Geriatrics Recruitment Resources

at the University of Texas Health Science Center at San Antonio

Program Overview

The goal of this approach is to attract residents into geriatrics fellowship training slots at the University of Texas Health Science Center at San Antonio through mentoring by a geriatrician. Research indicates that forming a personal relationship with a role model or mentor in a given field is an effective recruitment strategy.

Second-year Internal Medicine and Family and Community Medicine residents who are undecided about an area of specialization or who have already expressed an interest in geriatrics fellowships are invited to participate in the program, which began in 1998 under the San Antonio Hartford Foundation Center of Excellence in Geriatric Medicine and Training.

Program Operations

Geriatrics faculty review all the annual applications, scores, and personal statements of trainees entering Family and Community Medicine (FCM) and Internal Medicine (IM) residencies. This includes 25 second-year IM residents and 12 second-year FCM residents (out of a total of 36 FCM residents who enter the program annually). They are triaged into three categories:

• residents who are unlikely to pursue geriatrics because they have already indicated another subspeciality interest
• residents who are undecided about a specialty
• residents who have already expressed an interest in geriatrics or an interest in an academic career in any field.

Family and Community Medicine
During the first year, geriatrics faculty establish informal relationships with the targeted residents. They begin their three-year continuity training at long-term care facilities with an orientation during the month of training. About eight times a year, at an assigned long-term care facility, residents spend a half day with a geriatrician.

Residents are invited to various didactic activities and social events during their second year, such as a welcoming dinner, where they meet fellows, former fellows, and other residents interested in geriatrics. This exposes them to the geriatrics community at San Antonio and enables them to get to know geriatricians better. Geriatricians are “pitched” as a select group of individuals pursuing a unique and challenging discipline.

Residents are also invited to attend the “Geriatrics is Your Future” resident recruitment weekend at Baylor College of Medicine and to lunch with a geriatrician who has completed a fellowship. Former geriatrics fellows are the most credible and effective recruiters. During this year, residents are approached about applying for the fellowship and told what it involves.

Third-year residents complete a two-month rotation in geriatrics. One month is spent at an inpatient facility, and one month at a nursing home. During the third year, the application process is facilitated for those residents who have chosen a geriatric fellowship.

Internal Medicine
The Extended Care Treatment Center at the VA hospital is one of the sites where second- year IM residents can be assigned for continuity training, and where they then receive mentoring. Assignment is based on an expressed interest in geriatrics. In addition, all second-year residents have a required rotation in geriatrics. These two clinical rotations give geriatricians a chance to serve
as mentors and to form relationships with potential fellowship candidates.

Staffing Requirements

There are no additional staffing requirements. Faculty and current and former fellows are asked to attend several social evenings each year to get to know the residents.

Program Costs and Funding Sources

There are modest costs for social events, covered by the Hartford Foundation Centers of Excellence budget.

Process and Outcomes Data

Since the start of the program nine years ago, 24 residents have been recruited: six former fellows are in academic slots at San Antonio; one is in an academic position at UAB; and two are associate faculty at the UT extension campus on the Texas-Mexico border.

During this time, the number and qualifications of fellowship program applicants has improved steadily.

Implementation Lessons

• Recruitment efforts should not be targeted at interns. Interns indicated that attempts to get them to commit to geriatrics during this overwhelming first year added too much pressure and thus were counterproductive.
• Recruitment messages have to be personalized and should be tailored to each individual as much as possible. Messages must address concerns that prevent trainees from pursuing geriatrics, such as how to fund research training and how to pay off student loans. Having current or recent fellows address solutions to these issues is most effective.
• It is important to emphasize the breadth and variety of possible career paths in geriatrics and to communicate information about salaries and career satisfaction in the field.

Available Materials

Tools/Resources

• List of recruitment events

Website

• UTHSCSA CoE website: http://geriatrics.uthscsa.edu

For More Information

Cynthia L. Alford, MD
Associate Professor
Department of Family and Community Medicine
University of Texas Health Science Center
7703 Floyd Curl Drive, Mail Code 7794
San Antonio, Texas 78229-3900
(210) 358-3885
alford@uthscsa.edu

Download the program as a PDF file