Table 1 Characteristics and results of the included studies

Chua [15]

To determine medical students’ attitudes towards older people and their willingness to consider a career in geriatric medicine

Quantitative; cross-sectional survey

244; RR 97,6%; Medical students (first year, prior to formal clinical exposure)

Medical school; Yong Loo Lin School of Medicine, National University of Singapore

Singapore

Attitudes towards older people using a modified UCLA-GAS (14 items)[27]

Willingness to consider geriatric medicine as a career choice (1 item)

Significant positive relationship between medical students’ attitudes towards older people and the willingness to consider geriatric medicine as a career (r = 0.48, p < 0.001)

45%

Fitzgerald [16]

To examine the relationship between medical students’ attitudes toward older adults and their interest in geriatric medicine as a career

Quantitative; cross-sectional survey

171; RR 89%; Medical students (first year, entering medical school)

Medical school; University of Michigan

USA

Attitudes about older adults using UCLA-GAS (14 items)[27]

Interest in geriatric medicine as a career (1 item)

Significant positive relationship between medical students’ attitudes towards older adults and interest in a geriatric medicine career (β = 0.28, t = 0.28, p < 0.001)

49%

Hughes [20]

To evaluate the relationship between medical students’ attitudes toward older people and their willingness to consider a career in geriatric medicine, and the effects of a geriatric medicine training program

Quantitative; cross-sectional survey and one group pretest–posttest study

233; RR 99% and 58%; Medical students (first year before clinical exposure (n = 169), fourth year before and after geriatric medicine clinical training program (n = 70))

Medical school; University of Aberdeen

UK

Attitudes toward older people using a modified UCLA-GAS (14 items)[27]

Likelihood of considering a career in geriatric medicine (1 item)

Significant positive relationship between first year medical students’ attitude toward older people and their willingness to consider a career in geriatric medicine (R² = 0.124, p < 0.001). No significant association between the post course rise of fourth year medical students’ willingness to consider a career in geriatric medicine and their attitude towards older people (p > 0.20)

43%

Meiboom [26]

To gain more insight in factors that have influenced postgraduate medical trainees in choosing elderly care medicine as a career during medical school

Qualitative; focus group discussions

34–35; RR unknown; Postgraduate medical trainees (elderly care medicine (n = 26–27) and gynecology (n = 8)

University medical center and a teaching hospital; VU University Medical Center and Saint Lucas Andreas Hospital, the Netherlands

The Netherlands

n.a

n.a

Some elderly care trainees were drawn to older patients because of their wisdom and stories. For some of them this played a role in choosing elderly care as a specialism, for others it did not play a role. Some trainees were scared by death, resulting in a negative perception of elderly care medicine during their medical education

63%

Merrill [21]

To investigate the reason some caregivers desire to avoid patients with terminal illnesses

Quantitative; cross-sectional survey

718; RR unknown; Caregivers (medical students (first and fourth year; n = 616), primary care physicians (n = 55), nurse students (undergraduate and graduate; n = 47))

Unknown, except for physicians; practicing in the community health clinics of Houston, Texas

USA

Thanatophobia using a rewritten Thanatophobia Scale (7 items)[33]

Self-esteem in caring for elderly patients using an unnamed scale (10 items)[34]

Significant negative relationship between fourth year medical students’ thanatophobia scores and self-esteem when treating elderly persons (p < 0.0001). Relationship between thanatophobia among first year students and their self-esteem when treating elderly persons was not reported

50%

Ng [28]

To analyze medical students’ attitude towards older adults and interest in geriatric medicine as a career before and after implementation of a course

Quantitative; pretest–posttest study

68; RR 71%; Medical students (third year, before and after Healthcare of Elderly course)

Medical school; Universiti Putra Malaysia

Malaysia

Attitude towards older adults using UCLA-GAS (14 items)[27]

Interest to pursue geriatric medicine as a career (number of items unknown)

No significant relationship between post course third year medical students’ attitude toward older adults and their interest in a future career in geriatric medicine (β(SE) = 0.38 (0.26), 95% CI = 0.14, 0.90, p = 0.152)

39%

Perrotta [17]

To examine the influence of medical students’ general attitudes toward the aged on their attitudes toward geriatric patients and geriatric medicine

Quantitative; cross-sectional survey

127; RR 100%; Medical students (first-year)

Medical school; attendees of the first-year student orientation program at the State University of New York at Buffalo School of Medicine

USA

Attitudes toward the aged using Kogan scale (34 items)[29]

