Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 30

The teaching of medical students about the medical care of sick elderly people had long been recommended, but it was not until 1949 that Lord Amulree was appointed to University College Hospital, a London teaching hospital. Further advance had to wait until 1965, when Sir Ferguson Anderson became the first UK Professor of Geriatric Medicine. After this, progress was slow; but by 1998, almost all the London teaching hospitals had a professorial chair in the specialty, and increasing numbers of chairs in geriatric medicine were made in the country as a whole. These academic departments were usually based on an active geriatric unit with good community links. The curricula vary but could include biological and sociological gerontology in addition to clinical geriatric medicine. Postgraduate research courses leading to the degrees of MSc and PhD had been set up. Some universities have a cluster of associated chairs, such as the University of Manchester with two chairs in geriatric medicine and one each in cognitive gerontology, old‐age psychiatry, gerontology, biological gerontology, and social gerontology.

However, research on attitudes of medical students toward older people has shown that they tend to lose their initial interest and empathy for older people as they train and qualify. A survey of their attitudes before qualification showed that they had empathy for, and a ‘bedside interest in’, the elderly, which disappeared after graduation when the doctors considered their career prospects.²² Parkhouse and McLaughlin²³ found that no doctor who had graduated in 1974 wished to enter geriatric medicine. Lambert et al.²⁴ showed that little had changed in a review of career preferences among newly qualified doctors: preferences for geriatric medicine remained very low at 0.9%, well below general medicine and surgery, although above genetics. Factors blamed included the prejudice of medical teachers against geriatric medicine, poor image/role of the geriatrician, and mediocre working conditions. As a result, recruitment of medical staff into the specialty was poor. The Royal College of Physicians responded in 1972 and 1977 with a range of recommendations, including integration of geriatric medicine with general medicine, appointment of consultant physicians with a special interest in geriatric medicine, and rotation of junior training posts between the two specialties.^25,26 The College also introduced the Diploma of Geriatric Medicine in 1986 to encourage general practitioners to gain interest in the care of older people.