As the world’s older population grows faster than any other age group, a critical gap is widening between the healthcare needs of aging patients and the training that most medical graduates actually receive. The International Association of Gerontology and Geriatrics is stepping forward to address this head-on, issuing a formal call to action urging medical schools across every region of the world to adopt a unified, competency-based framework for geriatric education.
The appeal is grounded in an uncomfortable reality: in many countries, a physician can graduate from medical school having spent fewer than a handful of hours studying the complexities of aging. Yet within the next two decades, one in six people on the planet will be over 60 years old. The mismatch between supply and need has become impossible to ignore.
A Global Aging Crisis Demands a Global Response
According to the World Health Organization, the number of people aged 60 years and over will reach 2.1 billion by 2050 — more than double the figure recorded in 2020. Low- and middle-income countries are aging especially rapidly, and in many of these regions, the shortage of trained geriatric professionals is most severe.
Older adults typically present with multiple coexisting conditions — polypharmacy, cognitive decline, frailty, falls risk, and complex psychosocial needs — that require clinical reasoning and patient management skills not well covered by standard adult medicine curricula. When these skills are absent, the consequences ripple outward: avoidable hospitalizations, inappropriate prescribing, premature institutionalization, and a lower quality of life for patients who deserve better.
The International Association of Gerontology and Geriatrics has been at the forefront of advocating for aging-related research, clinical practice, and policy since 1950. This latest initiative builds on decades of that foundational work, translating evidence into a concrete demand for systemic educational reform.
The Current State of Geriatric Training: A Patchy Picture
Despite widespread acknowledgment of the problem, the integration of geriatrics into undergraduate medical education remains inconsistent at best. Surveys conducted across medical institutions in Europe, North America, Asia, Africa, and Latin America reveal striking disparities — not only between continents, but often within the same country.
Some of the most common gaps identified include:
- No dedicated geriatrics rotation in the clinical years
- Geriatric content embedded in general internal medicine without specific learning objectives
- Limited exposure to community-based or long-term care settings
- Absence of assessment tools that test geriatric competence specifically
- Faculty with insufficient geriatric training to teach the subject confidently
- Curricula that treat older patients as an afterthought rather than a primary focus
In some high-income nations, geriatrics is taught as an elective rather than a mandatory subject. In several low-income countries, there may be no geriatricians at all to serve as role models or educators. The International Association of Gerontology and Geriatrics IAGG recognizes that no single solution fits all contexts — but argues convincingly that baseline standards must exist everywhere.
Regional Comparison: Geriatrics in Medical Curricula
| Region | Mandatory Geriatrics Module | Dedicated Clinical Rotation | Specialist Faculty Available |
|---|---|---|---|
| North America | Varies by institution | Often optional | Mostly available |
| Western Europe | Increasingly common | Growing adoption | Generally available |
| Eastern Europe | Inconsistent | Rare | Limited |
| Asia-Pacific | Inconsistent | Emerging in some countries | Variable |
| Sub-Saharan Africa | Largely absent | Very rare | Scarce |
| Latin America | Emerging | Limited | Growing but insufficient |
What Standardization Would Look Like: The IAGG Framework
Rather than prescribing a one-size-fits-all curriculum, IAGG is advocating for a core competency framework that medical schools can adapt to their national context, healthcare system, and available resources. The framework identifies essential knowledge areas, clinical skills, and professional attitudes that every graduating physician should possess — regardless of their intended specialty.
The proposed core competencies fall across five domains:
1. Biomedical and Clinical Knowledge
Graduates should understand how aging changes physiology, pharmacokinetics, and disease presentation. This includes recognizing atypical symptom patterns in older patients, understanding frailty as a clinical syndrome, and managing the particular challenges of polypharmacy.
2. Comprehensive Geriatric Assessment
Comprehensive Geriatric Assessment (CGA) is the cornerstone of quality geriatric care. Medical students should learn to perform functional assessments, cognitive screening, nutritional evaluations, and social history-taking as structured skills — not improvised afterthoughts.
3. Person-Centered Communication
Effective communication with older patients, including those with hearing loss, cognitive impairment, or limited health literacy, is a distinct skill. Equally important is the ability to involve family members and caregivers appropriately while preserving the patient’s autonomy and dignity.
4. Ethics and Decision-Making
End-of-life care, advance care planning, capacity assessments, and decisions around life-prolonging treatment are among the most complex situations in medicine. Future physicians need structured education in how to navigate these ethically and legally — with compassion.
5. Interprofessional and Systems-Based Practice
Older adults rarely benefit from siloed, single-specialty care. Medical graduates should understand how to function within multidisciplinary geriatric teams — alongside nurses, social workers, physiotherapists, pharmacists, and occupational therapists — and how to coordinate care across hospital, community, and long-term care settings.
Why Medical Schools Have Been Slow to Adapt
Despite the demographic pressure, curricular reform in medicine is notoriously difficult. Medical school programs are typically dense, with competing demands for time from every specialty. Geriatrics, which lacks the procedural prestige of surgery or the diagnostic drama of emergency medicine, has historically struggled to secure space in packed timetables.
