Geriatric Medicine — Specialty Profile

Subspecialty fellowship of Internal Medicine or Family Medicine.

Exploratory, not prescriptive. This profile blends hard data (pay, match rates, burnout, demographics — each sourced and dated) with generalizations and synthesized online opinion about culture and "who fits." It's here to help you get curious and go find out for yourself — not to tell you who to become. Numbers marked ⟳ verify change every year; check the linked source before you quote one. Last reviewed: 2026-07-25.

Also called: geriatrics, geri, geriatric medicine. A 1-year fellowship you enter after completing an Internal Medicine or Family Medicine residency, rather than a residency you match into from med school. Organ system: all of them, through the lens of aging, covering frailty, multimorbidity, cognition, function, and polypharmacy.

The 30-second version

Geriatric medicine is the specialty of the whole older person, the field organized around aging itself rather than any single organ. Where most of medicine subtracts a diagnosis at a time, a geriatrician holds the whole picture at once: the twelve-medication list, the falls, the memory that's slipping, the depression, the caregiver who's exhausted, and what the patient actually wants the rest of their life to look like. It is almost entirely cognitive work, from long visits and careful de-prescribing to care coordination and goals-of-care conversations, with no OR and few procedures. And it carries one of the starkest paradoxes in American medicine: after an extra fellowship year, geriatricians frequently earn less than the general internist or family doctor they already qualified to be. People choose it anyway, for the work, and they report some of the highest job satisfaction in all of medicine.12

Quick dashboard (details and sources below)
Training after med school IM or FM residency (3) + Geriatrics fellowship (1) = 4 yrs after med school
Total from college start ~12 years (4 undergrad + 4 med school + 3 residency + 1 fellowship)
Competitiveness (as a subspecialty fellowship) Low — among the least-filled fellowships in all of medicine (~39% of positions filled, 2026) ⟳
Typical full-time pay ~$290,000–$320,000 total comp ⟳
Pay range (structure) ~$220k early-career outpatient · ~$290k–$320k typical · higher for a senior physician stacking SNF directorships, though no publisher outside the staffing industry prices that stack ⟳
The pay paradox Frequently pays LESS than general IM/FM despite the extra year ⟳
Lifestyle Outpatient-forward, steady daytime hours, minimal overnight call
Burnout Relatively low (folded into IM in most surveys; cognitive/continuity fields sit low) ⟳
Job security Extreme — structural, worsening shortage; <7,300 practicing vs. ~20,000 needed ⟳
% women Practicing: "just over half" (AAMC). Fellows: 65.2% on the IM track and 64.3% on the FM track (ACGME AY2024-25) ⟳
DO / IMG accessibility Among the most open in medicine: 42% IMG of matched fellows (2026), the second-highest US-citizen-IMG share of any fellowship NRMP reports; DO 17% ⟳

What they actually do

Geriatricians manage the health of older adults, usually the frailest and most medically complex ones, as whole people rather than as a stack of separate diseases. The core skill is integration: sorting out how a dozen chronic conditions, a dozen medications, cognition, mobility, mood, nutrition, and the patient's own goals all interact, and then simplifying rather than adding. A huge part of the job is de-prescribing (safely removing medications that now do more harm than good), managing polypharmacy and drug interactions in bodies that metabolize everything differently, working up falls and frailty, staging and supporting dementia, and running honest goals-of-care conversations with patients and families.

The work is continuity-driven and relationship-based; Barton describes it as work where "intensity scales through patient complexity and care coordination rather than procedural throughput."2 There is no OR and there are essentially no lucrative procedures. The value a geriatrician adds is cognitive and relational, delivered over years.

Representative work (not procedures, since this is a cognitive field): comprehensive geriatric assessment · cognitive/dementia evaluation and staging · falls and gait assessment · medication reconciliation and de-prescribing · management of frailty, delirium, incontinence, and multimorbidity · goals-of-care and advance-care planning · coordination with pharmacy, social work, PT/OT, and family caregivers · nursing-home and skilled-nursing-facility (SNF) rounds · house calls / home-based primary care.

A day in the life: Mostly daytime and mostly outpatient. A typical week blends continuity clinic, rounds at skilled-nursing and long-term-care facilities, and, for many, house calls, plus a lot of phone-and-message coordination with families, pharmacists, and social workers.23 Visits run long because the problems are layered and the conversations matter. Clinical days average around 8 hours, with minimal-to-no in-house overnight call in most outpatient/SNF roles (facility coverage is largely daytime and phone-based).23 The pace is deliberate rather than frantic, and the intensity is in the complexity rather than the clock.

