Geriatrician

What geriatricians make

Job Bank's page for geriatricians pools every specialist physician and lists a median of about $311,000 a year. CIHI (Canadian Institute for Health Information) does not break geriatric medicine out; it reports average gross payments of about $445,000 for internal medicine and its subspecialties (2023 to 2024). Those are billings before overhead. Geriatric visits are long and there are no procedures, so it sits at the lower end of internal medicine, with most netting roughly $250,000 to $340,000. This is an estimate. Many jobs are salaried, and it varies by province.

During residency

Paid employees with benefits and a union contract. Quebec pays the least, Alberta and Ontario the most.

Long visits, lower billing

You cannot rush a person with memory loss, six diagnoses and twelve medications. Provinces pay extra for geriatric consults, but not enough to match specialties that see a patient every 10 minutes. Many geriatricians take a hospital salary instead.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

Licensing exam (the MCCQE, the national medical exam) and two Royal College exams (internal medicine, then geriatric medicine)

$1,500 for the MCCQE, plus two Royal College exam fees of several thousand dollars each

Roughly, all in

$75,000 to $170,500

Tuition, fees, exams and kit. Not rent, food or travel

The low end is three years of undergraduate study at $7,000 a year, a three year medical degree at $15,000 a year, and the exam and application fees. The high end is four years of each at the top of the range, plus MCAT (Medical College Admission Test) costs, the MCCQE (Medical Council of Canada Qualifying Examination), and two Royal College exams, one for internal medicine and one for geriatric medicine, at several thousand dollars each. The five residency years are paid work. Most graduates owe $80,000 to $150,000 leaving medical school, and geriatric medicine pays less than most specialties, so that debt takes longer to clear here than in a procedural field.

Typical debt at the end of medical school is $80,000 to $150,000. Five paid residency years help you pay it down.

Benefits

• Pension often, if salaried

  Hospital and academic contracts are common in geriatrics. Ontario residents are in HOOPP (the Healthcare of Ontario Pension Plan) during training and often after.

• Union contract during residency

  Provincial residents' associations negotiate pay, call limits and leave.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association), mostly reimbursed by the province. Fees are low for a non-procedural specialty.

• Light call

  Little overnight work. One of the more predictable schedules in hospital medicine.

The path

You become an internal medicine doctor first, then a specialist in older adults.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. You need a very high average for a science undergrad.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations.

4. 4

   Internal medicine residency

   3 years

   Matched through CaRMS (the residency matching service). Hospital wards, the ICU (intensive care unit) and clinics. In year 3 you apply to the subspecialty match.

5. 5

   Geriatric medicine residency, then certification

   2 years

   Memory clinics, falls and frailty, rehab units, long-term care and hospital consults on older patients. Pass the Royal College exams to become FRCPC (Fellow of the Royal College of Physicians of Canada) and register with your provincial College of Physicians and Surgeons.

High school courses that help

• Biology and chemistry

  Required for nearly every pre-med path.

• Calculus and functions

• Physics

  Tested on the MCAT (medical school admission test).

• Psychology and English

  Half the job is talking with frightened families and untangling memory problems.

Time and money, at a glance

Years after high school

11 to 13

Med school acceptance rate

Roughly 5% to 15%

Subspecialty match

Not competitive, spots go unfilled most years

Total tuition

$90,000 to $150,000

Paid while training?

Only during residency, 5 years of it

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise, and Royal College certification in both internal medicine and geriatric medicine. Both are national credentials, so moving provinces is mostly paperwork. Quebec requires working French. Family doctors can also add a year of care-of-the-elderly training; that is a different credential and does not make someone a geriatrician.

Focus areas that shape the job

• Memory and dementia

  Diagnosing and managing Alzheimer's and other dementias. The biggest single part of most practices.

• Orthogeriatrics

  Co-managing older patients with broken hips alongside surgeons. Shortens stays and saves lives.

• Rehabilitation

  Running a rehab unit that gets people home after a stroke or a fall.

• Long-term care

  Medical director of a nursing home. Part-time, steady, and desperately needed.

Nice-to-haves before med school

• Time with older people

  Volunteering in a seniors' home tells you fast whether this is your specialty.

• Patience

  Visits are slow by design.

• French

  Opens Ottawa, New Brunswick and Quebec programs.

• Liking whole-person medicine

  Geriatrics is about function and quality of life, not one organ.

A typical day

A morning consult on the ward: an 88-year-old admitted after a fall, confused, on eleven medications. You spend an hour with her and her daughter, cut four drugs, order a walker and a home safety visit. Then memory clinic: two new patients with possible dementia, each a 90-minute assessment with cognitive tests and a family interview. Afternoon on the rehab unit or at a long-term care home. Lots of team meetings with nurses, therapists and social workers. Home at a normal hour.

The honest trade-offs

Work life

Typical hours

40 to 50 a week

Remote work

Some virtual follow-ups and nursing home calls

Physical demand

Low to moderate

Unionized

Residents yes, attending doctors no

Similar paths

• Internal Medicine DoctorThe hospital doctor for adults with complicated problems, and the gateway to a dozen specialties. Four to five years of residency.
• Family DoctorThe longest path on this site, and one of the highest paid. Ten years, then a job for life.
• Occupational TherapistHelp people do the everyday things illness or injury took away: dressing, driving, working, living at home.

Only a few hundred in the whole country

CIHI (Canadian Institute for Health Information) counted just 425 geriatricians in Canada in 2024, about 1 for every 20,000 people aged 65 and older. It is one of the smallest specialties in the country and one of the most needed.

A quarter of Canada will be seniors

The Public Health Agency of Canada counted 6.6 million seniors in 2019, about 17.5% of the population, and expects close to a quarter of Canadians to be 65 or older by 2040. Every one of them is a potential patient.

Pills are often the problem

About 37% of Canadian seniors have at least two chronic diseases, and many take a long list of drugs. One of a geriatrician's most common prescriptions is to stop medications. Dizziness, falls and confusion often clear up when the pill count drops.

Sixty-five is not old anymore

A Canadian who reaches 65 can expect to live about 21 more years on average, according to the Public Health Agency of Canada. Geriatricians mostly see patients in their 80s and 90s, and a lot of them are still living at home.