Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T15:57:59.166Z Has data issue: false hasContentIssue false

Geriatric psychiatry education in Canada: the pathway to subspecialty recognition

Published online by Cambridge University Press:  18 May 2010

Melissa H. Andrew*
Affiliation:
Division of Geriatric Psychiatry, Queen's University, Kingston, Ontario, Canada
Catherine Shea
Affiliation:
Division of Geriatric Psychiatry, University of Ottawa, Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
*
Correspondence should be addressed to: Melissa H. Andrew, Assistant Professor, Division of Geriatric Psychiatry, Queen's University, Unit 2-640 Cataraqui Woods Drive, Kingston, ON, CanadaK7P 2Y5. Phone: +1 613-384-9088; Fax: +1 613-384-6107. Email: andrewm@queensu.ca.

Abstract

Background: This paper outlines the evolution of the training of Canadian physicians and other professionals in the mental health care needs of older adults over the past 2 decades, which has culminated in long-awaited subspecialty recognition by the Royal College of Physicians and Surgeons of Canada (RCPSC). Despite the fact that Canada has more than 4000 psychiatrists officially recognized by RCPSC, and a national body of more than 200 members who practice primarily in geriatric psychiatry, the status of geriatric psychiatry as a subspecialty of psychiatry in Canada remained “unofficial” until 2009.

Methods: Early along the pathway toward subspecialization, Canadian educational efforts focused on enhancing the capacity of primary care physicians and other mental health professionals to meet the mental health needs of older adults. Over the past decade, and with the encouragement of RCPSC, Canadian psychiatric educators have carefully and collaboratively defined the competencies necessary for general psychiatrists to practice across the life span, thereby influencing the psychiatry training programs to include dedicated time in geriatric psychiatry, and a more consistently defined training experience.

Results: With these two important building blocks in place, Canadian psychiatry was truly ready to move ahead with subspecialization. Three new psychiatric subspecialties – geriatric, child and adolescent, and forensic – were approved at the RCPSC in September 2009.

Conclusions: The developments of the past 20 years have paved the way for a subspecialty geriatric psychiatry curriculum that will be well-aligned with a new general psychiatry curriculum, and ready to complement the existing mental health work force with subspecialized skills aimed at caring for the most complex elderly patients.

