Gericon Returns to the Oldest Living City as Geriatrics Spreads its Wings!

Varanasi hosted the annual national conference of the Indian Academy of Geriatrics, affectionately called Gericon, last in 2010. Having not started my medicine residency then, I missed being a part of it. It has been fourteen long years, and the 21st edition of Gericon is now back in the oldest living city on the planet, on the chaotic banks of the Ganges. Varanasi has transformed at a mind-boggling pace, drawing swarms of frenzied tourists. Geriatrics in India has grown too, though the pace has been more pedestrian. In 2010, at the time of the last edition in Varanasi, there was a single geriatrics residency program in the country, in Chennai. There now are more than fifteen, and steps to initiate more programs are in progress. As more graduate medical students opt for geriatrics, the pool of trained geriatricians continues to grow. The distance learning PGDGM (Postgraduate Diploma in Geriatric Medicine) program of the Indira Gandhi National Open University has augmented regular residency courses by generating excellent course material and spreading geriatric basic training to mostly independent medical practitioners and doctors in peripheral health services. The National Programme for Health Care of the Elderly (NPHCE) is the flagship program of the Ministry of Health and Family Welfare of the Government of India. It has provided thrust to the expansion of geriatrics by investing at all levels from tertiary institutions needing hand-holding for initiating residency programs and independent departments to district hospitals which now have dedicated geriatric in-patient services. A major development has been the coming up of two dedicated national centers of ageing (NCA) at the All India Institute of Medical Sciences, New Delhi, and at Madras Medical College, Chennai. A third is under construction in the Banaras Hindu University campus at Varanasi. The NCAs aim to provide comprehensive older care services under one roof, including intensive care, dialysis, operative interventions, and cognitive and fall clinics. The Institute of Medical Sciences, Banaras Hindu University also initiated the country’s first geriatric rheumatology fellowship program under the leadership of Prof Anup Singh (Organizing Chairman of Gericon-2024). Such fledgling upskilling programs for geriatric residents add to the charm of geriatrics as a career option. The Indian Academy of Geriatrics (IAG) has been at the forefront of older care advocacy in the country. Executive members have been involved in residency program curriculum development under the aegis of the National Medical Commission. They have engaged with international bodies such as the United Nations, the World Health Organization, and the International Association of Gerontology and Geriatrics. As geriatrics as a specialty is still under-recognized and often misunderstood as simple palliative care in India, the role of the IAG has been of paramount importance in spreading awareness about geriatrics. Two particularly remarkable developments have been the initiation of the student chapter of the IAG to popularize the subject among graduate medical students, and the online post-graduate teaching program being exemplarily conducted by the geriatrics team of the Armed Forces Medical College, Pune, incidentally the hosts of the next Gericon in 2025. The immediate past president of the IAG Prof Ashish Goel and the current President Prof Surekha V have been instrumental in these initiatives. Word-of-mouth publicity and team-based care, which are quite different from physician-centric care in standard general medicine services have started popularizing geriatric units as a point-of-first contact for older people. The specialty has grown as a result in the service provision domain too. There are still challenges to geriatrics. The resistance of a large part of the medical community who refuse to see the need for specialized older care doctors has been an impediment. Institutions across the country have suffered from artificially generated space crunches, where geriatric services have been considered expendable. Faculty recruitment has been slow leading to a low mentor-mentee ratio in residency programs, and inpatient services have not been allowed to thrive in some institutions. The Indian Academy of Geriatrics needs to be at the forefront of the fight to set things right. Just like Varanasi amidst all its chaos has a divine calming force at the center of the city, a calming force is needed to sort out the chaos in Indian geriatrics. As we welcome you to Gericon-2024, we see Indian geriatrics for what it is. It is like a young bird just spreading its wings for its first few flights. It is probably a much better time to pursue a career in geriatrics in India than it was fourteen years ago, but it is still a work in progress. We believe the bird will one day rule the skies like an eagle.