to the Geriatric Patient,” a program with the goal of addressing ageism in healthcare practice, fearing that students are developing a “distorted view” of seniors and internalizing stereotypes [1].

Studies have shown that seniors’ complaints are often dismissed, with little effort put into a diagnosis by medical professionals. Marcia Levine, an 88-year-old retired family therapist, shared with the students her experience with a gastroenterologist who overlooked her symptoms of fatigued, noting that “at her age she can’t expect to have much energy” [1]. However, after visiting another doctor, Marcia learned that she was suffering from a low-grade infection.

Combating ageism could be as simple as altering the way we teach medicine to students. In Canada, the population over the age of 65 began to outnumber the population of children under age 14. However, only 5 of 17 medical schools have a required geriatrics clinical rotation, as opposed to all schools requiring four- to six-week pediatric clinical rotations. Moreover, the fact that students are subtly learning ageist attitudes by observing their instructors during shifts is alarming. For example, when senior patients present with “atypical clinical presentations,” they are usually diagnosed with acopia, defined as “a patient’s inability to cope with activities of daily living” [2,3]. Instead of being given the time and effort of a proper diagnosis by medical professionals, older patients are “often met with ageist therapeutic nihilism” [2]. Learning these attitudes from their teachers results in medical students viewing senior patients as “impediments to clinical efficiency and medical education,” which may be the reason why students are less likely to choose geriatric training programs in comparison to other specialty programs.

Moreover, medical research frequently fails to include seniors, which leads to medical professionals postulating what kinds of treatments would best fit the situation at hand. The lack of knowledge regarding patient care for seniors is troubling, due to the fact that most physicians, besides pediatricians, will have to treat older patients. For instance, endocrinologists treating diabetes patients will find that approximately forty percent will be above 65 years of age. Oncologists will see that the majority of cancer survivors are also above 65 years of age. Demand for geriatricians in the United States is speculated to increase by forty-five percent by 2025, while supply is nowhere near sufficient [1].

The yearly program created by Dr. Adelman, which all second-year students are required to participate in, gives medical students the chance to meet and bond with seniors beyond the hospital setting. Other medical schools have followed Dr. Adelman’s lead, with approximately twenty schools implementing comparable programs to encourage bonding between students and healthy seniors [1]. Administrators of the programs have noticed the positive impact the programs, with more students and seniors bonding and choosing to meet outside of the program as friends. While additional efforts must be made to combat ageist approaches in medical research and education, this program offers an initial step towards bettering senior patients’ healthcare experiences.

References:

  1. Paula Span, “Every Older Patient Has a Story. Medical Students Need to Hear It.” The New York Times, October 12, 2018.

  2. Nathan Stall, “Time to End Ageism in Medical Education,” NCBI, April 3, 2012.

  3. Physiopedia Contributors, “Acopia,” Physiopedia, January 8, 2015.




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