Several structural barriers have contributed to the slow pace of change:
- Faculty shortages: Many institutions simply do not have enough trained geriatricians to lead a robust teaching program.
- Attitudinal barriers: Negative stereotypes about aging — among both students and faculty — can diminish the perceived value of geriatric training.
- Lack of regulatory pressure: In the absence of accreditation requirements, institutions have little external incentive to prioritize geriatric content.
- Funding constraints: Developing new curricula, training educators, and building clinical teaching sites all require investment that is not always forthcoming.
The International Association of Gerontology and Geriatrics argues that these are not reasons to defer reform — they are precisely the reasons reform must be coordinated at the international level, where shared resources, shared models, and shared advocacy can make a larger impact than institution-by-institution efforts.
Collaborative Partnerships: Who Needs to Act
IAGG’s call to action is directed not only at medical schools but at the full ecosystem of stakeholders that shapes what doctors learn. Lasting change requires simultaneous action from multiple actors.
| Stakeholder | Expected Role |
|---|---|
| Medical School Deans & Curriculum Committees | Integrate geriatric competencies into core curricula and assessment frameworks |
| National Medical Councils & Licensing Bodies | Establish geriatric competency requirements for graduation and licensure |
| Accreditation Agencies | Include geriatric education standards in institutional accreditation criteria |
| Health Ministries & Governments | Fund geriatric workforce development and mandate training standards |
| Teaching Hospitals & Nursing Homes | Provide clinical placements and mentorship in geriatric settings |
| International Academic Societies | Share best practices, curricula, and faculty development resources globally |
International Association of Gerontology and Geriatrics IAGG member organizations span more than 70 countries, giving the association a uniquely positioned network to facilitate these collaborations. National geriatric societies affiliated with IAGG are being encouraged to engage directly with their respective accreditation bodies and health ministries to advocate for formal curriculum reform.
Lessons from Pioneering Models
A number of countries have already made meaningful progress, and their experiences offer valuable lessons for the rest of the world.
In the United Kingdom, the British Geriatrics Society has worked with the General Medical Council to ensure that aging-related competencies are embedded throughout undergraduate training. In Australia, the Australian and New Zealand Society for Geriatric Medicine has developed specific learning outcomes for medical students and supported simulation-based teaching in aged care environments. In Japan — which has one of the oldest populations on earth — geriatrics has been woven into national medical licensing examinations.
These models are not perfect, and no single approach translates cleanly from one healthcare system to another. But they demonstrate that progress is achievable when professional societies, regulators, and educators align around shared goals — precisely the kind of alignment that the International Association of Gerontology and Geriatrics is working to catalyze on a global scale.
Technology as an Equalizer
One area of particular opportunity lies in digital education. In regions where geriatric specialists are scarce, online learning platforms, virtual clinical simulations, and international faculty exchanges can help fill the gap. IAGG is exploring how its global network can support the development and distribution of high-quality, open-access teaching materials in multiple languages.
Simulation-based training — using case scenarios that replicate the complexity of caring for frail older patients — has shown promise in improving students’ confidence and competence even before they enter clinical settings. Expanding access to these tools in under-resourced institutions could accelerate progress significantly.
Looking Ahead: IAGG’s Roadmap for Reform
The International Association of Gerontology and Geriatrics has outlined a phased approach to advancing this initiative over the next five years:
- Phase 1 (2025–2026): Conduct a comprehensive global audit of current geriatric content in medical school curricula across all member nations.
- Phase 2 (2026–2027): Publish a formal IAGG consensus framework for undergraduate geriatric competencies, developed with input from medical educators, clinicians, patient advocates, and policymakers.
- Phase 3 (2027–2028): Launch a faculty development program to train medical educators in geriatric teaching methods, with particular emphasis on low- and middle-income countries.
- Phase 4 (2028–2030): Support pilot institutions in implementing the framework, gather outcome data, and refine recommendations based on real-world experience.
Progress reports will be presented at the World Congress of Gerontology and Geriatrics, the flagship scientific event convened by IAGG, ensuring ongoing accountability and global visibility for the initiative.
Conclusion: An Obligation to Future Generations of Patients
The mathematics of global aging are unambiguous. Within the lifetimes of today’s medical students, older adults will constitute a dominant share of every clinical practice — in every specialty, in every country. The physicians who graduate without adequate geriatric training are not just personally underprepared; they represent a systemic risk to the health systems that will depend on them.
The International Association of Gerontology and Geriatrics is clear that standardizing geriatric education is neither a niche agenda nor a specialty-specific concern. It is a fundamental pillar of preparing medicine for the world it is actually going to face.
Reform of this scale is never simple. It requires sustained political will, meaningful investment, and the kind of cross-border cooperation that the International Association of Gerontology and Geriatrics IAGG is uniquely positioned to facilitate. The organization has extended an open invitation to medical schools, professional bodies, governments, and civil society partners to engage with this initiative — and to help build a global healthcare workforce genuinely equipped to care for aging populations with skill, dignity, and humanity.
Because in the end, the quality of care that tomorrow’s older patients receive depends almost entirely on the quality of training that today’s medical students are given.