The training path & time to completion

Medical school (4 yrs) → Internal Medicine OR Family Medicine residency (3 yrs) → Geriatric Medicine fellowship (1 yr) → board-certified. This is a two-step entry: you do not match into geriatrics from medical school. You first complete a full IM or FM residency (becoming a board-eligible generalist who can already practice), and then you apply to a 1-year geriatrics fellowship through the NRMP Medicine and Pediatric Specialties Match.45

  • Dual entry (IM or FM), where geriatrics is unusual. Trainees enter from two different residencies, and the fellowship is jointly overseen (it "operates under multiple Review Committees, Family Medicine and Internal Medicine").5 IM and FM fellows train side by side in the same ACGME-accredited program.
  • From Internal Medicine → board certification via ABIM subspecialty certification in Geriatric Medicine.46
  • From Family Medicine → board certification via the ABFM Certificate of Added Qualifications (CAQ) in Geriatric Medicine.47
  • Fellowship length: 1 year minimum (FREIDA lists geriatric medicine as a 1-year minimum). Many academic programs offer an optional 2nd year for research or a clinician-educator track, common for those headed into academia but not an ACGME requirement.4 ⟳
  • Total from the start of college: ~12 years (4 undergrad + 4 med school + 3 residency + 1 fellowship).

How competitive is it?

Judged as a fellowship, geriatrics is one of the least competitive entries in all of medicine, because so few people apply rather than because there aren't enough seats. This is the mirror image of the usual "how do I get in" question: the seats are wide open, and the crisis is a lack of applicants.

  • 2026 appointment year: of 388 positions offered, only 151 filled, a 38.9% fill rate and the lowest of all internal medicine subspecialties. It was one of just 8 subspecialties (out of 81) that filled under 50% of positions.89 ⟳
  • The trend is down, and the shape is worth seeing. NRMP's own five-year table runs 51.1% (2022) → 43.1% (2023) → 41.5% (2024) → 44.2% (2025) → 38.9% (2026), a 12-point fall from the 2022 peak rather than a clean slide, since 2025 came in above 2024. Capacity did not grow to cause it either: positions offered ran 411 → 411 → 419 → 382 → 388 across the same five cycles, a net contraction.10 ⟳
  • 2025 detail (NRMP primary): 145 programs, 382 positions offered, 169 filled, only 204 applicants ranked the specialty at all, and 103 programs had at least one unfilled position.10 ⟳
  • Geography of the gap: unfilled slots cluster hard by state (2026 state fill rates ranged from Massachusetts ~76% down to Virginia ~17%, Ohio ~19%, Rhode Island ~20%), and more than a dozen states offered no geriatric medicine fellowship positions at all.8 ⟳

The honest read for a premed: if you complete IM or FM and want to do geriatrics, matching is realistically attainable. This is not a research-and-pedigree arms race like cardiology or GI. The same softness that makes it accessible is a signal about why (see Compensation): the money doesn't reward the extra year, and that, plus ageism in medicine, is what keeps applicants away.111

Compensation — the robust version

This is the heart of the geriatrics story, so treat it carefully. A note on sources first: Medscape folds geriatrics into internal medicine and doesn't report it as a separate line, so the best geriatrics-specific benchmarks are Doximity (large sample), SalaryDr (a panel of 19), and Barton Associates (recruiter aggregate), with SalaryDr as a small-sample self-report anchor.12213

National number. A defensible mid-2026 figure is ~$290,000–$320,000 total compensation, clustering just under $300k on the large-sample benchmark. Doximity's 2025 report (2024 data) puts geriatrics at $291,968, near the bottom of its whole specialty ranking. Smaller self-report samples run a bit higher (SalaryDr median $320,000, average $314,432, base $260,747, but on only 19 verified submissions, so directional only).1213 ⟳

The pay paradox, named squarely. Geriatrics is one of the starkest compensation paradoxes in American medicine: it frequently pays less than the general IM or FM practice a physician already qualified for, after an extra fellowship year. Same source, same year (Doximity 2025, 2024 data):12

Specialty Total comp (Doximity 2025)
Internal Medicine (general) $326,116
Family Medicine $318,959
Geriatrics $291,968

That's roughly $34k below general internal medicine and $27k below family medicine, after an additional year of forgone attending income (commonly estimated at $150k–$250k+ of lost first-year pay).12 A separate analysis put geriatricians at about $20,000/yr less than internists who never did the fellowship, and a JAMA piece framed it as ~9% below general internists and ~14% below hospitalists.111 The mechanism is structural, not incidental: the work is almost entirely cognitive E/M billing, heavily Medicare-reimbursed at low fee-schedule rates, with longer visits and no procedures or imaging to bill. A resident who finishes IM/FM and simply starts practicing will, on average, out-earn a peer who spends an extra year training in geriatrics. This is the central economic fact of the field, and the primary driver of its workforce shortage. It deserves to be weighed without shame.

