L to R: Minjie (Jessica) Guo, MD; Mary Connolly, MD; Angela Heysel, MD; Kelley Bellia, DO; Celestine Chistensen, MD
The United States faces an unprecedented shortage of geriatricians at the very moment older adults represent the fastest-growing segment of the population. In the 2025 national match, only 145 of 388 certified geriatrics fellowship slots (~37%) were filled, one of the lowest fill-rates among medical subspecialties. Because many programs failed to fill all (or any) of their slots, the actual number of trainees entering geriatrics remains far below what is needed to replace retiring clinicians, even as the demand for expert care for older adults continues to rise.
Against this backdrop, Pitt/UPMC has reshaped how trainees discover, pursue, and advance in geriatric medicine. With new integrated training pathways, expanded scholarly options, and more intentional recruitment strategies, the institution is working to build a sustainable pipeline of geriatric clinicians and academic leaders.
Guaranteed Pathway: A New Integrated Approach to Training
In 2022, Pitt/UPMC received ACGME approval for its four-year Internal Medicine–Geriatrics Integrated Training Program, a redesigned pathway that blends three years of internal medicine residency with one year of geriatrics fellowship. Graduates are eligible to sit for both the Internal Medicine and Geriatric Medicine board exams at the end of the four-year sequence.
This structure provides clarity for residents from the start of training and integrates geriatrics into all the first three years of residency, helping them build their clinical practice, learn key skills, develope expertise, and form relationships in the field of geriatrics early on in their training. These trainees benefit from protected time during PGY4 for deeper professional development. This may include research, coursework, quality-improvement initiatives, or other scholarly work, making the program especially appealing to those interested in academic geriatrics.
The program offers two integrated IM-Geri slots each year, and its first class is midway through training, assuring that future fellowship classes have local, well-trained residents from UPMC’s own residency four years in advance.
Strengthening Recruitment and Retention
Recognizing that interest in geriatrics often begins before residency, often inspired by exposure to strong role models, Pitt/UPMC reexamined opportunities for connecting with learners. Faculty teach geriatrics principles to all second-year medical students, and clinical electives in geriatrics are available to third- and fourth-year students. Geriatrics research faculty welcome learners at all levels to participate in ongoing research projects. Elective rotations in geriatric medicine are offered to UPMC internal medicine and family medicine residents throughout the UPMC system. Internal Medicine residents at UPMC Presbyterian-Shadyside who are interested in caring for older adults but uncertain about formal training can participate in a geriatrics “track” throughout their 3 years. This track gives them mentored geriatrics outpatient experience and exposure to other clinical experiences.
One consistent challenge nationally is the structure of traditional one-year geriatrics fellowships. Residents who discover a passion for geriatrics often prefer to remain at the institution where they trained and develop their careers within that supportive culture, rather than relocate for a single-year fellowship. With this in mind, Pitt/UPMC has taken steps to make academic geriatrics training more flexible and accessible. The institution continues to offer four traditional one-year Geriatric Medicine fellowship slots and also offers an optional second research or clinical specialization year for fellows interested in academic careers. Opportunities for a second training year are available to all incoming fellows. Fellows wishing to develop research careers have opportunities for a three-year fellowship with bridge funding to independence. Hospitalists within UPMC are able to train in a part time capacity over multiple years in order to become certified in geriatrics.
Investing in the Future of Geriatrics
Through these innovative pathways and recruitment strategies, Pitt/UPMC is working to help solve a national workforce crisis. By offering multiple entry points – accessible electives in geriatrics for medical students and residents, a geriatrics-interest track, integrated residency-fellowship training with guaranteed 3+1 matching, and traditional fellowship with options for extended training – Pitt ensures that future geriatricians can choose the option that best aligns with their goals while benefiting from robust mentorship and research opportunities.
As the country’s aging population expands, the need for skilled geriatricians will only become more pressing. Pitt/UPMC’s commitment to reimagining training is positioning the institution, and the field, to meet that need with a new generation of physicians dedicated to advancing the care of older adults.