Journal of General Internal Medicine

, Volume 29, Issue 6, pp 940–946

Complexity in Graduate Medical Education: A Collaborative Education Agenda for Internal Medicine and Geriatric Medicine

  • Anna Chang
  • Helen Fernandez
  • Danelle Cayea
  • Shobhina Chheda
  • Miguel Paniagua
  • Elizabeth Eckstrom
  • Hollis Day


Internal medicine residents today face significant challenges in caring for an increasingly complex patient population within ever-changing education and health care environments. As a result, medical educators, health care system leaders, payers, and patients are demanding change and accountability in graduate medical education (GME). A 2012 Society of General Internal Medicine (SGIM) retreat identified medical education as an area for collaboration between internal medicine and geriatric medicine. The authors first determined a short-term research agenda for resident education by mapping selected internal medicine reporting milestones to geriatrics competencies, and listing available sample learner assessment tools. Next, the authors proposed a strategy for long-term collaboration in three priority areas in clinical medicine that are challenging for residents today: (1) team-based care, (2) transitions and readmissions, and (3) multi-morbidity. The short-term agenda focuses on learner assessment, while the long-term agenda allows for program evaluation and improvement. This model of collaboration in medical education combines the resources and expertise of internal medicine and geriatric medicine educators with the goal of increasing innovation and improving outcomes in GME targeting the needs of our residents and their patients.


medical education graduate assessment/evaluation geriatrics aging care transitions comorbidity 


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Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  • Anna Chang
    • 1
  • Helen Fernandez
    • 2
  • Danelle Cayea
    • 3
  • Shobhina Chheda
    • 4
  • Miguel Paniagua
    • 5
  • Elizabeth Eckstrom
    • 6
  • Hollis Day
    • 7
  1. 1.Division of Geriatrics, Department of MedicineUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Brookdale Department of Geriatrics and Palliative MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Division of Geriatric Medicine and GerontologyJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Division of General Internal Medicine, Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  5. 5.Division of General Internal MedicineSaint Louis University School of MedicineSt LouisUSA
  6. 6.Division of General Internal Medicine & GeriatricsOregon Health & Science UniversityPortlandUSA
  7. 7.Division of General Internal MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA

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