Type
Special Issue Articles
Copyright
Copyright © International Psychogeriatric Association 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Camus, V. et al. (2003). Teaching and training in old age psychiatry: a general survey of the world psychiatric organization member societies. International Journal of Geriatric Psychiatry, 18, 694699.Google Scholar
Canadian Coalition for Seniors’ Mental Health (CCSMH) (2006a). National guidelines for seniors’ mental health: the assessment and treatment of depression, Available at: http://www.ccsmh.ca/en/natlGuidelines/depression.cfm.Google Scholar
Canadian Coalition for Seniors’ Mental Health (CCSMH) (2006b). National guidelines for seniors’ mental health: the assessment and treatment of mental health issues in long term care (focus on mood and behavioural symptoms). Available at: http://www.ccsmh.ca/en/natlGuidelines/ltc.cfm.Google Scholar
Canadian Coalition for Seniors’ Mental Health (CCSMH) (2006c). National guidelines for seniors’ mental health: the assessment of suicide risk and prevention of suicide. Available at: http://www.ccsmh.ca/en/natlGuidelines/suicide.cfm.Google Scholar
Canadian Coalition for Seniors’ Mental Health (CCSMH) (2006d). National guidelines for seniors’ mental health: the assessment and treatment of delirium. Available at: http://www.ccsmh.ca/en/natlGuidelines/delirium.cfm.Google Scholar
Carraccio, C., Wolfsthal, S. D., Englander, R., Ferentz, K. and Martin, C. (2002). Shifting paradigms: from Flexner to competencies. Academic Medicine, 77, 361367.Google Scholar
Charcot, J. M. (1881). Clinical Lectures on the Diseases of Old Age. New York: William Wood and Company.Google Scholar
Cole, M. G. (1999). Progress in geriatric psychiatry in Canada. International Psychogeriatrics, 11, 359362.Google Scholar
Draper, B., Brodaty, H. and Low, L. (2006). A tiered model of psychogeriatric service delivery: an evidence-based approach. International Journal of Geriatric Psychiatry, 21, 645653.Google Scholar
Frank, J. R. et al. (eds.) (2005). Report of the CanMEDS Phase IV Working Groups. Ottawa: The Royal College of Physicians and Surgeons of Canada. Available at: http://rcpsc.medical.org/canmeds/CanMEDS2005/index.php.Google Scholar
Herrmann, N. (2004). Geriatric psychiatry in Canada: a subspecialty whose time has come. Canadian Journal of Psychiatry, 49, 415416.Google Scholar
Herrmann, N., Shulman, K. I. and Silver, I. L. (1992). Intensive early exposure to geriatric psychiatry in residency training: impact on career choice and practice. Canadian Journal of Psychiatry. 37, 549552.Google Scholar
Kates, N., Ackerman, S., Crustolo, A. M. and Mach, M. (2006). Collaboration Between Mental Health and Primary Care Services: A Planning and Implementation Toolkit for Health Care Providers and Planners. Mississauga, Ontario: Canadian Collaborative Mental Health Initiative (CCMHI). Available at: http://www.ccmhi.ca/en/products/toolkits/providers.htm.Google Scholar
LeClair, J. K. and Sadavoy, J. (1998). Geriatric psychiatry subspecialization in Canada: past, present and future. Canadian Journal of Psychiatry, 43, 681687.Google Scholar
Lieff, S. J., Andrew, M. H. and Tiberius, R. (2004). Community psychiatrists who see geriatric patients: what's training got to do with it? Academic Psychiatry, 28, 2733.Google Scholar
Lieff, S. J., Kirwin, P. and Colenda, C. C. (2005). Proposed geriatric psychiatry core competencies for subspecialty training. American Journal of Geriatric Psychiatry, 13, 815821.Google Scholar
PIECES Consult Group: Hamilton, P., Harris, D., Le Clair, K. and Collins, J. (2008). Putting the P.I.E.C.E.S.(tm) Together: A Model for Collaborative Care and Changing Practice. A Learning Resource for Professionals Providing Long-Term Care to Older Adults with Complex Physical and Cognitive/Mental Health Changes. (6th edn, revised). Tillsonburg, Ontario: Shopforlearning Publishers. More information available at: www.piecescanada.ca.Google Scholar
Royal College of Physicians and Surgeons of Canada (RCPSC) (2006). Objectives of Training and Specialty Training Requirements in Psychiatry 2005. Ottawa: Royal College of Physicians and Surgeons of Canada.Google Scholar
Royal College of Physicians and Surgeons of Canada (RCPSC) (2007a). Objectives of Training in Psychiatry. Ottawa: Royal College of Physicians and Surgeons of Canada. Available at: http://rcpsc.medical.org/information/index.php?specialty=165&submit=Select.Google Scholar
Royal College of Physicians and Surgeons of Canada (RCPSC) (2007b). Specialty Training Requirements in Psychiatry. Ottawa: Royal College of Physicians and Surgeons of Canada. Available at: http://rcpsc.medical.org/information/index.php?specialty=165&submit=Select.Google Scholar
Shea, C. and Andrew, M. (2009). Geriatric psychiatry. In Leverette, J., Hnatko, G. and Persad, E. (eds.), Approaches to Postgraduate Education in Psychiatry in Canada: What Educators and Residents Need to Know (pp. 127138). Ottawa: Canadian Psychiatric Association.Google Scholar
Thorpe, L., LeClair, J. K., Donnelly, M. and MacBeath, L. (1993). Geriatric psychiatry: training guidelines and their application. Canadian Journal of Psychiatry, 38, 9095.Google Scholar
World Health Organization (WHO) (1996). Psychiatry of the Elderly: A Consensus Statement. Geneva: WHO. Available at: http://www.who.int/mental_health/media/en/17.pdf.Google Scholar