Time to end ageism in medical education

Nathan Stall

doi:10.1503/cmaj.112179

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Aging
Hans F. Reichenfeld

Posted on: 27 June 2012
Four score and ten
Hans F. Reichenfeld

Posted on: 17 April 2012
Time to end ageism in medical education
Gerald E. Sinclair

Posted on: 12 April 2012

Posted on: (27 June 2012)
Page navigation anchor for Aging
Aging
Hans F. Reichenfeld, Psychiatrist (Retired)
According to Stats Canada the fastest growing portion of our population is my generation, and not just my generation, but my age group, the over 80s, soon to be part of the over 90s and even the centenarians! No wonder the media, including the CMAJ (the Canadian Medical Association Journal)are full of stories how to look after us as we tooter off towards the inevitable endpoint of our earthly existence.
A recent fea...
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According to Stats Canada the fastest growing portion of our population is my generation, and not just my generation, but my age group, the over 80s, soon to be part of the over 90s and even the centenarians! No wonder the media, including the CMAJ (the Canadian Medical Association Journal)are full of stories how to look after us as we tooter off towards the inevitable endpoint of our earthly existence.
A recent feature article in the Globe and Mail, our self proclaimed 'national' newspaper, devoted four (4!) of its pages to an account of the life and recent death, at the age of 98, of the dad of one Ian Brown, complete with a list of all the medications he had been taking and their indications.
Nathan Stall, in the pages of the CMAJ, complains of the "crucial deficiency of geriatricians practicing in Canada" which he attributes to "ageism in medical education".
Well, I have news for you. As a result of having been a patient of a variety of doctors during the last year I can claim to be an expert in assessing how their lack of geriatric training affected the quality of my treatment. I claim that it was their clinical expertise in their specialties,which included cardiology, infectious diseases, urology,and rheumatology as well as Family Medicine, called General Practice in my previous life, which provided them with the knowledge to order effective treatment.
Similarly,I experienced excellent professional attention by members of related disciplines, such as nurses, physiotherapists,paramedics, even firefighters who were the first to arrive when a call for an ambulance was made to 911!
Now that I am back to "normal", whatever that normal may be, the rest is up to me. I feel that is where education is needed most, to make potential patients responsible for their own health, teach them how to use their own abilities instead of letting others do things they should be able to do themselves. That will sometimes bring them into conflict with their loved ones, but conflict can bring out the best of us, no matter the age!
Hans F. Reichenfeld, MB BS FRCPC
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (17 April 2012)
Page navigation anchor for Four score and ten
Four score and ten
Hans F. Reichenfeld, Psychiatrist - Retired
In 1970 (Is it really that long ago?) I was slowly, ever so slowly, winding my way through the residency program that would eventually help me satisfy the examiners of the Royal College who would then allow me to call myself a psychiatrist. Part of the program consisted of giving a presentation at a seminar. As a natural rat pack I retained my contribution which was called "AGEING". The contents of my essay were wide ran...
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In 1970 (Is it really that long ago?) I was slowly, ever so slowly, winding my way through the residency program that would eventually help me satisfy the examiners of the Royal College who would then allow me to call myself a psychiatrist. Part of the program consisted of giving a presentation at a seminar. As a natural rat pack I retained my contribution which was called "AGEING". The contents of my essay were wide ranging. I commented on the fact that "the mean expectation of life at birth in England and Wales began to exceed childbearing age a mere 90 years ago (i.e. 1880 - HFR). Were I to look at the current expectation of life in the older and oldest age groups I would have to acknowledge the impact of effective treaments for numerous disorders previously considered untreatable.
As I am within months of reaching the age of four score and ten I look upon myself more as a patient than a physician. When I see the call by Nathan Stall "...to end ageism in medical education" I have to ask myself how "the crucial deficiency of geriatricians practicing in Canada" has affected me as a patient. As a result of having carried out intensive qualitative research with a sample of one I concluded that the lack of a geriatric teaching program during their formative years has not caused me to be exposed to inadequate treatment by physicians, nurses, physiotherapists, paramedics or firefighters connected with the ambulance services. They all approached their tasks with appropriate detachment and consummate skill. Although I was sometimes taken aback by the proliferation of advanced technological tests, I was reassured by the fact that the methods of clinical examination had not changed significantly since the days I myself was a medical student some 70 years ago. They had obviously stood the test of time.
However, what I feel is sadly lacking is a universal teaching program aimed at keeping the population healthy, rather than merely treating us when we are sick. True, there are patchy efforts aimed at disease prevention carried out in different centres by a variety of organizations too numerous to list, but I feel they should be coordinated to include the whole population, from the youngest age groups to the oldest. Health promotion in its many sided aspects affects us all!
Conflict of Interest:
None declared
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Competing Interests: None declared.
Posted on: (12 April 2012)
Page navigation anchor for Time to end ageism in medical education
Time to end ageism in medical education
Gerald E. Sinclair, physician (internist)
As an 83 year old, retired physician, I presume that I qualify as a member of Canadian society potentially in danger of ageism, a term coined by Dr. Robert Butler, the founder of Gerontology in America. However, I have not experienced any of the problems so forcefully outlined by Nathan Stall.
Yet my health has certainly deteriorated, with advancing Parkinsonism, bouts of paroxysmal atrial fibrillation, bilater...
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As an 83 year old, retired physician, I presume that I qualify as a member of Canadian society potentially in danger of ageism, a term coined by Dr. Robert Butler, the founder of Gerontology in America. However, I have not experienced any of the problems so forcefully outlined by Nathan Stall.
Yet my health has certainly deteriorated, with advancing Parkinsonism, bouts of paroxysmal atrial fibrillation, bilateral cataract surgery, and hospitalization 2 years ago for hemicolectomy for a malignant polyp. My medical care throughout has been excellent, provided by family physicians,and a variety of independent specialists including a couple of psychiatrists, internists, a neurologist, a gastroenterologist and a general surgeon. Never a hint of ageism, from anyone, even remotely involved in my care.
Accordingly, if the spectre of ageism has indeed begun to infiltrate medical education, it is certainly time to end it! A time comes in every life where a gentle touch of therapeutic nihilism may be appropriate. Geriatrics perhaps, but not necessarily geriatrics.
Conflict of Interest:
None declared
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Competing Interests: None declared.