Healthcare

How to Become a Geriatrician (Health of the Elderly) in Ontario: Salary, Training, and Career Outlook

by Occupations.ca Team
11 min read

Are you drawn to helping older adults live well, stay independent, and keep their dignity as health needs change? If yes, becoming a Geriatrician (Health of the elderly) in Ontario could be a deeply rewarding path for you.

Job Description

What a Geriatrician does in Ontario

A Geriatrician is a medical doctor who specializes in the health and care of older adults, typically age 65 and above. In Ontario, you work in hospitals, outpatient clinics, community programs, and sometimes long-term care homes. You focus on complex medical issues, such as memory loss, falls, frailty, multiple chronic diseases, and medications that interact. You collaborate closely with family physicians, nurses, pharmacists, physiotherapists, occupational therapists, social workers, and community services.

Your primary tool is the Comprehensive Geriatric Assessment (CGA)—a holistic evaluation of a patient’s medical, cognitive, functional, psychological, and social needs. You use this assessment to create personalized care plans that help patients maintain function, Safety, and quality of life.

Geriatricians in Ontario are also active in Specialized Geriatric Services, including programs supported by the Regional Geriatric Programs of Ontario. Learn more about these services at the Regional Geriatric Program of Ontario: https://www.rgpo.ca

Daily work activities

  • See older adults in Hospital consults (e.g., on general medicine, Surgery, or emergency departments) to address delirium, falls, medication issues, and discharge planning.
  • Run outpatient clinics such as memory/dementia clinics, falls clinics, frailty clinics, or general geriatric medicine clinics.
  • Conduct CGAs, capacity assessments for decision-making, and coordinate care plans with families and caregivers.
  • Lead or participate in interdisciplinary team meetings.
  • Work with community supports (home care, day programs, caregiver Support, Transportation, meal services).
  • Provide guidance on advance care planning and goals-of-care discussions.
  • Teach medical students, residents, and other health professionals, especially in academic centres.
  • Contribute to research and quality improvement initiatives in aging care.
  • Use virtual care (e.g., via Ontario Health’s virtual care supports) to reach patients across the province: https://www.ontariohealth.ca and https://otn.ca

Main tasks (bullet points)

  • Perform Comprehensive Geriatric Assessments and develop care plans.
  • Diagnose and manage dementia, delirium, depression, frailty, osteoporosis, falls risk, and complex chronic diseases.
  • Optimize polypharmacy, deprescribe unsafe medications, and adjust treatment for age-related changes.
  • Assess decision-making capacity and support substitute decision-makers under Ontario law.
  • Coordinate Rehabilitation and community supports to maintain independence.
  • Provide hospital consults and help with safe discharge planning.
  • Educate patients, caregivers, and healthcare teams about aging and functional health.
  • Participate in Specialized Geriatric Services and interdisciplinary care models.
  • Engage in Teaching, research, and Leadership in geriatric medicine.
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Required Education

Diplomas and credentials you need

To be a Geriatrician (physician specialist) in Ontario, you complete the following:

  • Bachelor’s Degree (Undergraduate): Usually 3–4 years, with prerequisite courses depending on the medical school. Many students complete 4 years. You apply through OMSAS: https://www.ouac.on.ca/omsas/
  • Medical Degree (MD): 4 years at an Ontario medical school.
  • Residency in Internal Medicine: 3 years (Core Internal Medicine).
  • Subspecialty Residency in Geriatric Medicine: typically 2 years after Internal Medicine.
  • Royal College Certification (Certificate): You must pass the Royal College exam in Internal Medicine (if applicable) and the Geriatric Medicine subspecialty exam via the Royal College of Physicians and Surgeons of Canada: https://www.royalcollege.ca/en/education-Training/specialties.html
  • Licensing in Ontario: Registration with the College of Physicians and Surgeons of Ontario (CPSO): https://www.cpso.on.ca
  • Medical Council of Canada (MCC) exam: MCCQE Part I (and other requirements as set by CPSO): https://mcc.ca
  • Liability protection: Membership with the CMPA (Canadian Medical Protective Association): https://www.cmpa-acpm.ca

Note about “College Diploma”: There is no college diploma route to become a geriatrician (physician). College diplomas in Ontario can prepare you for related roles (e.g., Personal Support Worker, OTA/PTA), but those are different careers.

Important distinction: Geriatric Medicine is a subspecialty of Internal Medicine. Do not confuse it with Care of the Elderly (a 1-year enhanced skills program for family physicians) or Geriatric Psychiatry (a psychiatry subspecialty). These roles work closely together but have different training paths and scopes.

Length of studies

Plan for about 10–13+ years after high school:

  • Bachelor’s degree: 3–4 years (most do 4 years)
  • MD: 4 years
  • Internal Medicine residency: 3 years
  • Geriatric Medicine subspecialty: 2 years
    Total: typically 12–13 years. If you add research degrees (e.g., MSc, MPH, PhD) or fellowship training, it can be longer.

