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Facing the challenge of ageing
Since Professor Stout’s report, the research community has shown increasing recognition of the fact that ageing is one of the greatest challenges facing the world. Here, we are talking not only about geriatric medicine, but everything to do with ageing. It is not a cliché to say that demographic change and the effects of conditions such as Alzheimer’s disease will change and potentially threaten society as we know it. Ageing research has been recognised as an overlooked orphan: it did not belong to any one research council or charity, and so received no clear or directed support. On the contrary, it was recognised that the challenges faced by ageing would potentially require biomedical, social, and technological responses. Using this thinking, initiatives such as SPARC and joint funding collaborations between research councils have developed. The research funding bodies have therefore become more evidently interested in ageing research. It is to be hoped that increased and co-ordinated funding for ageing research will eventually create a change in the way universities organise themselves. But ultimately this will also require the university research assessment processes to value such work. In the Research Assessment Exercise in 2008, there was no unit of assessment for ageing. A simple poll of academic geriatricians in the BGS illustrated this: BGS researchers in some Universities were assessed as part of groups in social policy, or as allied health professions, or as psychiatry or as hospital based subjects or as community based subjects.

Professor Stout’s report particularly mentioned the major change in the way doctors are trained, which has led to a welcome greater focus on the quality of clinical training, but which has also potentially reduced attention upon academic training. These concerns were not unique to geriatric medicine. Since his report, a new process for the training of clinical academics has been established. This offers the chance for academic training to be better and more structured than ever before.

The two positive changes (new funding streams for ageing research, new academic medical training pathways) offer opportunities for academic geriatric medicine. To grasp these opportunities however, two major points need to be understood:

1. An increased interest in ageing research is not the same as an increased interest in academic geriatric medicine. Ageing research includes research into the meaning of ageing, demography, pensions, social policy (sociogerontology). Ageing research includes research into the biological processes underlying ageing organisms, and is interested in preventing the consequences of ageing (biogerontology). Recently the field of gerotechnology has emerged, recognising the need to put new technologies to use to overcome issues that arise as a consequence of ageing. Of course, ageing research also includes dealing with the clinical consequences of ageing (geriatric medicine). The increased funding in ageing research does not automatically mean increased support for academic geriatric medicine.

2. Academic training pathways are generic and not specifically for geriatric medicine. Bigger and more established specialities will be better placed to exploit these opportunities. If these pathways become the dominant way to develop academic medicine, and if geriatric medicine does not have a foot on the ladder, it is possible that academic geriatric medicine could fare even worse than before.

It follows from these two points that the British Geriatrics Society should recognise that it is likely that the best strategy to develop and sustain academic geriatric medicine will be through collaboration with other researchers in the wider field of ageing, rather than as a stand-alone discipline. Not only will this give better access for academic geriatricians to research funding, but it will also enable there to be sufficient critical research mass to encourage new academic training posts to be in geriatric medicine.

As a first step towards this, the British Geriatrics Society will work with its sister organisations the British Society for Gerontology and British Society for Research into Ageing, through the British Council of Ageing. Together, these bodies could help to facilitate regional ageing research networks, populate the BGS website “Research Centres of Good Practice” to reflect all ageing research in the UK, not only that done by geriatricians, and continue to explore opportunities for collaboration (such as seeking educational and research contributions from BSG and BSRA members at BGS meetings).

Other steps include

• exploration of further opportunities along the lines of the existing BGS / Research into Ageing Research Fellowship for trainees in geriatric medicine
• increased inclusion of socio-gerontology, bio-gerontology and gerontechnology in the BGS’s educational programme
• encouraging trainees in geriatric medicine to consider ageing research and not just clinical geriatric medicine research during the two academic half days per week (that together make up the equivalent of a year of full time study over the training period)
• co-hosting the IAGG meeting (or putting forward a bid to do so) for 2015 in London, subject to the financial viability of doing so.
  

John Gladman
on demitting from the Chair
of the BGS Academic and Research Committee

BGS Newsletter, March 2009
Issue 20 ISSN 1748-6343 20