The spread (structure). SalaryDr's small-sample distribution (n=19, directional): 10th pct $270k · 25th $289k · median $320k · 75th $345k · 90th $355k, range ~$270k–$373k.13 A realistic full-field range runs from roughly ~$220k–$250k (early-career outpatient) upward for a senior physician stacking a clinical salary with nursing-home directorships and locum work (see employment models), though nobody outside the staffing industry publishes a figure for that stack. The ceiling is narrow compared with procedural fields. For scale, Medscape 2025 put orthopedics ~$611k and cardiology ~$575k.121314 ⟳

Seniority helps modestly; the real lever is stacking revenue streams. By experience (SalaryDr, small cells): 0–2 yr ~$250k → 6–10 yr ~$325k → 16+ yr ~$355k.13 Because straight outpatient pay is the floor, geriatricians build income by combining:15

  • Outpatient continuity clinic. The baseline and lowest-paying pure model (~$220k–$290k).
  • Nursing-home and SNF medical directorships, the classic income lever. Serving as medical director for one or several skilled-nursing or long-term-care facilities is typically paid as a 1099 stipend separate from clinical W-2 pay, on top of billing for rounds. Amounts aren't standardized publicly and vary by facility, and directorships plus a SNF panel are the most common way experienced geriatricians push total compensation above a clinical salary. How far above is not something anyone publishes.15
  • House calls / home-based primary care. Often value-based / Medicare-Advantage-aligned, growing, competitive pay; travel time is the trade.
  • PACE programs (Program of All-Inclusive Care for the Elderly), which is capitated, team-based, salaried, often better lifestyle and no fee-for-service treadmill.16
  • Hospice & palliative overlap. Many geriatricians dual-practice or dual-board; palliative overlap comp reported ~$324k.13
  • Locum tenens. Geriatrics locum work is abundant, and it is one of the more common ways geriatricians add income to a clinical base. No dollar figure appears here: the only published locum rates for the field come from staffing agencies, which sell the service they are pricing, and this site does not quote a seller's own price list.2

Geography. Like other cognitive primary-care fields, geriatrics pays more in rural/underserved, high-Medicare, lower-cost regions (recruitment premium) and less in oversupplied coastal academic hubs. Barton names the highest state-level means as Maine, Louisiana, Alaska, Idaho, and Hawaii (specific per-state dollars not published).2 ⟳

Academic vs. private. No clean geriatrics-specific figure is published. Applying the general rule that academic pay runs 10–15% below private to Doximity's $291,968 average gives roughly $248,000–$263,000 for academic geriatricians, which is this page's own arithmetic rather than anyone's published band, and the 10–15% input is itself crowd-sourced.17 ⟳ Geriatrics is disproportionately academic (fellowships, VA, university systems, grant-funded programs), which itself drags the specialty average down versus private-practice-heavy fields.15

Trend. Modest upward drift, from $275,704 (Doximity 2023) to $291,968 (Doximity 2025), about +5.9% over two years, but not keeping pace with procedural specialties, so the relative gap persists. The credible path to better economics is value-based care (Medicare Advantage, ACOs, PACE, chronic-care-management codes) rather than fee-for-service E/M. Notably, the John A. Hartford Foundation documented that even a ~$24,000 Medicare bonus (>10% of the average salary) failed to lift fellowship numbers. They dropped anyway ("+10% = −10%"), which tells you modest pay tweaks haven't fixed the incentive.121811 ⟳

Lifestyle & the trade

The single most-cited pro of geriatrics after the meaning: the lifestyle is genuinely humane. Clinical days run around 8 hours, the work is outpatient-forward, overnight in-house call is minimal-to-none in most roles, and the schedule is steady and predictable.23 Practice settings span university medical centers, private clinics, rural health centers, SNFs, and home visits, a menu that lets geriatricians shape their week and their panel, and locum and part-time arrangements are abundant given the shortage.3

The trade is emotional rather than circadian or physical (see Wellbeing). And it's financial: the same cognitive, unhurried, no-procedure character that makes the days sustainable is exactly what keeps the pay low. You are buying lifestyle and meaning partly with income.

Lifestyle rating: 4/5. High schedule control, steady daytime hours, light call, and an easy taper to part-time or pure clinic/house-call work later in a career. Docked from 5 mainly by the coordination load and the emotional weight, not by hours.

Wellbeing — the part to take seriously

Burnout is relatively low, with an honest data caveat. Medscape typically folds geriatrics into internal medicine, so a clean specialty-specific burnout number is scarce; flag that.19 What is consistent is that cognitive, continuity-based, non-procedural fields with controllable hours sit toward the lower-stress end of the spectrum, and geriatricians themselves frequently name their deep patient relationships as protective against burnout.1920 ⟳

Satisfaction is quietly one of the highest in medicine. This is the field's signature paradox: despite the lowest pay in its neighborhood, geriatricians report unusually high fulfillment. AGS cites research finding geriatrics "ranks among the most satisfying health professions," with one study reporting geriatricians had the highest job satisfaction of physicians in any subspecialty. The recurring driver is meaning: relationships, whole-person care, and being genuinely wanted by patients and families.3 ⟳

The real trade-off is emotional weight. Geriatricians manage decline, dementia, goals-of-care and end-of-life conversations, caregiver strain, and frequent patient death. Those who thrive reframe "cure" as comfort, dignity, and function, but grief and loss are baked into the job, and multiple sources call this the most underrated hard part of the field.20

