Med-Geri: A Novel Integrated Residency and Fellowship Model to Expand the Geriatrics Workforce

The demand for Geriatricians is outpacing the current supply, indicating a need for innovative workforce solutions. Early exposure and mentorship are key factors influencing trainees' decisions to pursue geriatric medicine. In response, the Med-Geri pathway, a 48-month integrated Internal/Family Medicine Residency and Geriatric Medicine Fellowship, was developed.

The Med-Geri pathway was created through national collaboration and stakeholder engagement, supported by the Association of Directors of Geriatric Academic Programs (ADGAP) and the American Geriatrics Society (AGS). A needs assessment and environmental scan culminated in application for an Accreditation Council for Graduate Medical Education (ACGME) Advancing Innovation in Residency Education (AIRE) pilot. The program was approved and launched at three initial sites in 2020.

The Med-Geri pathway integrates geriatric medicine clinical experiences, mentorship, and competency-based assessments throughout all 4 years of training. The fourth year is distinguished by enhanced professional development tailored to individual career goals. Program structures vary to reflect local strengths. Since 2020, the number of approved programs has grown from 3 to 14, with 38 trainees enrolled for the 2025-2026 academic year.

The Med-Geri pathway offers a promising strategy to address the geriatrics workforce gap. The initial experience of pilot sites indicates many benefits with high retention, increased visibility of geriatric medicine in the residency program, and development of trainees poised for leadership careers in geriatric medicine. Continued evaluation of outcomes is essential. Transitioning from an AIRE pilot to a recognized ACGME pathway is a critical next step toward national scalability and sustainability.