geriatrics in Finland

GERIATRIC MEDICINE IN FINLAND

Population

The population of Finland is about 5,4 million. The proportion of people aged 65 and over is 18 % and it is expected to rise up to 26 % by the year 2030.
Legistlation and reforms concerning older people
An act on Supporting Functional Ability of Older People and Social and Health Care Services for Older People has been under preparation in Finland and it will come into force on the 1st of July in 2013. The act aims to eg secure the quality of social and health care services for older people. The act also emphasizes the possibilities of older people themselves to take part in designing these services.
At the same time there is an ongoing process of reforming the structure for social and health care services. According to the reform, the municipalities may have in the future responsibilities of organizing a greater proportion of even specialized health care services of a defined social and health care district with a suitable population base. The reform is still under a lot of discussion.

Geriatricians in Finland

In the beginning of 2012 there were 251 physicians with a speciality in geriatric medicine of whom 239 were practising geriatricians. Of the geriatricians 168 were females. The number of geriatricians has been constantly increasing. At the moment there are 171 physicians registered as trainees in geriatric medicine in the five universities providing specialist training.
A special feature among Finnish geriatricians is that most of them work in the primary health care. In the biggest cities, many of the geriatricians work in city hospitals, which are in fact in many cases geriatric hospitals providing acute and long-term care and rehabilitation, at outpatient clinics and in home care. Geriatricians have had a key role in developing care pathways and good practice of care for memory impaired patients and many of the memory clinics are run by geriatricians and their teams.
The speciality of geriatric medicine is represented only in five of the 20 central hospitals of the hospital districts which are providing acute and specialized health care across the country. There is a clear call and need of developing geriatric services at the acute specialized hospitals given that an increasing number of older patients are treated in these hospitals

Chairs of geriatric medicine

There are chairs of geriatric medicine at all the five universities with medical faculties (Helsinki, Eastern Finland in Kuopio, Tampere, Turku and Oulu). The fifth chair of geriatric medicine was finally grounded at the university of Tampere in 2010.

Undergraduate and postgraduate training in geriatric medicine

Undergraduate training is not standardized across the country. At the moment the curriculum is in progress and the amount of undergraduate training is going to increase.
The specialist training in geriatric medicine takes five years. There is a common trunk of two years shared with general practice. Training in primary health care and hospitals are included in the trunk. The remaining three years includes two years training in geriatric medicine itself and also training in internal medicine, neurology and psychiatry (favourably in psychiatry of old age). The training for the speciality is given at health centres, university and central hospitals, nursing homes, memory clinics or other accepted places with proper guidance. In some parts of the country, where there are only a few geriatricians, local training arrangements have been agreed with the universities. Until very recently, the requirements for specialist training has varied remarkably between the universities but during the last year there has been an aim to standardize the requirements nationally.
Each unit should organize 100 hours of theoretical teaching at their sites and it is recommended that physicians participate in continuing medical education organized outside their site of practice at least 10 days a year. Finally there is the written specialist exam. In some universities, new technologies have been applied as teaching methods such as web based courses or video broadcasted meetings for trainees.

Societies of geriatric medicine and gerontology

The Finnish Geriatricians is the most important professional society for clinical geriatricians. The society also negotiates, gives statements and aims to increase knowledge of geriatric medicine in the country. Other specialists dealing with older patients can also become members. The committee of the Finnish Geriatricians is based in one of the university cities and changes every three years. At the moment the committee is based in Turku.
Societas Gerontologia Fennica (SGF) is another important society related to geriatric medicine. The society is multidisciplinary covering all fields of gerontology. The specific aim of the society is to support scientific activities and research in all aspects of gerontology.

Meetings in geriatric medicine and gerontology

One of the major tasks of the Finnish Geriatricians is to arrange the annual two-day meeting of Finnish Geriatricians which is the major educational event in clinical geriatric medicine. The meeting has been arranged since 2005 and it has become very popular. It provides a fruitful meeting place for specialists in geriatric medicine, trainees and some general practitioners who work among older patients. The meeting is arranged each year by the end of January and always in the same city where the committee of the Finnish Geriatricians is based.

There is a national multidisciplinary meeting of gerontology arranged every three years. The meeting provides an excellent opportunity to present research work and projects and to communicate across disciplines. The Meeting of Gerontology is held in June 2013 in Helsinki and there are international quests speekers invited.
The SGF arranges each year in March a one-day multidisciplinary scientific symposium in Helsinki.
Since 2010 there has been an innovative two-day educational event held in Tampere for trainees and trainers in geriatric medicine at the end of October. In the meeting, there is an ideal opportunity for networking in educational and training issues with a lot of communication and interaction between the trainees and trainers. Also a specific meeting of professors and trainers has been arranged at the meeting with the aim to improve and standardize the quality of specialist training in geriatric medicine. The meeting has been a success and will be arranged annually.

contacts in Finland

Dr. MD, PhD

Maria Nuotio

maria.nuotio@utu.fi
Dr.

Jouko Laurila

jouko,laurila@fimnet.fi