Attitudes toward geriatric patients and geriatric medicine using a questionnaire containing items developed by various authors (8 items; 5 subscales, i.e. Characteristics of Elderly Patients, Choice of Patient Population (preference for younger or older patients and interest in geriatric medicine), The Chance of Successfully Treating the Aged, Social and Emotional Characteristics of Elderly Patients, Amount that Elderly Patients Contribute to the Treatment Process)[35,36,37]

Significant positive relationship between first year medical students’ attitude toward the aged and the subscale characteristics of elderly patients (r = 0.27, p = 0.006). No significant relationship between first year medical students’ attitude towards the aged and their attitudes towards geriatric patients and geriatric medicine (and other subscales of the questionnaire)

50%

Ruiz [22]

To determine the relationship between medical students’ explicit and implicit anti-aging bias and their intent to treat older patients

Quantitative; cross-sectional survey

103; RR 14%; Medical students (first year (n = 33), second year (n = 35), third year (n = 22), fourth year (n = 12))

Medical school; attendees of a Liaison Committee on Medical Education (LCME) accredited medical school in the USA

USA

Attitudes toward the elderly using Fraboni Scale of Ageism (29 items; explicit attitude)[31] and Implicit Association Test (pairing 10 pleasant and unpleasant words with pictures of old and young men; implicit attitude)[39]

Intent to practice with older patients using Intended Practice Patterns with Older Patients (10 items), adapted from unnamed questionnaire[38]

Significant positive relationship between medical students’ explicit attitude toward the elderly and their intent(ion) to practice with older patients (r = 0.38, p < 0.001). No significant relationship between their implicit attitude toward the elderly and intent(ion) to practice with older patients

46%

Schigelone [18]

To examine medical students’ attitudes, experiences, beliefs about older adults, and their fears about aging and death, that are relevant to their pursuit of geriatrics

Qualitative; semi-structured interviews

20; RR 53%; Medical students (first year), sample contained students that were moderately interested (n = 10) or not interested (n = 10) in geriatric medicine as a career

Medical school; situated Midwestern

USA

n.a

n.a

Students who were moderately interested in geriatrics expressed much more fear about aging and death than those students who were not interested in geriatrics. Those who were afraid expressed more fears about the death of others close to them than about their own death. This concern about death extended to their patients as well. Their fears of aging applied to both the aging of others and of themselves

50%

Wilderom [19]

To examine medical students’ attitudinal correlates to specialize in geriatric medicine

Quantitative; cross-sectional survey

663; RR 82%; Medical students (first year, entering medical school; in 6 consecutive years)

Medical school; a large northeastern American state university school of medicine

USA

Attitude toward the aged in general using Kogan scale (34 items)[29]

Interest in providing medical care to elderly patients and in specializing in geriatric medicine (number of items unknown).Perception of the elderly as patients (number of items unknown)

Significant positive relationship between first year medical students’ attitude toward the aged and their perception of the elderly as patients. Attitude toward the aged explained 10% of the variation in perception of the elderly as patients. Significant positive relationship between first year medical students’ attitude toward the aged and their interest in specializing in geriatric medicine. Attitude toward the aged explained 2% of the variation in their interest in specializing in geriatrics

57%

Yao [23]

To explore medical students’ willingness to work with older persons and the associated factors

Quantitative; cross-sectional survey

580; RR 72,5%; Medical students (first year (n = 85), second year (n = 146), third year (n = 199), fourth year (n = 150)

Medical school; 6 or 7 Medical universities situated in Taiwan

Taiwan

Attitudes towards older adults using (Polizzi’s refined version of the) Aging Semantic Differential (24 items)[30]

Willingness to take care of older adults using Willingness towards the Elderly Care Scale (15 items)

Significant positive relationship between medical students’ attitudes towards older adults and their willingness to care for older adults (r = 0,313, p < 0.000)

51%

Zhao [24]

To examine the relationship between attitude toward older adults and willingness to consider a career in geriatric medicine

Quantitative; cross-sectional survey

1022; RR 96%; Medical students (first year (n = 212), second year (n = 273), third year (n = 300), fourth year (n = 172), fifth year (n = 65)

Medical school; Huanzhong University of Science and Technology and Shanxi Medical University

China

Attitude towards older adults using Fraboni Scale of Ageism (29 items)[31]

Willingness to consider a career in geriatric medicine after graduation (1 item)

Significant positive relationship between medical students’ attitude towards older adults and their willingness to consider a career in geriatric medicine after graduation (t = 4.281, p < 0,001, Cohen’s d = 0.268)

57%