Career longevity is excellent. No radiation, no OR time pressure, no brutal overnight surgical call; a cognitive skill set that deepens with experience; and an easy late-career taper to part-time, clinic-only, or house-call work. This is a field a physician can genuinely sustain for decades, the opposite of the young-attrition problem seen in shift-heavy specialties.20

Who's in the field (demographics)

  • Women: "just over half" of practicing geriatric medicine physicians, one of a small set of specialties (with dermatology and endocrinology) where women exceed 50%. The fellow class runs well ahead of that: ACGME Table C.21 gives 172 of 264 IM-track geriatric medicine fellows as women (65.2%) and 18 of 28 on the FM track (64.3%), or 190 of 292 across both, 65.1%, in AY2024-25. Among geriatric medicine (IM) program faculty, ~65% are full-time female physicians, which is the same level.21224 ⟳
  • DO: 17.2% of matched fellows (26 of 151, 2026 appointment year), an ordinary share rather than a standout one. The five most DO-heavy fellowships NRMP names that year all sit at 29% or above.10 ⟳
  • IMG: 42.4% of matched fellows (64 of 151, 2026), split almost exactly in half between US-citizen graduates of international schools (32, 21.2%) and non-US-citizen graduates (32, 21.2%). NRMP's own report names geriatric medicine the second-highest US-citizen-IMG share of any fellowship in both the 2025 and 2026 cycles, behind critical care medicine. The practicing and faculty workforce leans the same way, on international graduates filling gaps US graduates leave open.10 ⟳
  • Race/ethnicity (URiM): geriatric medicine is identified as among the most-chosen specialties for Hispanic physicians (disproportionately concentrated in the field), and the fellow counts bear it out. ACGME Table C.23 gives the 264 IM-track fellows as 114 Asian, 69 White, 31 Hispanic or Latino (11.7%), 20 Black or African American (7.6%), 6 multiple, 14 other and 10 unknown; the 28 FM-track fellows are 13 White, 6 Asian, 4 Hispanic and 3 Black. These are head counts on a small row, so read the two smallest categories as counts rather than rates.2122 ⟳

Culture, personality & the online stereotypes

Who gravitates here: the reputation is that geriatrics draws some of the kindest, most patient, most mission-driven personalities in all of medicine, people who genuinely love complex multimorbidity and the puzzle of the whole person (the medication list, the falls, the cognition, the family system), who are energized rather than drained by slow, non-linear progress, and who explicitly value meaning over money. AGS describes practitioners pulled in by compassion, curiosity about people's life histories, and a desire for continuing, person-centered care, often with a personal connection to an aging relative.3 Plenty of geriatricians won't fit any single mold, but that's the honest, warm center of the pattern.

The stereotypes. Community caricatures rather than facts, each with an unfair edge:

  • "Saintly but underpaid." The admiration is real and so is the pay gap, but it flattens a field with real intellectual depth (polypharmacy, multimorbidity, cognition) into pure altruism.
  • "The anti-cardiology." Online it gets called the exact inverse of the procedure-heavy, high-RVU, high-pay path. True as a contrast, and unfair if it implies "less rigorous," because integrating twelve interacting problems is its own hard skill.
  • "Worst ROI in medicine." The one-line meme: pay for an extra year to earn less. Accurate about the economics, silent about why people still love it.
  • "You can just do this as a generalist." Partly true, since a lot of geriatric care is delivered by internists and family docs, which is exactly what fuels the ROI debate, but undersells fellowship-level expertise in frailty, dementia, and de-prescribing.

What people say online (synthesized and paraphrased, not quotes): Across trainee and physician forums the picture is remarkably consistent and two-sided. There's near-universal respect for geriatricians as doing some of the most humane, needed work in medicine, paired almost every time with genuine confusion about the economics ("why would anyone fellowship to earn less?"). The pay paradox is the single most-discussed thread. People repeatedly note you can already do a lot of geriatric care as a generalist (fueling the ROI debate), broadly agree the lifestyle is excellent (steady hours, light call, controllable panel), and describe the people who choose it as unusually warm and values-first. Two quieter themes recur: the emotional load (death, decline, dementia, family dynamics) is underrated, and ageism in medicine, meaning trainees writing off older patients as "complex and unfixable," is named by several as the real reason the field under-recruits, more than pay.

Voices from the field. Paraphrased from public writing, with links to the originals:

  • A family physician writing for KevinMD argues the deep bonds with older patients are exactly what protect her from burnout, recounting how an 82-year-old's "wound visit" was really about grief, and that whole-person listening is the heart of the work.20
  • The American Geriatrics Society frames the field as person-centered, relationship-rich, steady-hours work that consistently ranks at or near the top for physician job satisfaction.3
  • A John A. Hartford Foundation leader documents the paradox directly: even a ~$24,000 Medicare bonus (>10% of the average salary) failed to lift fellowship numbers, which fell anyway, in what he calls "not how supply and demand was supposed to work."18
  • A JAMA commentary argues the recruitment crisis is driven by ageism as much as pay: geriatrics earns ~9% less than general IM and ~14% less than hospitalists despite the extra year, but the deeper barrier is trainees' negative attitudes toward caring for older adults.1

Why people choose it / why people leave

Why choose it: among the highest career satisfaction and sense of meaning of any field · excellent, controllable lifestyle (steady daytime hours, light call, sustainable for decades) · enormous structural demand and near-total job security · intellectually deep (multimorbidity, polypharmacy, cognition, function, family systems) · a genuinely accessible fellowship (one extra year, programs under-subscribed) · practice almost anywhere, including near family or in low-cost areas · relationships that span years and whole life stories.

