Comparison of United States and Australian pharmacy student attitudes towards careers in geriatrics

Introduction: The population of older adults is expanding globally, but there remains a lack of healthcare professionals trained to meet growing care needs. The primary objective of this study was to compare the top three to four factors driving interest vs. lack of interest in geriatrics among pharmacy students in the United States (US) vs. Australia.

Methods: US pharmacy students were recruited from two different schools, one utilizing a dual campus model and the other being a single campus. A 23-item survey was distributed to 611 first- through fourth-year pharmacy students from February through September 2022. These surveys were distributed during class time or via email with a website link. Australian pharmacy students were recruited from a single school to complete a 25-item survey that was distributed to 285 third-year pharmacy students in September of 2022 and to 251 pharmacy interns in February of 2023 via learning management system announcement. In both countries, answers were anonymous, and participation was voluntary. Data analysis was conducted using Fisher's exact test, descriptive statistics, and t-tests.

Results: A total of 363 responses were collected, 210 from the US and 111 from Australia. Interest in geriatrics was higher in the Australian cohort versus the US cohort (75 % interested or extremely interested vs. 51 %, p < 0.001). Students in both countries identified interest in deprescribing (US 47 %, Australia 40 %) and increased need for clinicians trained in geriatrics (43 %, 36 %) as top factors encouraging interest. Both US and Australian students indicated that the emotional impact of death and end-of-life care was a top factor discouraging interest in geriatrics (49 %, 31 %). US pharmacy students ranked past positive experiences with older adults (50 %) as a top encouraging factor and identified disinterest in geriatric syndromes (45 %) and inadequate exposure to geriatrics (25 %) as top discouraging factors. Meanwhile, Australian students indicated concerns over excessively limiting their scope (21 %) and professional liability stemming from care of a frail/vulnerable population (20 %) as top discouraging factors. Australian students identified complexity/clinical acuity of older adults as both a top encouraging and top discouraging factor (35 % and 20 %, respectively). Australian students also registered a higher level of agreement that they are adequately exposed to geriatrics in the didactic curriculum vs. US students (57 % vs. 40 %, p < 0.001).

Conclusion: US and Australian pharmacy students identified similar factors as encouraging vs. discouraging interest in a career in geriatrics, though differences between the two countries were noted. Australian students expressed greater interest in geriatrics. Further research investigating means and impact of addressing discouraging and emphasizing encouraging factors among pharmacy students is needed.