Structural ageism in health professional education: A Brazilian case with global implications

Ageism remains a pervasive yet underexamined form of discrimination within health professions education. This narrative review develops a typology of educational ageism comprising three interrelated dimensions: curricular ageism, reflected in the omission or tokenistic inclusion of geriatrics and gerontology; institutional-structural ageism, expressed through organizational priorities, resource allocation, and policy frameworks that devalue aging-related care; and perceptual ageism, reflected in student attitudes shaped by professional socialization and the hidden curriculum. Grounded in the Brazilian context and informed by international literature, the typology illustrates how educational systems may marginalize aging-related knowledge and discourage specialization in fields serving older adults. Guided by Critical Gerontology and Freirean pedagogy, the analysis identifies recurring interactions among stereotypes, curricular gaps, and institutional priorities. Across settings, common patterns include limited and fragmented exposure to aging, insufficient training incentives, variable effects of educational interventions, and the lower professional status assigned to aging-related practice. Positive explicit attitudes may also coexist with limited knowledge, implicit bias, and low interest in careers involving older adults. Proposed reforms include integrating gerontology across core curricula, expanding interprofessional education, providing longitudinal contact with diverse older adults, and strengthening institutional investment in aging expertise. The typology offers a framework for understanding and addressing ageism across health professions education systems.