Why leave or avoid it: the pay paradox, since it can pay less than the general IM or FM job you'd already qualify for, a real weight with student debt · emotional toll of frequent death, decline, dementia, and caregiver strain (wins are comfort and dignity, not cures) · no procedures / no OR · you can already deliver much geriatric care as a generalist, which weakens the financial case for the fellowship · ageism from some colleagues who wrongly treat the work as low-status.

Best fit if: you're patient, holistic, and genuinely drawn to older adults and their stories · you love untangling complex, multi-system, whole-person problems · you measure a career in meaning and relationships more than income or prestige · you want a humane, controllable schedule you can sustain for life.

Not for you if: you need procedures or fast, clear cures · you're easily drained by death and decline · you're carrying debt that makes earning less than a hospitalist untenable · you want a field peers treat as prestigious · you want to sub-specialize toward a high-RVU procedural niche.

The FLI angle — Geriatric Medicine for first-gen, low-income & immigrant students

Where geriatrics fits FLI realities well:

  • A genuinely accessible fellowship. With fill rates under ~40%, matching into geriatrics is realistically attainable, a low-competition, one-year path that does not demand the research/pedigree arms race of cardiology or GI. For a first-gen applicant without an insider network, that accessibility is real.8
  • IMG- and DO-friendly, and the IMG half is exceptional. 42% of 2026 matched fellows are international graduates, which NRMP's report puts second among all fellowships for US-citizen IMGs specifically, and 17% are DOs. If you trained abroad, very few doors in American medicine are open this wide.10
  • Excellent lifestyle + longevity. Steady hours and light call make it far easier to sustain family, caregiving, or a second income stream, and to practice for decades.23
  • Huge demand + strong job security. The shortage is structural and worsening, so you can work essentially anywhere, negotiate, and live in a low-cost area near family rather than chasing an expensive market.32
  • Income can be built up. The base salary hides real upside: SNF/nursing-home medical directorships (1099 stipends on top of clinical pay), hybrid locum work, home-based primary care, and PACE roles. The floor is modest and the ceiling sits above the sticker number, by an amount nobody outside the staffing industry publishes.15

The honest, prominent catch (named compassionately):

  • Here is the part that matters most if you're carrying debt: geriatrics can pay less than the general IM or FM job you'd already qualify for, roughly 9% below general internists and 14% below hospitalists, after an extra fellowship year.1 If you're the first in your family to reach medicine and money is real for you, that is not a small thing, and no one should shame you for weighing it. The meaning is genuine and the satisfaction data is real, but so is the paycheck. The honest move is to go in clear-eyed: if the numbers work for your life, this is one of the most humane and secure careers in medicine; if they don't, staying a generalist (where you can still care for older adults) or choosing another path is a completely valid decision.

Bottom line: Geriatrics is one of the most accessible, humane, and secure careers in medicine, chosen almost entirely for the work rather than the money, a field where an extra training year can genuinely lower your income even as it gives you some of the highest job satisfaction in the profession. Hope for the meaning and plan for the math, and if you can, shadow a geriatrician across a clinic day, a SNF round, and a house call before you commit.

Subspecialties, overlaps & adjacent paths

Geriatrics is itself a subspecialty, but it sits at a crossroads with two closely related fields geriatricians often add or co-practice:23

  • Hospice & Palliative Medicine (HPM). Heavy overlap; a separate 1-year fellowship, but the skill sets in goals-of-care, symptom management, and end-of-life care are deeply shared, and many geriatricians dual-practice or dual-board (palliative overlap comp reported ~$324k).13
  • Geriatric Psychiatry. A psychiatry fellowship focused on dementia, late-life depression, and behavioral symptoms; notably one of the few aging-focused fellowships to grow even as geriatric medicine shrank. Geriatricians and geriatric psychiatrists frequently co-manage the same complex patients.18
  • Income/leadership tracks within geriatrics: SNF/long-term-care medical directorships, PACE medical directorship, and home-based primary care leadership, the practical ways to broaden scope and income without a second fellowship.1516

