Ageing across Specialties:
A Structured Mapping of European Training Requirements outside Geriatric Medicine
Román Romero-Ortuño¹² ORCID: 0000-0002-4150-1637
Dafne Estefania Durón Reyes²
Gerda Kalinauskaitė³
Agnė Butkiemė³
Sara Solis-López²
Paulina Vergara²
Virgilio Alejandro Hernández Ruiz²
Michael Vassallo⁴
Marianne van Iersel⁵
Jūratė Macijauskienė³
on behalf of the UEMS Geriatric Medicine Section (UEMS-GMS)
¹ Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
² Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
³ Department of Geriatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania
⁴ Royal Bournemouth Hospital, University Hospitals Dorset; Bournemouth University, Bournemouth, United Kingdom
⁵ Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
Corresponding Author:
Prof. Román Romero-Ortuño
Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin
Mercer's Institute for Successful Ageing, St James's Hospital
James's Street, Dublin D08 NHY1, Ireland
Abstract
Background
Population ageing is one of the most significant demographic transformations affecting European healthcare systems. As life expectancy increases and fertility rates decline, the number of older adults living with multimorbidity, frailty, cognitive impairment, and other complex health conditions continues to rise. Although Geriatric Medicine specialises in the care of these patients, most older adults receive treatment in non-geriatric specialties. Ensuring that physicians across all disciplines possess appropriate knowledge and competencies in ageing is therefore essential for delivering high-quality care.
Objective
This study aimed to evaluate how ageing and the care of older adults are represented within European Training Requirements (ETRs) across medical specialties other than Geriatric Medicine.
Methods
A structured cross-sectional review of all UEMS-adopted European Training Requirements published up to December 2025 was conducted. Fifty-five ETRs relevant to the care of older adults were analysed using a predefined five-level framework assessing the degree of integration of ageing-related content, ranging from no reference to explicit competency requirements.
Results
Ageing-related content was identified in 45 of the 55 ETRs (82%). Twenty-six curricula (47%) included explicit competencies related to the care of older adults, while twelve (22%) specified knowledge requirements. Seven ETRs recommended collaboration with Geriatric Medicine, although only one did so without accompanying competency requirements. Ten curricula contained no ageing-related content, and almost half (40%) used terminology that is no longer considered age-inclusive, such as "the elderly."
Conclusions
Although most European specialist curricula acknowledge ageing, substantial variation exists in the depth and consistency of its integration. Greater incorporation of geriatric principles, interdisciplinary collaboration, and age-inclusive language within European Training Requirements would strengthen postgraduate medical education and better prepare future specialists to meet the needs of Europe's ageing population.
Keywords
Ageing; Geriatric Medicine; European Training Requirements; postgraduate medical education; curriculum development; multidisciplinary care; UEMS
Introduction
Europe is experiencing an unprecedented demographic transition driven by increasing life expectancy and declining fertility rates. Older adults now constitute a rapidly expanding proportion of the population, creating profound implications for healthcare delivery, workforce planning, and postgraduate medical education.
Older patients frequently present with complex combinations of multimorbidity, frailty, polypharmacy, cognitive impairment, functional decline, and geriatric syndromes that rarely fall within the boundaries of a single specialty. Although Geriatric Medicine has developed specific expertise and clinical models, including Comprehensive Geriatric Assessment (CGA) and multidisciplinary care, most older adults receive healthcare from physicians working in other specialties.
Because European Training Requirements developed by the Union Européenne des Médecins Spécialistes (UEMS) define minimum standards for specialist training across Europe, they provide an important opportunity to ensure that all specialists acquire competencies relevant to caring for older adults.
To evaluate the current situation, the UEMS Geriatric Medicine Section conducted a structured review of all available European Training Requirements outside Geriatric Medicine, examining the extent to which ageing-related knowledge, competencies, and collaboration with geriatric specialists are incorporated into postgraduate training standards.
Mapping Ageing Across European Training Requirements
A structured review of 55 European Training Requirements was performed using a five-level classification framework ranging from no ageing-related content to explicit competency requirements.
Overall, 82% of the reviewed curricula contained some reference to ageing or the care of older adults. However, considerable variability was observed between specialties.
