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Perceptions and Experiences of Geriatric Medicine Among European Medical Students: a Multinational Multilingual Open Online Survey

A multinational survey of 448 European medical students reveals significant gaps in their perceived knowledge of key geriatric topics and a generally low interest in pursuing geriatric medicine as a career, highlighting the need for enhanced education that moves beyond traditional lectures toward active learning approaches.

Original authors: William McKeown, Grace Pearson, Karolina Piotrowicz, Giulia Ogliari, Carmelinda Ruggiero, Roberta Vullo, Vikki O'Neill, Marina Kotsani, Anna Marie Herghelegiu, Ana Prada, Luca Soraci, Premtim Rashiti

Published 2026-08-06

📖 5 min read🧠 Deep dive

CC BY 4.0

Original authors: William McKeown, Grace Pearson, Karolina Piotrowicz, Giulia Ogliari, Carmelinda Ruggiero, Roberta Vullo, Vikki O'Neill, Marina Kotsani, Anna Marie Herghelegiu, Ana Prada, Luca Soraci, Premtim Rashiti, Qendrese Daka, Naim Jerliu, Shpresa Kushaj, Zyta Beata Wojszel, Jerzy Gąsowski, Robert Kupis, Aleksandra Popovac, Slađana Šobajić, Tatjana Puškar, Marian Dejaeger, Sonja Genadieva Stavrikj, Biljana Petreska-Zovic, Gulistan Bahat, Meltem Koca, Sumru Savas, Serdar Ozkok, Zeynep Fetullahoğlu, M. Cristina Polidori, Regina Roller-Wirnsberger, Helgi Kolk, Tahir Masud

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

The Growing Room and the Missing Keys

Imagine the world as a giant, bustling house. For a long time, the rooms were filled with energetic kids and busy adults, but lately, the house has been quietly filling up with wise elders. In Europe, this shift is happening faster than anywhere else; nearly a quarter of the population is now over 65, and that number is climbing. This isn't just a demographic fact; it's a massive change in how the house needs to be run. Older people often carry complex "household issues"—multiple health conditions, mobility challenges, and unique needs that require a special kind of care.

To handle this, the house needs a team of skilled caretakers. In the medical world, these specialists are called geriatricians. They are the experts who know how to fix the tricky, multi-layered problems that come with aging. However, there's a problem: the house is getting older, but the number of people trained to be these specific experts is running low. Many countries don't even have a formal "specialist training room" for geriatric medicine yet. The big question is: how do we get the next generation of caretakers excited about learning these skills? To find out, researchers decided to peek into the minds of the people who will eventually run the house: the medical students. They wanted to see what these future doctors know, what they think about older people, and whether they'd ever want to become the experts the house needs.

The Great European Student Survey

In this study, a massive team of researchers from across Europe launched a digital treasure hunt. They created an open online survey, translated into 24 different languages, to ask medical students about their experiences with geriatric medicine. It was like sending out a giant, multilingual questionnaire to 448 students from 23 different countries, asking them to rate their knowledge, interest, and future career dreams on a scale of 1 to 5.

What They Found: The Knowledge Gap
The students were surprisingly confident in some areas but completely lost in others. When it came to "bone health," "depression," and "falls," the students felt they had a pretty good grip on things, with average knowledge scores around 3.5 out of 5. It was as if they had a well-stocked toolbox for these specific jobs.

However, when the researchers asked about more specialized tools, the toolbox looked empty. The students rated their knowledge of "gerodontology" (dental care for the elderly), "geriatric rehabilitation," and "orthogeriatrics" (bone and joint care for the elderly) as very low, with scores hovering around 2.1 to 2.5. It seems the students had never been shown how to use these specific tools. Interestingly, even though they felt they didn't know much about these topics, they still thought they were relevant to their future jobs. They knew they needed to know this stuff, even if they didn't feel they knew it yet.

The Career Dream (or Lack Thereof)
Here is where the story takes a turn. Despite knowing that older people need care, very few students wanted to be the ones providing it. When asked, "Would you like to become a geriatrician?" a whopping 64% said "No." Only 7% said "Yes." The rest were on the fence or hadn't thought about it.

The researchers dug into why students were saying no. The biggest barrier wasn't that the job was too hard or that there were too many geriatricians already. The most common reason, chosen by nearly 60% of the students, was simply: "I just don't want to be a geriatrician." Other reasons included the belief that the job didn't pay as well as other specialties or that there weren't many job openings. Interestingly, the study found that male students were actually more likely to say "maybe" or "yes" compared to female students, which was a bit of a surprise since other studies often suggest the opposite.

The Classroom Experience
The study also looked at how these students were being taught. About 70% of them had taken a specific course or lecture on geriatric medicine, and about half had done a rotation (a temporary job shadow) in a hospital ward for older people. However, fewer than a third had ever visited a care home or a rehabilitation center.

The students were very clear about how they wanted to learn. They hated the old-school method of just sitting in a lecture hall listening to a professor talk. Instead, they loved "case-based learning" (solving real-life patient puzzles) and "problem-based learning." They wanted to be active detectives, not passive listeners. They also preferred online or hybrid learning formats over strict in-person-only classes.

The Verdict
The paper suggests that while medical students in Europe generally enjoy working with older people (about 33% said they had high or very high enjoyment), they are not currently being inspired to become geriatric specialists. The current education system seems to be missing the mark in a few key ways: it's not exposing students enough to community settings like care homes, it's relying too much on boring lectures, and it's not highlighting the cool, specialized skills needed for topics like dental care or rehabilitation for the elderly.