Fun facts

  • Geriatrics is one of the very few fields where an extra year of fellowship training can lower your income relative to the general IM or FM job you already qualified for, the defining "worst-ROI" reputation.111
  • Fellowship fill rates have fallen from 51.1% in 2022 to 38.9% in 2026 (151 of 388 positions filled; 237 unfilled), making it one of the most accessible fellowships in medicine.10
  • The number of board-certified geriatricians actually fell, from ~10,270 in 2000 to ~7,413 in 2022, even as the over-65 population exploded.1
  • Estimates put the need near ~20,000 geriatricians today and ~30,000 by 2030 against fewer than ~7,300 practicing, one of the widest supply-demand gaps in US medicine. Each geriatrician can effectively serve only ~700 older adults, and more than 60% of US counties have no geriatric specialist of any kind.2411
  • A ~$24,000 Medicare pay bonus (>10% of the average salary) once failed to raise fellowship numbers, and they dropped anyway.18
  • Despite the lowest pay in its cohort, geriatrics repeatedly lands at or near the top for physician job satisfaction, the field's signature paradox.3
  • It's one of the few specialties where women exceed 50% of physicians, alongside dermatology and endocrinology.21

Sources

Footnotes

  1. Gurwitz JH, "The Paradoxical Decline of Geriatric Medicine as a Profession," JAMA, 2023 — geriatrics ~9% below general IM and ~14% below hospitalists; board-certified geriatricians fell ~10,270 (2000) → ~7,413 (2022); recruitment crisis driven by ageism as much as pay. Copy via Brookline, MA: https://www.brooklinema.gov/DocumentCenter/View/44523/The-Paradoxical-Decline-of-Geriatric-Medicine-as-a-Profession-_-Geriatrics-_-JAMA-_-JAMA-Network (2023). ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  2. Barton Associates, "Geriatric Medicine Salary Guide 2026" — $253k–$289k band, $289,201 median; continuity/relationship-based work; 8-hour days, steady hours; high-pay states (Maine, Louisiana, Alaska, Idaho, Hawaii). https://www.bartonassociates.com/geriatric-physician-salary-guide/ (2026). Corrected 2026-08-17. Barton Associates is a locum tenens staffing agency, so where it publishes rates for locum work it is the seller publishing the price, and this site's price rule turns on whoever publishes the price not being the one selling the service. Removed from this page: the $100–$180/hr locum band (typical $125–$145), the **$278k/yr full-time-locum scenario**, and the **$289k base + ~$40k locum ≈ ~$329k hybrid scenario**, which appeared in the employment-models section and again in the FLI section. The dashboard's ~$370k–$400k+ stacking SNF directorships/locums cell and the same band in the compensation spread rested on those figures and are gone with them. The structural claim — that locum work and SNF directorships are how geriatricians raise total compensation — stands without a number. The identical class of figure was removed from the gastroenterology profile on the same ground. Barton's permanent-placement salary band is kept: it is a recruiter aggregate of what employers pay rather than a price for a service Barton sells, which is a weaker case under that rule than the hourly rates and is flagged here rather than acted on. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10

  3. American Geriatrics Society, "Is Geriatrics Right For You" — steady work hours, practice-setting range, person-centered draw, and geriatrics ranking at/near the top for physician job satisfaction. https://www.americangeriatrics.org/geriatrics-profession/why-geriatrics/geriatrics-for-you (accessed 2026). ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10

  4. FREIDA — Geriatric Medicine (IM): 1-year minimum fellowship length; ~65% full-time female faculty. https://freida.ama-assn.org/specialty/geriatric-medicine-im (accessed 2026). ↩ ↩2 ↩3 ↩4 ↩5

  5. NRMP SMS Results and Data 2025 — geriatric medicine "operates under multiple Review Committees (Family Medicine and Internal Medicine)"; matches through the Medicine and Pediatric Specialties Match (SMS). https://www.nrmp.org/wp-content/uploads/2025/02/SMS_Results_and_Data_2025.pdf (2025). ↩ ↩2

  6. ABIM — subspecialty board certification in Geriatric Medicine (IM-trained); requires ACGME-accredited fellowship. https://www.abim.org/certification/becoming-certified-in-internal-medicine/confirm-your-eligibility/ (accessed 2026). ↩

  7. ABFM — Certificate of Added Qualifications (CAQ) in Geriatric Medicine (FM-trained). https://www.theabfm.org/added-qualifications/geriatric-medicine/ (accessed 2026). ↩

  8. Trilliant Health, "Geriatric Medicine Fellowship Fill Rates Collapse to 38.9%" — 2026 SMS: 388 offered, 151 filled, 38.9% fill (lowest of IM subspecialties); state-level fill-rate spread; ~$292k vs. cardiology. https://trillianthealth.substack.com/p/geriatric-medicine-fellowship-fill-rates-collapse (2026). Corrected 2026-08-17: this page previously took its multi-year fill trend from this article, which opens "between 2023 and 2026, geriatric medicine fell from 58.7% to 38.9%." NRMP's Table 6A puts 2023 at 43.1%, and the article's own filled count for that year (177 of NRMP's 411 offered) reproduces NRMP's rate rather than its own. The trend now comes from NRMP directly under 10; the state-level spread, which NRMP does not publish, still comes from here. ↩ ↩2 ↩3

