Europe's Demographic Shift Demands Robust Geriatric Expertise
Europe is undergoing a profound demographic transformation, with the number of people aged 65 and older projected to reach 151 million by 2050, representing nearly one in four residents. This aging population brings complex health challenges, including multimorbidity, frailty, and geriatric syndromes like falls and delirium. A groundbreaking study published on April 15, 2026, in Age and Ageing titled 'Mapping the landscape of geriatric medicine education, training and practice in Europe' provides the most comprehensive overview to date, surveying 38 European countries to assess the readiness of higher education institutions and training programs.
Conducted under the COST Action PROGRAMMING CA21122, the research highlights significant progress but also stark disparities. Led by experts from Jagiellonian University Medical College and collaborators across the continent, it reveals that geriatric medicine (GM), the branch of medicine focused on improving health in older adults through comprehensive geriatric assessment (CGA)—a holistic evaluation of physical, cognitive, and social needs—is recognized as a distinct specialty in 63% of countries, primarily in Northern and Western Europe.
Undergraduate Foundations: Integrating Geriatrics into Medical Schools
Across European universities, principles of geriatric medicine are embedded in undergraduate curricula for medical students in 95% of countries, marking a strong commitment to early exposure. Institutions like University College London (UCL) and Karolinska Institutet lead with dedicated modules on frailty and polypharmacy management, where polypharmacy refers to the use of multiple medications increasing risks like adverse drug events.
In Northern Europe, such as Sweden and Denmark, nearly all medical schools mandate geriatric rotations, often spanning weeks in acute care settings. Southern Europe lags, with only 42% full integration, though progress is evident at universities like the University of Barcelona. For nursing students, coverage reaches 97%, with programs at Germany's Charité – Universitätsmedizin Berlin emphasizing interprofessional care. Allied health professionals (AHPs), including physiotherapists and occupational therapists, see 82% inclusion, but gaps persist in practical training.
The 2014 European undergraduate curriculum, developed via Delphi consensus by the European Union Geriatric Medicine Society (EuGMS), outlines core competencies like ethical decision-making and rehabilitation. Updated efforts by EuGMS's Special Interest Group (SIG) on Education ensure alignment, fostering graduates equipped for aging societies.
Postgraduate Training: Pathways to Specialization
Postgraduate geriatric training, averaging 5.7 years, is available in 55% of countries, with mandatory clinical rotations in geriatrics wards averaging 35 months. Leading programs at the University of Edinburgh and Leiden University align closely with the 2025 European Training Requirements (ETR) from the Union Européenne des Médecins Spécialistes (UEMS)-Geriatric Medicine Section, mandating competencies in CGA, deprescribing (reducing unnecessary medications), and multidisciplinary team leadership.
In the UK, the British Geriatrics Society's curriculum integrates research and quality improvement, while France's Fédération des Polycliniques et Cliniques Privées emphasizes subspecialties like orthogeriatrics. Eastern Europe's programs, such as in Poland's Jagiellonian University, are expanding rapidly, though research components lag at 25% inclusion versus 75% elsewhere. The ETR recommends the European Geriatric Medicine Specialty Exam (EGeMS) for standardization, piloted to ensure mobility under EU Directive 2005/36/EC.
Continuous medical education (CME) courses thrive in 61% of countries, with EuGMS congresses and online platforms bridging gaps.
Interprofessional Education: Nurses and Allied Health in Focus
European colleges prioritize interprofessional education, recognizing that geriatric care requires teams. Nursing programs at KU Leuven in Belgium cover GM principles comprehensively, including delirium screening tools like the Confusion Assessment Method (CAM). AHP training at the University of Southern Denmark integrates falls prevention and cognitive rehab, vital as Europe's over-80 population doubles by 2050.
Challenges include uneven advanced practitioner roles; only 24% have GM-specific postgraduate paths for nurses. Initiatives like Geriatrics for Juniors (G4J), scaled Europe-wide by EuGMS, train early-career professionals collaboratively.
Research Hubs: Europe's Forefront in Geriatric Innovation
Research is integral to training in 62% of specialty programs, fueling breakthroughs at top institutions. UCL's Institute of Cardiovascular Science leads in frailty biomarkers, while Karolinska's Aging Research Center pioneers multimorbidity models. King's College London excels in longitudinal studies via the Survey of Health, Ageing and Retirement in Europe (SHARE), tracking 150,000+ over-50s across 28 countries. Explore SHARE data.
Funding streams from Horizon Europe Cluster 1 (Health) support projects like SmILE for smart implants in elderly care (€ several million). Despite this, Eastern Europe trails, underscoring the need for pan-European grants. Scimago rankings place UCL, Karolinska, and KCL atop gerontology research.
Country Variations: From Leaders to Emerging Hubs
Northern Europe shines: 89% specialty recognition, wards in all countries. Sweden's Karolinska offers model 5-year training; the Netherlands' Leiden integrates community geriatrics. Western Europe's UK boasts robust wards (73% Europe-wide) and research at Oxford. Southern Europe's Italy and Spain advance via EuGMS, but only 42% integration. Eastern Poland and Romania build via PROGRAMMING COST surveys.
| Region | Specialty Recognition (%) | GM Wards (%) |
|---|---|---|
| Northern | 89% | 100% |
| Western | 71% | 86% |
| Eastern | 80% | 60% |
| Southern | 42% | 58% |
No services in 8 countries, mostly Southern.
Persistent Challenges: Shortages and Heterogeneity
Despite advances, specialist shortages loom, with 1/3 doctors over 55 retiring soon (Eurostat). GM attracts few due to workload perceptions; only 55% training availability exacerbates this. Heterogeneity hampers mobility; curricula align with ETR in just 29%.Review ETR details.
Aging workforce strains systems; WHO predicts 1M health worker gap by 2030. PROGRAMMING identifies unmet needs via focus groups, urging ICT for remote training.
Harmonization Initiatives: EuGMS and Beyond
EuGMS SIG Education drives surveys and G4J expansion. COST PROGRAMMING maps needs, co-creates courses for ambulatory/long-term care. UEMS ETR 2025 standardizes via CanMEDS competencies. Horizon Europe funds interdisciplinary projects.EuGMS Education SIG.
Spotlight on Leading Institutions
- UCL (UK): Top-ranked, frailty clinics, SHARE hub.
- Karolinska (Sweden): Aging Research Center, global leader.
- University of Zurich (Switzerland): Robust wards, research in longevity.
- Jagiellonian (Poland): Emerging leader, study lead.
- University of Barcelona (Spain): Orthogeriatrics excellence.
Future Directions: Building a Unified Framework
The study recommends EU-wide standards, dedicated wards, and policy integration for over-65s. Universities must amplify research, attract trainees via incentives. With Horizon 2026-2027 health calls (€ billions), collaborative projects can scale innovations.
By harmonizing curricula and boosting academic posts, Europe's higher education can meet the geriatric imperative, ensuring quality care amid demographic pressures.
