‘It Is A Big Need’: N.C. Needs Almost 1,000 Doctors For Geriatric Patients

(Spectrum News 1, Syndey McCoy) — From its coast to its mountains, North Carolina has much to offer, including a spot for retirees to settle down. With the Tar Heel State consistently ranking in the top states to retire, special care will be needed to accommodate this age group like geriatricians, but a national shortage in this field may not keep up with the demand.

Everyone has a reason to pursue a future career, including Tamara Damjanac, a fellow in the UNC Geriatric Medicine Fellowship Program.

“I knew the things that were important to me, were focusing on people’s quality of life. And things that were important to patients. I really liked how I got to spend a lot of time with patients and got to really get to know them and all the medications that they were taking and whether or not they really needed those medications,” Damjanac said.

Damjanac, in her early twenties when her mother was diagnosed with cancer, said she’s always felt a calling to medicine. She said she thought of many different fields but landed on geriatrics.

Geriatricians specialize in older adults’ care, as noted on Mount Sinai Hospital’s site.

“The thing that drew me to geriatrics is that I could really be like a full PCP, like a medicine doctor, and also talk about all of these things like end-of-life care and staying comfortable and thinking about quality of life,” Damjanac said.

Her favorite part — hearing her patients’ stories.

Now, she is in her first and only year of the UNC Geriatric Medicine Fellowship Program after completing internal medicine.

After the fellowship, Damjanac said she will become an assistant professor in geriatrics, with goals of being a primary care doctor for geriatric patients.

She is just one of four fellows in this year’s UNC Geriatric Medicine Fellowship Program.

Emily Cetrone, a clinical assistant professor and associate program director for the program, said the fellowship has two goals — to teach their fellows how to provide excellent care for patients and to inspire the next generation of geriatricians.

“Our goal is for our fellows to kind of go out into the world then and be excellent geriatricians, and then also sort of create these systems where older adults can thrive,” Cetrone said.

The American Geriatrics Society said, as of 2016, North Carolina had 227 certified geriatricians and is expected to need 931 by 2030.

“The truth is that we won’t have enough geriatricians just based on the kind of that growing population of… North Carolina,” Cetrone said. “It is a big need just across the entire country.”

The N.C. Office of State Budget Management predicts the state’s older adult population, age 65 and up, will double to about 2.7 million in 2040, compared with the 1.8 million it reported in 2023.

This year, all the spots in UNC’s fellowship program are full, with fellows learning and experiencing crucial hands-on learning to better their care.

From working as primary care doctors for geriatric patients, spending time at local nursing homes, UNC’s PACE program for the most vulnerable adults and more, these fellows learn everything to take care of geriatric patients.

“They also get to spend a lot of time learning about quality improvement, working with a lot of inter-professional colleagues such as social work, pharmacy, wound care, nursing,” Cetrone said.

Cetrone said this group of fellows will graduate in June. Other schools in our state have geriatric programs as well, a commodity to North Carolina.

“The number of overall spots in geriatrics fellowship is remaining about the same, but it’s becoming a little bit more spread out, which is nice in terms of geography, but it is still something where many places do not have access to a geriatrician,” Cetrone said.

Nationally, fewer than half of the spots for fellows in geriatric medicine were filled in 2025, according to the National Resident Matching Program.

“Sometimes recruitment into geriatrics can be a little bit of a challenge,” Cetrone said. “Some things that we’re trying to do are really reaching students as early as possible.”

Cetrone says one of the biggest challenges of geriatrics is the complexity of care and medical conditions both past and present, such as frailty, dementia, heart failure and diabetes.

“They need someone who understands how medications affect them very differently as they get older,“ Cetrone said.

Every geriatrician needs to be highly skilled in patient care, understanding individual needs through personal accounts and struggles.

“Another challenge is just the realities of some of our health care system in terms of finding, you know, that as patients get need more and more help and they need more caregivers in the funding for that is not often available,” Cetrone said. “It’s not covered by, you know, Medicare, that home care that they really need. And so trying to find those resources for patients is probably the biggest challenges that I see.”

The UNC Geriatric Medicine Fellowship Program said it has graduated an estimated over 70 fellows since 1988 and two fellows are registered for next year.

“By sharing those stories and sharing the need and sharing the joy, I think we can really capture more students in that way,” Cetrone said.