  9. NRMP, "2026 Specialties Matching Service Results" news release — geriatrics among only 8 of 81 subspecialties filling under 50%; overall 2026 SMS 84.4% fill. https://www.nrmp.org/about/news/2026/02/nrmp-publishes-results-and-data-for-the-2026-specialties-matching-service/ (2026). ↩

  10. NRMP SMS Results and Data, geriatric medicine (IM RC). 2025 appointment year — 145 programs, 382 offered, 169 filled, 44.2% fill, 204 applicants ranked, 103 programs with ≥1 unfilled; matched-fellow composition (Table 2) US MD 77 (45.6%), US DO 25 (14.8%), Canadian 1 (0.6%), US IMG 36 (21.3%), non-US IMG 30 (17.8%), the five summing to 169. https://www.nrmp.org/wp-content/uploads/2025/02/SMS_Results_and_Data_2025.pdf (2025). 2026 appointment year — 146 programs, 388 offered, 151 filled, 38.9% fill, 192 applicants ranked, 112 programs with ≥1 unfilled; composition (Table 2) US MD 61 (40.4%), US DO 26 (17.2%), US IMG 32 (21.2%), non-US IMG 32 (21.2%), Canadian 0. Five-year fill from Table 6A: 51.1% (2022), 43.1% (2023), 41.5% (2024), 44.2% (2025), 38.9% (2026), on 411, 411, 419, 382 and 388 positions offered. NRMP's own narrative in both editions ranks geriatric medicine second of all fellowships for the share of positions filled by US-citizen IMGs, at 21.3% in 2025 and 21.2% in 2026, behind critical care medicine. https://www.nrmp.org/wp-content/uploads/2026/02/SMS_Results_and_Data_Report2026.pdf (2026). Corrected 2026-08-17: this footnote previously gave the 2025 composition as DO 57 (~34%), US-IMG 16 (~9%) and non-US IMG 15 (~9%). Those counts appear nowhere in SMS 2025 for this specialty and sum to 165 against the 169 filled stated in the same sentence. The DO share was overstated by roughly 19 points and the combined IMG share understated by roughly 21. The dashboard, the demographics section and the FLI section all repeated them and are corrected to the 2026 row, which is the current cycle. The accessibility argument the page was making survives and gets stronger: the standout number is the IMG share, not the DO share. ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  11. Association of Health Care Journalists, "What to know about the geriatric workforce shortage" — geriatricians ~$20,000/yr less than internists who skipped the fellowship; ~1 geriatrician per ~10,000 older adults; >60% of US counties with no geriatric specialist; ~1 in 10 med schools require clinical geriatrics (down from ~1 in 4); ~78 million Americans 65+ by 2040. https://healthjournalism.org/blog/2026/07/what-to-know-about-the-geriatric-workforce-shortage/ (July 2026). ↩ ↩2 ↩3 ↩4 ↩5

  12. Doximity 2025 Physician Compensation Report (2024 data) — Geriatrics $291,968; Internal Medicine $326,116; Family Medicine $318,959; +3.7% YoY; metro figures; 26% gender pay gap. https://www.doximity.com/reports/physician-compensation-report/2025 (2025). Doximity 2023 (~2022 data) geriatrics $275,704 via MDLinx: https://www.mdlinx.com/article/the-5-lowest-earning-medical-specialties/5mDKud5v8o7bhgAaLQgzHt. ↩ ↩2 ↩3 ↩4 ↩5 ↩6

  13. SalaryDr, "U.S. Geriatrician Salary 2026" (updated July 23, 2026; n=19, small sample — directional only) — median $320,000, average $314,432, base $260,747, percentiles ($270k–$373k), experience curve, metro samples, palliative overlap ~$324k. https://www.salarydr.com/specialty/geriatrics (2026). ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  14. Becker's Hospital Review, "29 physician specialties ranked by annual compensation: Medscape" (Medscape 2025 report, 2025 data) — Internal Medicine $307k, Family Medicine $288k, Pediatrics $266k; orthopedics ~$611k, cardiology ~$575k; geriatrics not broken out separately. https://www.beckershospitalreview.com/compensation-issues/29-physician-specialties-ranked-by-annual-compensation-medscape/ (2026). ↩

  15. Physician forum, reported as anecdote rather than as data. White Coat Investor Forum, "Skilled Nursing Facility Medical Directorship Pay" — posters describe directorships paid as separate 1099 stipends on top of clinical pay, with amounts varying widely by facility and no standardized public figure. https://forum.whitecoatinvestor.com/practice-management/1175-skilled-nursing-facility-medical-directorship-pay (accessed 2026). Corrected 2026-08-17: this footnote named the forum, which this site requires of any forum citation, and omitted the word anecdote, which it requires of any forum-sourced pay figure. Both are here now. The thread's post dates are required too, and are still missing. The $350k–$400k+ stacked-income band this thread had been used to support is no longer on this page: it was replaced by "how far above is not something anyone publishes," which is what the thread actually supports. ↩ ↩2 ↩3 ↩4 ↩5

