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GERIATRIC MEDICINE ACROSS COUNTRIES: SPECIALISED WORKFORCE, TRAINING AND SYSTEM INTEGRATION CHALLENGES

Matteo Cesari, Jotheeswaran Amuthavalli Thiyagarajan, Antonio Cherubini, Theresa Diaz, Marina Kotsani, Teena Kunjumen, Tahir Masud, John W Rowe, Ritu Sadana, Mirko Petrovic, Representatives from 48 National Geriatric Societies

BACKGROUND: The development and integration of geriatric medicine into national health care systems vary widely across countries. While a robust care workforce requires providers from several disciplines, including nursing, social sector, rehabilitation, psychiatry, neurology, and others, a strong core of highly qualified geriatricians is essential to delivering older person-centred and integrated care. The number and professional profile of geriatricians, along with the status of the specialty, are important to informing efforts to reshape health care systems in response to the global ageing scenario. METHODS: WHO developed and distributed a structured questionnaire to representatives of national geriatrics and gerontology societies beginning in March 2025. The survey collected data on the status of the geriatric medicine specialty, including its formal recognition at the country level, the estimated number of practising geriatricians, and information on training curricula, professional environments, and systemic challenges. RESULTS: A total of 48 national societies completed the survey. Recognition of geriatric medicine ranged widely, from full specialty status in some countries to subspecialty or non-recognition in others. The number of practicing geriatricians per 100,000 persons aged 60 years and older ranged from <0.1 to >30 across countries, illustrating marked workforce disparities and some severe shortages. Where the geriatric medicine specialty is formally available, pre-service training durations ranged from 24 to 96 months. Geriatricians worked in diverse settings, though integration into primary care and public health was limited. Training in and exposure to geriatric medicine principles during undergraduate and postgraduate medical training were minimal in many countries. Key challenges included workforce shortages, fragmentation of care, and undervaluation of the speciality’s role in informing health care for older people. Strategic priorities reported by respondents included investment in training, policy development, and institutional support. CONCLUSIONS: The survey highlights disparities in geriatric medicine across countries and identifies several challenges and priorities. Strengthening education, policy, and workforce development is essential to meet the needs of ageing populations and support healthy ageing worldwide. At the same time, countries should also think of innovative approaches and building capacity of existing other health occupations to improve geriatric care. Future updates of this survey will provide longitudinal insights into workforce evolution. These findings provide a global evidence base to guide workforce planning and policy under the United Nations Decade of Healthy Ageing (2021–2030).

CITATION:
Matteo Cesari ; Jotheeswaran Amuthavalli Thiyagarajan ; Antonio Cherubini ; Theresa Diaz ; Marina Kotsani ; Teena Kunjumen ; Tahir Masud ; John W Rowe ; Ritu Sadana ; Mirko Petrovic ; Representatives from 48 National Geriatric Societies (2025): Geriatric medicine across countries: Specialised workforce, training and system integration challenges. The Journal of Frailty and Aging (JFA). https://doi.org/10.1016/j.tjfa.2026.100152>