AGS Publishes Updated Minimum Geriatrics Competencies for Graduating Medical Students

In 2009, the Minimum Geriatrics Competencies for Graduating Medical Students were created to ensure that medical school graduates across the United States were prepared to provide high-quality care for us all as we age.¹ The American Geriatrics Society (AGS) recently published an updated version with 27 competencies integrating new concepts that have emerged more recently in the field of geriatrics, including frailty and person-centered care. The refreshed set of minimum competencies are also now framed around five key areas of focus for all geriatrics health care professionals.

“The updated competencies reflect an evolution in how we frame the work of geriatrics health professionals, a greater understanding of frailty, and a greater focus nationally on ensuring that care is person-centered and driven by individual goals,” explained AGS President Peter Hollmann, MD, AGSF. “With these competencies, the field of geriatrics has defined not just what all physicians should know as they embark on their careers but also how they should put that knowledge into practice.”

The new AGS Minimum Geriatrics Competencies for Graduating Medical Students are organized around the Geriatrics 5Ms, a framework developed in 2017 by Frank Molnar, MD, Allen Huang, MD, AGSF, and Mary Tinetti, MD, AGSF, around five key areas: Mind, Mobility, Medications, Multicomplexity, and what Matters most.² Clinical educators in medical schools are rapidly adopting the 5Ms as a framework for teaching medical students the skills, knowledge, and abilities they should have to provide high-quality clinical care for older adults. In the updated competencies set, each of the “Ms” contains new or modified competencies. Of particular note, multicomplexity, which describes the person who benefits most from geriatrics care, includes guidance on integrating a health equity lens into the practice of medicine.

“When we added a 27th competency, we believed it was critically important to highlight how important it is that physicians not only understand the impact that ageism and other forms of discrimination can have on the health of older adults but also take steps to overcome their own bias in addressing issues of health equity,” AGS CEO Nancy E. Lundebjerg, MPA said. The 27th competency also reflects the priorities of the AGS’s multiyear, multipronged initiative to address structural racism and ageism, which the organization formally announced last fall.³

A workgroup of AGS leaders cochaired by Rosanne Leipzig, MD, PhD, Andrea W. Schwartz, MD, and Mandi Sehgal, MD, updated the 26 original competencies using a modified Delphi method to reach a group consensus based on expert and stakeholder input, a literature review, and a national survey of geriatrics educators. (The latter was a part of Project EDGE, a collaboration between the American Geriatrics Society, Harvard Medical School and the VA New England’s Geriatric Research Education and Clinical Center.) The workgroup obtained IRB exemption from Harvard Medical School for their project. Having presented their work at the 2021 AGS Virtual Annual Scientific Meeting, the team is currently working on a paper describing their methodology and key qualitative findings from their research. The updated competencies are now available on the AGS website, at https://adgap.americangeriatrics.org/education-training/competencies/geriatrics-competencies-medical-students.

Moving forward, the AGS will ensure that the updated competencies serve as established standards for the most basic knowledge, skills, and attitudes graduates of medical schools can be expected to demonstrate, and the organization will continue to advocate for an undergraduate medical education that prepares graduating physicians to care for us all as we age. The AGS is also developing educational tools to help educators to integrate attention to the new competencies into their programs.

References

1. Leipzig RM, Granville L, Simpson D, Anderson MB, Sauvigné K, Soriano RP. Keeping granny safe on July 1: a consensus on minimum geriatrics competencies for graduating medical students. Academic Medicine. 2009;84(5):604-610. doi:10.1097/ACM.0b013e31819fab70.
2. Tinetti M, Huang A, Molnar F. The Geriatrics 5M’s: a new way of communicating what we do. J Am Geriatr Soc. 2017;65(9):2115-2115. doi:10.1111/jgs.14979.
3. AGS launches new initiative addressing the intersection of structural racism and ageism in health care [news release]. The American Geriatrics Society. November 2, 2020. Accessed July 13, 2021. https://www.americangeriatrics.org/media-center/news/ags-launches-new-initiative-addressing-intersection-structural-racism-and-ageism