Teaching Geriatrics in Medical Education II Department of Ageing and Life Course and IFMSA In response to the global demographics challenges, WHO launched a new programme on ageing and health in 1995 designed to advance the state of knowledge about how ageing impacts on public health, health care in old age and gerontology through special training and research efforts, information dissemination and policy development1. The programme’s perspectives focus on the following: • approaching ageing as part of the life course rather than compartmentalizing health promotion and health care for older people; • concentrating on the process of healthy ageing and the promotion of long-term health; • respecting cultural contexts and influences; • adopting community-based approaches by emphasizing the community as a key setting for interventions, taking into account that many health problems need to be dealt with outside the health sector; • recognizing gender differences; • strengthening intergenerational links; • respecting and understanding ethical issues related to health and well-being in old age In all countries and in developing countries in particular, measures to help older people remain healthy and active are a necessity, not a luxury. To promote active ageing, health systems need to take a life course perspective that focuses on health promotion, disease prevention and equitable access to quality primary health care and long-term care. It is time for a new paradigm, one that views older people as active participants in an age-integrated society and as active contributors as well as beneficiaries of development. Ageing and Life Course, WHO Our mission is to offer future physicians a comprehensive introduction to global health issues. Through our programming and opportunities, we develop culturally sensitive students of medicine, intent on influencing the transnational inequalities that shape the health of our planet. IFMSA (International Federation of Medical Students Associations) Mission Statement Contents Acknowledgements Background The TeGEME II Study Methodology • Coding • Participants • Confounding factors • Type of analysis o Table 1: Number of Medical Schools and Medical Schools Participation per Country Results • Americas o Bolivia o Chile o Panama o Peru • Europe o Bulgaria o Czech Republic o Finland o Germany o Malta o Norway o Romania o Spain o Switzerland o United Kingdom • Asia o Lebanon o Hong Kong o Malaysia o Pakistan o Thailand • Africa o Ghana o Nigeria o South Africa o Sudan o Tanzania Discussion Appendices Appendix I: ASD Table for all Countries Appendix II: Medical Schools for all Countries Appendix III: Case Study – Ghana Appendix IV: Case Study – United Kingdom Acknowledgements The Teaching Geriatrics in Medical Education II Study was conducted between March 2005 and August 2007. The study report was assembled by Dr Nidhi Gupta (UK), and co-written and coordinated by Dr Nidhi Gupta, Dr Manuela Moraru (Romania), and Dr Jo Lyn Chooi (UK), and co- written by Dr Colin Brown (UK). The study was supervised by Ms. Ingrid Keller (Associated Professional Officer with WHO/ALC) and Dr. Alexandre Kalache, Coordinator WHO/ALC. Additional IFSMA support: Dr. Nikola Borojevic (Croatia), Dr. Jacco Veldhuyzen (the Netherlands) and Dr. Arttu Makipaa (Finlnd), Dr. Wael Shamseddeen (Lebanon) and Dr. Usman Ahmad (Pakistan). The support of all the Standing Committee for Medical Education Directors, and those active members who helped with the project in its early stages, is much appreciated. The results from Africa were collated by Dr. Ntobeko Nutsi (South Africa). The data collection would have been impossible without the support all of the National Focal Points (in bold) and Local Focal Points in the participating countries. Our appreciation goes to: Europe: Bulgaria: Rishabh Kedia; Czech Republic: Marek Nemek, Petr Houska, Lenka Bosanska, Jan Latta, Mariana Zarubova, Tereza Luzna, Magdalena Klimesova, Andrea Svinkova Tomas Indruch, Zuzana Elbertova, Michal Lesko Amir Zolal, Mirka Casova Lucia Frcova, Matej Smizansky, Hana Lattova; ;k, Tuuli Savolainen, Ossi Kaijanen, Sara TornbergنFinland: Suvi Vainiom Germany: Malte Braunroth, Jan Hilgers, Thorsten Hornung, Jan Baier, Philipp Schweinfurt; Malta: Philip Amato Gauci; Norway: Rita Helleren, Sigrid Bjrondal, Camilla Smedtorp, Hansen Torstein Schroder, Renee B. Alstad; Portugal: Francisco Botelho, Nono Fereira Francisco; Romania: Sebastian Manoleasa, Maria Opritoiu, Cristina Apostol, Silvia Pop, Alexandra Moraru; Spain: Manuela Moraru, Aida Rodriguez Sainz, Elsa de la Fuente Briongos, Nuria Millán guez Cubillo, Sandra AudiيGarcía del Real, Xoana Barros Freiria , Beatriz Rodr Lapiedra, Diego Jarast; Switzerland: Camille Piguet; United Kingdom: Colin Brown, Aurélie