A focus on subspecialty certification
By Gregory James, DO, MPH, FACOFP dist., AOBFP Immediate Past Chair, and Katherine E. Galluzzi, DO, FACOFP dist., AOBFP Director
Physicians certified through the American Osteopathic Board of Family Physicians (AOBFP) are eligible to earn a subspecialty certification in the following subspecialties:
- Addiction Medicine
- Correctional Medicine
- Geriatric Medicine
- Hospice & Palliative Care Medicine
- Pain Medicine
- Sleep Medicine
- Sports Medicine
- Undersea & Hyperbaric Medicine
In this issue, we are highlighting the importance of Geriatric Medicine certification. The AOBFP administers subspecialty Geriatric Medicine certification exams and osteopathic continuous certification (recertification) examinations.
One of the most significant demographic shifts in the U.S. is the rapid growth of the population over the age of 65, which is projected to reach 73 million by 20301—a number which, it has been speculated, may mean that there are more older persons on earth now than have ever existed throughout history. While this “silver tsunami” has been anticipated for decades, the number of physicians specializing in geriatrics has not kept pace with the wave.
Geriatric board certification signifies a physician’s advanced knowledge and expertise in caring for older adults. Certification ensures a physician’s ability to diagnose and manage complex, age-related medical conditions, leading to improved patient outcomes and greater credibility with both patients and employers. Geriatric board certification reflects a commitment to lifelong learning and maintaining high professional standards within the field of geriatrics.
Board-certified geriatricians approach the care of an older adult from the perspective of the five M’s: mind, mobility, medications, multi-complexity and what matters most.2 This holistic approach promotes comprehensive management of multiple chronic conditions with consideration of cognitive and physical functional limitations as well as psychosocial factors impacting well-being. Geriatricians are trained to consider the needs of the whole person and focus on function and quality of life. Some geriatricians routinely make home visits to see how a patient lives and what modifications could improve safety, nutrition, function and mobility. They recognize the importance of including family members and other caregivers in medical appointments and coordinating care with specialists.
Medication management is a crucial aspect of geriatric care. Older adults frequently take multiple prescriptions, increasing the risk of drug interactions and adverse effects; they are especially vulnerable to side effects because their bodies process drugs differently than younger people do. Even over-the-counter medications or supplements can be problematic, and the effects can be cumulative. Up to 10% of hospital admissions in older adults are due to adverse drug reactions, but up to half of these events are preventable. That is why it’s essential to monitor possible drug interactions and to calibrate pain medications carefully. Unfortunately, physicians without specialized training in geriatric medicine may dismiss signs of adverse drug reactions such as dementia, depression or other issues typically associated with aging. Geriatricians have the focused, specialized expertise to evaluate an individual’s medications and recommend changing or stopping certain drugs to optimize patient safety.
For health care professionals, geriatric board certification can lead to increased career opportunities and open doors to specialized roles in geriatric medicine. These include medical directorships, staff privileges in nursing homes, assisted living facilities and/or in specialized geriatric clinics, such as memory centers. Many health care organizations value board certification when hiring and promoting clinicians, particularly in settings where geriatric care is a major focus. Maintaining board certification requires ongoing education and annual assessments; these ensure board-certified geriatricians stay updated with the latest advancements in geriatric medicine. Your certification can be used by yourself and your company to promote your practice.
Geriatric certification demonstrates a higher level of expertise and commitment to the field, potentially leading to increased referrals from other health care providers and patients seeking specialized geriatric care.3 Most importantly, in surveys of multiple specialties, geriatricians have consistently endorsed the highest levels of professional satisfaction. Geriatric board certification not only benefits older adults but also enriches the careers of the physicians dedicated to their care.
Confirm board eligibility
Eligible candidates must:
- Hold active AOA primary certification in family medicine or family medicine/OMT.
- Complete an AOA-approved/ACGME-accredited fellowship training program in geriatric medicine, OR be on track to complete an AOA-approved/ACGME-accredited fellowship in the same year of the spring exam administration.
Exam content areas
The Geriatric Medicine Written Exam is offered once per year in the spring. The application period opens six to eight months prior to the exam date. There are 200 single answer multiple-choice questions on the Geriatric Medicine exam. Exam content includes Allergy, Immunology & Rheumatology; Cardiology & Pulmonology; Dermatology; EENT; Emergency Medicine; Endocrinology; Gastroenterology; Hematology & Oncology; Infectious Disease; Nephrology & Urology; Neurology; Orthopedic & Musculoskeletal Medicine; Osteopathic Principles and Practice; Palliative Care; Population Health; Psychiatry; and Women’s Health.
References
- America Counts Staff. Census will help policymakers prepare for the incoming wave of aging boomers. United States Census Bureau. 2019. https://www.census.gov/library/stories/2019/12/by-2030-all-babyboomers-will-be-age-65-or-older.html.
- Monette PJ, and Schwartz AW. Optimizing medications with the geriatrics 5Ms: an age-friendly approach. Drugs & Aging 2023; 40:391-396. http://doi.org?10.1007/s40266-023-01016-6.
- Why choose a geriatrician? – Harvard Health; accessed Feb. 1, 2025