The authors conclude that to fix this, medical schools need to change their approach. They need to show students how relevant these skills are and use fun, interactive teaching methods to spark interest. It's not about forcing students to care; it's about showing them that caring for older people is a fascinating, essential, and rewarding part of being a doctor. The house is getting older, and the next generation of caretakers needs to be ready, willing, and excited to step up.

Technical Summary: Perceptions and Experiences of Geriatric Medicine Among European Medical Students

Problem Statement
Europe faces a significant demographic shift, with the proportion of the population aged 65 and over projected to increase. This aging population necessitates a healthcare workforce equipped to manage complex geriatric needs, including frailty and multimorbidity. However, there is a documented shortage of trained geriatricians across Europe, and in some countries, geriatric medicine is not yet recognized as a distinct specialty. While the strategy of "teaching all clinicians how to care for older adults" is advocated to mitigate workforce shortages, there is a lack of contemporary, multinational data regarding European medical students' perceived educational needs, attitudes toward the specialty, and their experiences with undergraduate geriatric medicine education. Understanding these perceptions is critical for designing effective educational interventions.

Methodology
This study utilized data from a multinational, multilingual, open online cross-sectional survey conducted by the COST Action CA21122 PROGRAMMING (PROmoting GeRiAtric Medicine in countries where it is still eMergING).

Participants: The analysis focused on 448 medical students (274 women, 61.2%) from 23 European countries. The cohort included students from both EU-27 (n=238) and non-EU-27 (n=210) nations, with significant representation from Türkiye, Romania, Poland, Italy, and Serbia.
Instrument: The survey was translated into 24 languages to ensure inclusivity. It assessed demographics, perceived knowledge, relevance, and interest across 33 key geriatric topics and skills (rated on a 5-point Likert scale from "very low" to "very high"). It also evaluated exposure to geriatric education (courses, rotations, volunteer work), attitudes toward becoming a geriatrician, perceived barriers to the specialty, and preferred teaching modalities.
Analysis: Descriptive statistics were used for categorical and continuous variables. Spearman's rank correlation coefficients analyzed relationships between knowledge, relevance, and interest. Pearson's Chi-square tests compared distributions between EU-27 and non-EU-27 students.

Key Contributions and Results
The study provides a comprehensive snapshot of the current state of geriatric medicine education and student perception across a diverse European sample.

Knowledge, Relevance, and Interest:
- Highest Perceived Knowledge: Bone health (mean 3.53), depression (3.17), and falls/mobility (3.16).
- Lowest Perceived Knowledge: Gerodontology (2.14), geriatric rehabilitation (2.45), and orthogeriatrics (2.54).
- Highest Relevance: Bone health (3.94), multidisciplinary team communication (3.87), and MCI/dementia screening (3.81).
- Highest Interest: Depression (3.83), MCI/dementia screening (3.82), and management of behavioral and psychological symptoms of dementia (3.81).
- Correlations: Perceived knowledge showed a mild correlation with relevance ( $r=0.24$ ) and interest ( $r=0.13$ ). However, perceived relevance was strongly correlated with interest ( $r=0.71$ ).
Educational Exposure:
- 69.7% of students attended or planned to attend specific geriatric courses (59.2% mandatory, 10.5% elective).
- Clinical rotations were common in acute hospital wards (57.4%) and outpatient clinics (47.3%) but less frequent in rehabilitation settings (29.0%) and care homes (24.5%).
- EU-27 students were significantly more likely to attend specific geriatric courses (mandatory or elective) compared to non-EU-27 students (p<0.001).
Career Aspirations and Barriers:
- Only 7% (30 students) expressed a desire to become geriatricians, while 17% were open to considering it.
- The primary barrier cited was a lack of personal desire to enter the field (59.6%).
- Other significant barriers included lower remuneration compared to other specialties (10%) and limited job opportunities (8.7%).
- Notably, male students were more likely than female students to answer "yes" or "maybe" to becoming a geriatrician (40% vs. 20%, p<0.05).
Attitudes and Teaching Preferences:
- 32.8% of students reported high or very high enjoyment in engaging with older people.
- Students perceived geriatric medicine as having "fair" or "little" prestige in their respective countries.
- Preferred Teaching Methods: Case-based learning (77%), clinical tool learning (61%), and problem-based learning (58%) were rated as most effective.
- Least Preferred: Textbook and lecture-based learning (24%) and student short presentations (35%).

Significance and Claims
The authors claim that this study offers essential, contemporary insights for leaders in undergraduate medical education to address the geriatric workforce crisis. The paper posits that:

Educational Gaps Exist: There is a discrepancy between students' perceived knowledge and the complexity of geriatric care, particularly in areas like gerodontology and rehabilitation, likely due to limited clinical exposure in non-hospital settings (e.g., care homes).
Pedagogical Shift is Needed: The strong preference for active learning methods (case-based and problem-based) over traditional lectures suggests that curriculum designers should adopt these strategies to improve engagement and perceived relevance.
Relevance Drives Interest: The strong correlation between perceived relevance and interest implies that educational strategies demonstrating the clinical necessity of geriatric competencies may simultaneously boost student interest in the field.
Undergraduate Intervention is Critical: Given that the majority of students do not intend to specialize in geriatrics, undergraduate education represents a vital window to ensure all future physicians possess basic competencies in caring for older adults.

The study concludes that while interest in the specialty remains low, the high enjoyment of interacting with older people and the preference for active learning provide a foundation for improving geriatric medical education across Europe.

The Growing Room and the Missing Keys

The Great European Student Survey

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