Hay-David, Nicholas Foster, Bilal Jamal, Catherine Grier, Jasmin Ohlsson, Celine Vousden, Nabihah Sachedina, Balvinder Sagoo, Raguwinder Bindy Sahota, Phillip Williams, Catherine Fletcher, Ciarán Trolan, Nishamali Jayatileke, Leigh Bissett, Ben Lawton, Aleem Sachedina. Americas: Bolivia: Cristian Ayala Carreo; Chile: Maricarmen Andrade and Jose Manuel Burgueno Rivera; Daniela Andrea Meza Benavides, Leonardo Hernan Santander Hess, Alicia Francisca Muos Araneda; Panama: Tathiana Castillo, Yarisel Carrasco, Kevin Cedeo; Peru: Vanessa Karina Valderrama Victoria, Yael Saavedra Valiente, Alfredo V. Laguna Urdanivia. Asia: Lebanon: Wael Shamseddeen; Hong Kong: Chiu Ka Fung Peter, Maggie Mok, Jack Tsang; Malaysia: Yeenwan Choong; Pakistan: Usman Ahmad Raza, Fahd Anzaar, Abdullah Muhammad Rana, Durreshahwar Khursheed, Ayesha Khan, Bakht Taj, Saadia Wahid, Fahad Nauman Safir, Samar Zia, Muhammad Omar Butt, Bilal Kiran, Salman Gohar, Sabeen Shah, Mohammad Tariq Ali, Waseem Mohammad, Fahad Ajmal, Faris Khan; Thailand: Poranee Ganokroj, Nacha Harinrak , Aekarach Ariyachaipanich, Piyasak Vitayaburananont. Africa: We would also like to thank all of the coordinators and participants from Ghana, Nigeria, South Africa, Sudan and Tanzania. Background Global population ageing is an important challenge and opportunity to be addressed by virtually all countries. Population ageing changes the nature of demands on health care systems, which will have to accommodate the needs of the older population as well the care-needs of other population age groups. This will be especially the case in less developed countries, where health systems capacity is already stretched and under-resourced. Throughout the 21st century health professionals will increasingly be required to be familiar with old age care whatever the specialty they choose, because routine practice will increasingly include older patients. Thus, the basic principles of the special care-needs of older persons should not be of exclusive concern to specialists. The ALC has developed a fifteen-point template which has all the components. Undergraduate Medical Education 1requires equipping healthcare professionals of tomorrow for the challenges of an ageing population. 1 In an attempt to assess how Geriatric Medicine is being taught world-wide, the WHO Ageing and Life Course Programme (ALC) devised a study, the Teaching Geriatric in Medical Education study I (TeGeME I), and in December 1999 invited the International Federation of Medical Students’ Associations (IFMSA) to be a close collaborator in its implementation. The main goal of the TeGeME I study was to gain insight on if and how ageing issues are incorporated into the medical curriculum world-wide. WHO strongly advocates that all future medical doctors need to be well trained in ageing issues and in care of older persons, since most future doctors will see increasing numbers of older persons in daily practice. From the data obtained from 36 countries, the conclusion was that the majority of the health care systems were not prepared to provide adequate care to a growing older population even though a steep increase in the older population is predicted for decades to come. In 2002 the Teaching Geriatrics in Medical Education Study II (TeGeME II) was devised to explore further the area of Geriatric Teaching and Medical Students' Attitudes. Again, the IFMSA was a close collaborator in its implementation and coordination. The main goal of the TeGeME II study was to gain an insight into how clinical medical students view the older generation, relating their opinions to the extent of Geriatric training received and their personal and social interactions with the older generation. Today’s students need to acquire knowledge about how to treat older persons from an interdisciplinary point of view. WHO has established a firm partnership with IFMSA with the ultimate aim of fostering the adoption of Geriatric Medicine in the medical curriculum worldwide. One of the main features of the world population over the last few decades has been rapid increase in the absolute and relative numbers of older people in both developing and developed countries. This trend will accelerate over the next two or three decades. The total number of older people (defined as 60 years of age and over) world-wide is expected to increase from 605 million in 2000 to 1.2 billion by the year 20252. Currently, about 60% of older persons live in the developing world. This number is expected to increase to 75% (843 million) by the year 2025 and 85% in 2050. Figure 1 shows the proportional increase of older persons among the total population for selected developing countries. 1 World Health Organisation. International Association of Gerontology and Geriatrics: Geriatric Medicine: