Mapping the 5Ms: Identifying Gaps in a Geriatric Medicine Curriculum at a U.S. Medical School

A strong foundation in the care of older adults is crucial for caring for the growing aging population. While residency training curricula in geriatric medicine are well-studied, data on undergraduate medical education curricula are limited. This study compares the Minimum Geriatrics Competencies for Graduating Medical Students (which follows the 5Ms framework) to the geriatrics curriculum taught at the University of Missouri-Columbia School of Medicine.

Using the school's curriculum map, we identified curricular elements through a keyword search utilizing 5 M (Mobility, Mind, Medications, Multicomplexity, Matters Most) concepts. We used structured interviews or email surveys of directors to confirm which elements are covered, perceptions of how well the content is covered, and the perceived need for more age-related content. Identified curricular elements were categorized into the 27 5Ms subcategories.

The four-year curriculum at least partially addressed all 27 subcategories. Many of the topics are covered sparingly, including deprescribing, aging physiology, and frailty. Clerkship directors' perceptions of how well the 5Ms are taught are more favorable than those of pre-clerkship directors, although clerkship directors were more likely to report a greater need for age-related content.

The majority of the 5Ms are covered in the curriculum, though notable gaps remain in several subcategories. Recommendations include strengthening preclinical exposure to concepts students will encounter in clinicals, such as pharmacology and delirium. This is the first known published study to explicitly identify how the 5Ms are covered in a U.S. undergraduate medical school curriculum.