Geriatric medicine
Geriatricians provide comprehensive medical care to older people.
Geriatric medicine is the largest medical specialty, and your role will be a wide and varied one.
Life as a geriatrician
You’ll diagnose and treat acute illnesses, chronic diseases, disability and frailty. Your patients will often have several medical conditions and be taking a number of different medicines.
Common conditions you’ll treat include:
- fractures
- delirium
- dementia
- incontinence
- poor mobility
- frailty
As part of a multidisciplinary team, you’ll work closely with medical colleagues including GPs and other hospital doctors as well as experts in the community such as social workers. Your ability to collaborate and work well with others will be vital.
Given the varied nature of your role, you’ll work in a multitude of settings including:
- outpatient departments
- A&E
- medical assessment units
- acute care wards (e.g. coronary care, high dependence, intensive care [3] and acute stroke [4] care)
- rehabilitation wards
- intermediate and long-term care wards
- day-care centres
- care homes
- hospices
The role demands a strong sense of compassion and the ability to adopt a holistic [5], patient-centric approach. You’ll provide rehabilitation after illness and need a comprehensive knowledge of physical treatments, adaptations and aids.
Older people may react differently to drugs so you’ll need an excellent understanding of adverse drug reactions, drug interventions and how these might be affected by a patient’s condition.
An important part of your job will be to enable patients to be supported at home or transferred from hospital to home, which is often a complex process.
During your training it’s important you develop an excellent understanding of palliative and end of life care. You’ll also need to excel in orthogeriatrics (medical care for people with orthopaedic trauma), old age psychiatry and specialist stroke [4] care.
Due to the unique nature of your work, you’ll need to understand the legal and ethical issues surrounding work with older people, including appointment of power of attorney, guardianship, mental health legislation and resuscitation.
How much can I earn?
You’ll first earn a salary when you start your foundation training [6] after medical school. Find out details of current salary ranges for foundation and specialty training, SAS doctors [7] and consultants on the Pay for doctors [8] page.
How about the benefits?
- make a difference
- flexible and part-time working
- high income early in your career
- work anywhere in the world
- excellent pension scheme
- good holiday entitlement
- NHS discounts in shops and restaurants
Must-have skills
- excellent communication skills to manage a wide range of relationships with colleagues, and patients and their families
- emotional resilience, a calm temperament and the ability to work well under pressure
- teamwork and the capacity to lead multidisciplinary teams
- problem-solving and diagnostic skills
- outstanding organisational ability and effective decision-making skills
- first-class time and resource management for the benefit of patients
Entry requirements
Your first step is medical school. Typically, you’ll need excellent GCSEs and three A or A* passes at A level including chemistry for a five-year undergraduate degree in medicine. Many medical schools also ask for biology and others may require maths or physics.
If you already have a degree, you could study for a four-year postgraduate degree in medicine.
You’ll need to pass an interview and admissions test. You’ll be asked to show how you demonstrate the NHS values such as compassion and respect.
Some medical schools look to recruit a mix of students from different backgrounds and geographical areas, so your educational and economic background and family circumstances could be considered as part of your application.
I got a taste of what working in geriatric medicine was like as part of my medicine training and I really enjoyed it. I was also drawn to the intellectual challenge of dealing with multiple problems in a single patient so I decided to specialise in this branch of medicine.
Read Adam's story [9].
What are my chances of starting a career as a geriatrician?
There are approximately 1,514 geriatricians working in the NHS in England. In 2020, there were 392 applications for 202 specialty training places.
How to become a geriatrician
After medical school, you’ll join the paid two-year foundation programme [10] where you’ll work in six placements in different settings.
After your foundation programme, you can apply for paid specialty training [11] to become a geriatrician, which will take a minimum of six or seven years.
You may be able to train part time, for example for health reasons or if you have family or caring responsibilities.
Where a career as a geriatrician can take you
Once you’re a qualified geriatrician, you’ll have the chance to undertake an additional one-year training scheme in stroke [4] medicine to achieve what’s known as sub-specialty recognition.
Consultants are involved in managing geriatric services and you’ll have plenty of opportunities to undertake research and teach.
You’ll also have many opportunities to develop special interests within geriatrics. These can be based around a particular stage in a person’s illness (temporal illnesses) or based around specific disease processes. Most geriatricians enjoy looking after a wide range of conditions.
Other roles that may interest you
- Neurologist [80]
- Palliative medicine [81]
- Rehabilitation medicine [82]
- General internal medicine [83]