  16. National PACE Association — PACE capitated, team-based care model and geriatrician medical-director roles. https://www.npaonline.org/work-in-pace/jobs/ (accessed 2026). ↩ ↩2

  17. MaritHealth, "Academic vs Private Practice Physician Salaries" (2022 data) — academic ~10–15% below private. https://www.marithealth.com/posts/academic-vs-private-practice-physician-salaries (2022). Track-specific geriatrician figures: IM track ~$321k (https://www.marithealth.com/o/-/geriatrician-internal-medicine/salary), FM track $309k (https://www.marithealth.com/o/-/geriatrician-family-medicine/salary), 2026. On Marit Health: it publishes a panel of self-reported physician salaries, and displays MGMA and AMGA benchmarks beside them that are masked unless you create an account. The figure quoted here comes from the self-reported panel, not from either benchmark. Read it as crowd data: unweighted, of unstated sample size, and directional. Corrected 2026-08-17: the academic band on this page was derived rather than published — a 10–15% discount applied to Doximity's $291,968 — and it was the only compensation line in the section without a ⟳. It also did not close against its own inputs: the stated range ran to $220,000 on the low side where the arithmetic gives $248,000. The band now prints the arithmetic, carries the stamp, and says whose rule of thumb it rests on. The Quick dashboard's "$220k early/academic" cell inherited the low end and now reads "early-career outpatient," which is what SalaryDr's 0–2-year figure and the outpatient-clinic baseline actually support. ↩

  18. Langston C, "Decline in Geriatric Fellows Defies Pay Boost: +10% = −10%," John A. Hartford Foundation — a ~$24,000 Medicare bonus (>10% of average salary) failed to lift fellowship numbers; geriatric psychiatry grew as geriatric medicine shrank. https://www.johnahartford.org/blog/view/decline-in-geriatric-fellows-defies-pay-boost-10-10 (accessed 2026). ↩ ↩2 ↩3 ↩4

  19. Healthgrades summary of Medscape burnout data (2024) — geriatrics typically folded into internal medicine; cognitive/continuity fields with controllable hours sit toward the lower-burnout end. https://resources.healthgrades.com/pro/the-most-and-least-burned-out-physicians-by-specialty (2024). ↩ ↩2

  20. Smith SC, DO, "Why I love caring for geriatric patients," KevinMD (2020) — deep patient bonds as protective against burnout; the emotional/whole-person weight of the work. https://kevinmd.com/2020/02/why-i-love-caring-for-geriatric-patients.html (2020). ↩ ↩2 ↩3 ↩4

  21. AAMC, "What's your specialty? New data show the choices of America's doctors by gender, race, and age" — women "just over half" of geriatric medicine physicians (with dermatology, endocrinology); geriatrics among most-chosen specialties for Hispanic physicians. https://www.aamc.org/news/what-s-your-specialty-new-data-show-choices-america-s-doctors-gender-race-and-age (accessed 2026). ↩ ↩2 ↩3

  22. ACGME, Data Resource Book, Academic Year 2024-2025. Table C.21 (Active Residents by Specialty and Subspecialty and Sex): geriatric medicine under internal medicine — 118 programs, 264 fellows, 172 women (65.2%), 88 men (33.3%), 4 not reported (1.5%); geriatric medicine under family medicine — 44 programs, 28 fellows, 18 women (64.3%), 10 men (35.7%). Table C.23 (Race/Ethnicity) for the same two rows: IM track 114 Asian, 69 White, 31 Hispanic/Latino, 20 Black/African American, 6 multiple, 14 other, 10 unknown; FM track 13 White, 6 Asian, 4 Hispanic/Latino, 3 Black/African American, 1 multiple, 1 other. Table C.15 (Medical School Type) puts the IM-track fellows at 148 international graduates (56.1%), 83 US LCME (31.4%) and 32 osteopathic (12.1%), which is the practicing-workforce pattern showing up in the pipeline. https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf Corrected 2026-08-17: the demographics section said a precise percentage of women among current fellows "isn't confirmed to a primary source" and told the reader to verify it in this book, and said the same of the URiM breakdown. Both are published in it, in the two tables above, and the fellow figure is a materially different and stronger fact than the practicing one: 65% against AAMC's "just over half." The instruction was right and nobody had followed it. The AAMC figure is kept as what it is, a practicing-workforce number. ↩ ↩2

  23. ABFM 2026 Geriatric Medicine Exam Information Booklet and ABFM Certificates of Added Qualification — fellowship/certification structure and adjacent pathways. https://www.theabfm.org/added-qualifications/ (accessed 2026). ↩

  24. American Geriatrics Society, "Geriatrics Workforce By the Numbers" — <7,300 certified geriatricians practicing; ~20,000 needed now; ~30,000 needed by 2030; 14M+ older adults needing care; ~700 patients per geriatrician. https://www.americangeriatrics.org/geriatrics-profession/about-geriatrics (accessed 2026). ↩

Researched with AI assistance and reviewed by hand. How this site is made