Almost half of all curricula (47%) included explicit competencies relating to the assessment or management of older adults. These commonly addressed issues such as frailty, delirium, cognitive impairment, multimorbidity, medication management, and functional decline. A further 22% included defined knowledge requirements without specifying competencies, while 11% mentioned ageing only as background information. Only one curriculum recommended liaison with Geriatric Medicine without additional educational objectives, and 18% contained no ageing-related content whatsoever.
Specialties such as anaesthesiology, emergency medicine, internal medicine, neurology, medical oncology, rehabilitation medicine, and several surgical disciplines demonstrated particularly strong integration of ageing-related competencies. Conversely, some specialties with substantial involvement in the care of older adults—including cardiology and intensive care medicine—contained little or no explicit reference to ageing within their training requirements.
Collaboration with Geriatric Medicine
One of the most notable findings was the relatively limited recognition of collaboration with Geriatric Medicine.
Although multidisciplinary management has become increasingly important for older patients with complex health needs, explicit recommendations for consultation or liaison with geriatric specialists appeared in only seven curricula.
The authors argue that stronger recognition of these collaborative interfaces could enhance patient care and better reflect contemporary clinical practice. The recently updated European Training Requirements in Geriatric Medicine identify several established multidisciplinary models, including orthogeriatrics, oncogeriatrics, psychogeriatrics, perioperative medicine for older people (POPS), geriatric emergency medicine, cardiogeriatrics, and neurogeriatrics.
Including dedicated geriatric appendices or cross-cutting ageing competencies within specialty curricula may represent a practical mechanism for strengthening these interdisciplinary links without fundamentally altering specialty-specific training structures.
Language Matters
Beyond educational content, the study also examined the terminology used throughout European Training Requirements.
Forty percent of the reviewed curricula continued to use expressions such as "the elderly," terminology that is increasingly discouraged in favour of more person-centred language such as "older adults."
The authors acknowledge that these expressions may often reflect linguistic conventions rather than intentional ageism, particularly given the multinational nature of UEMS working groups. Nevertheless, updating terminology provides an opportunity to promote dignity, respect, and age-inclusive communication throughout European medical education.
The UEMS Geriatric Medicine Section therefore encourages specialty groups to adopt contemporary language when developing or revising European Training Requirements.
Implications for European Medical Education
The findings demonstrate encouraging progress in recognising ageing within specialist training while simultaneously highlighting important opportunities for further harmonisation.
As populations continue to age, healthcare systems increasingly require specialists capable of managing complex older patients regardless of their primary discipline. More consistent incorporation of geriatric principles into postgraduate education would improve preparedness across specialties and support safer, higher-quality care.
The authors also note that initiatives such as the European Geriatric Medicine Specialty Examination (EGeMSE) and the PROGRAMMING COST Action contribute to broader European efforts aimed at harmonising geriatric education, strengthening interdisciplinary collaboration, and promoting shared standards in ageing-related healthcare.
Discussion
This study provides the first structured overview of how ageing is represented across European Training Requirements outside Geriatric Medicine.
The overall inclusion of ageing-related content in more than four-fifths of curricula is encouraging and reflects increasing recognition of demographic change across European specialist medicine. However, the marked variation observed between specialties indicates that preparedness to care for older adults remains inconsistent.
The limited emphasis placed on collaboration with Geriatric Medicine further suggests opportunities to strengthen interdisciplinary training and encourage greater integration between specialties caring for complex older patients.
Equally important is the adoption of age-inclusive terminology, which contributes not only to respectful communication but also to shaping professional attitudes and educational culture.
Conclusion
Europe's ageing population presents one of the greatest challenges facing specialist healthcare over the coming decades.
This review demonstrates that although most European Training Requirements recognise ageing and the care of older adults, substantial differences remain in the depth and consistency of educational content.
Strengthening geriatric knowledge, promoting interdisciplinary collaboration, incorporating competency-based training, and adopting age-inclusive language would contribute to more harmonised postgraduate medical education across Europe and better equip future specialists to meet the evolving healthcare needs of an ageing society.
Open Access & Copyright
© 2026 The Authors. Published by the European Medical Specialist Review (EMSR) under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0).