Status and Perspectives on Geriatric Medicine in Norway, Sweden, Finland, and Denmark: A Cross-National Comparative Analysis of Educational Needs and System Development - a sub-analysis of PROGRAMMING – COST ACTION 21122 ​

Abstract Purpose The Nordic countries, despite shared welfare models, have developed distinct approaches to geriatric medicine and education in response to ageing populations. We explored how geriatric medicine has evolved across Norway, Sweden, Finland, and Denmark over the past decade. Methods We conducted a cross-national comparative descriptive study. Data encompassed COST PROGRAMMING educational needs assessment survey, national workforce and policy reports, and contextual information from national geriatrics societies. Data were analysed descriptively and synthesised to compare workforce development, educational structures, organisational integration, and strategic prioritisation of geriatric medicine across countries. Results Substantial variation was identified across countries despite comparable demographic development. Norway, Finland, and Denmark demonstrated coordinated national workforce planning and increasing geriatric workforce capacity. Norway had by far the highest participation in the European Academy for Medicine of Ageing (EAMA), a two-year postgraduate leadership and academic training programme in geriatric medicine. In Finland, many geriatricians work in primary care and community-based services, reflecting a more community-oriented model. Structural integration of geriatric services within hospital systems varied markedly, with Swedish geriatric services showed markedly regional variation and organisational structure. Survey findings highlighted persistent barriers across countries, including perceptions of workforce shortages, low prestige associated with geriatrics, and fragmented care pathways. Respondents emphasised the need for educational support in managing frailty, multimorbidity, and interdisciplinary care, and preferred clinically integrated, case-based educational approaches. Conclusions The development of geriatric medicine in the Nordic countries is shaped by workforce planning, educational investment, academic development, and structural integration of geriatrics within healthcare systems.