Admissions and application steps in Ontario

  • Apply to Ontario medical schools via OMSAS: https://www.ouac.on.ca/omsas/
  • After medical school, apply to residency through CaRMS (Canadian Resident Matching Service): https://www.carms.ca
  • Apply to the Geriatric Medicine subspecialty through the CaRMS subspecialty match after Internal Medicine residency.
  • Complete Royal College exams and register with CPSO for independent practice: https://www.cpso.on.ca

If you are an International Medical Graduate (IMG), explore Ontario-specific pathways and supports via HealthForceOntario: https://www.healthforceontario.ca and consider applying to Ontario residency programs through CaRMS. Licensing for specialists trained abroad can be complex; always confirm current CPSO requirements.

Where to study? (Ontario programs and useful links)

Medical schools in Ontario:

Ontario centres with active Internal Medicine and Geriatric Medicine training are typically based at the universities above and their affiliated teaching hospitals. For subspecialty details, check each university’s postgraduate medical education pages and the Royal College specialties listing: https://www.royalcollege.ca/en/education-training/specialties.html

Additional useful links:

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Salary and Working Conditions

Salary in Ontario (entry-level vs experienced)

Physician incomes in Ontario vary by payment model (fee-for-service, alternate payment plans, salary, caps), clinical mix, call, and academic roles. Geriatricians often work in academic or hospital-based models with blended funding.

  • Entry-level gross clinical payments (first years of independent practice): approximately $200,000–$300,000+ per year is common, depending on site and service mix.
  • Experienced geriatricians: approximately $300,000–$450,000+ gross clinical payments are achievable, with variation based on leadership roles, clinic volumes, inpatient service, and academic responsibilities.
  • Subtract typical overhead (office space, admin support, supplies, EMR, CMPA dues, etc.), which can range from about 10–35%, depending on practice setup and hospital supports.

For context on physician payments and variations by specialty and province, see the Canadian Institute for Health Information (CIHI) “Physicians in Canada”: https://www.cihi.ca/en/physicians-in-canada

Ontario’s insured billing and payment rules are governed by OHIP (Schedule of Benefits): https://www.health.gov.on.ca/en/pro/programs/ohip/sob/

Tip: Talk directly with Ontario departments and local geriatricians to understand the specific compensation model at your site.

Job outlook in Ontario

Ontario’s population is aging, and the need for specialized senior care is growing. There are relatively few geriatricians compared with the need, especially outside major urban centres. This creates strong demand in many regions.

Overall, the job outlook is favourable, with ongoing opportunities in hospitals, academic centres, regional programs, and community services.

Working conditions and lifestyle

  • Work settings: academic hospitals, community hospitals, outpatient clinics, memory clinics, and community outreach programs. Some geriatricians consult in long-term care and rehabilitation.
  • Schedule: Typically weekday clinics and inpatient consults; some on-call coverage, especially for consult services. Evening clinics or virtual care may be offered for accessibility.
  • Team-based care: You work closely with interprofessional teams, including Nursing, PT/OT, social work, and pharmacy.
  • Emotional and cognitive demands: Cases often involve medical complexity, cognitive disorders, ethical decisions, and caregiver support. Communication skills are essential.
  • Practice models: Academic roles include teaching and research; community roles may emphasize clinical service and outreach.

Key Skills

Soft skills

  • Empathy and patience with older adults and caregivers.
  • Clear communication, including explaining diagnoses and care plans in simple language.
  • Interprofessional collaboration with large teams across settings.
  • Cultural competence and sensitivity to language needs (bilingualism in English–French is an asset in parts of Ontario).
  • Ethical judgment in capacity, consent, and goals-of-care discussions.
  • Systems thinking to navigate hospitals, home care, and community programs.
  • Advocacy for seniors’ needs, accessibility, and caregiver support.
  • Time Management in busy clinics and consult services.
  • Resilience and compassion to support patients and families through change.

Hard skills

  • Conducting Comprehensive Geriatric Assessments (CGA).
  • Managing polypharmacy and safe deprescribing.
  • Diagnosing and treating dementia, delirium, depression, frailty syndromes, falls, osteoporosis, syncope.
  • Functional assessments and working with rehab plans.
  • Capacity assessments under Ontario frameworks and documentation standards.
  • Familiarity with Ontario community services, long-term care processes, and home care pathways.
  • Use of electronic medical records (EMR) and virtual care platforms.
  • Interpreting complex diagnostics with age-related changes (e.g., atypical presentations, altered pharmacokinetics).
  • Teaching, research methods, and quality improvement.
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Advantages and Disadvantages

Advantages

  • High impact on quality of life, function, and independence.
  • Growing demand across Ontario due to an aging population.
  • Team-based, collaborative practice with diverse professionals.
  • Variety of clinical settings and patient presentations.
  • Strong opportunities for teaching, leadership, and research in academic centres.
  • Broad scope to innovate in care models, virtual care, and community outreach.

Disadvantages

  • Emotional complexity related to cognitive decline, frailty, and caregiver stress.
  • Documentation-heavy due to CGAs, capacity assessments, and Coordination with multiple services.
  • Income may be lower than some procedural specialties, depending on model and site.
  • Workforce shortages can mean high service demand and waitlists.
  • Navigating system challenges (home care availability, long-term care placement) can be time-consuming.

Expert Opinion

If you enjoy solving complex puzzles, collaborating with teams, and supporting people through life changes, geriatric medicine offers a meaningful, sustainable career in Ontario. My practical advice:

  • Seek early exposure: shadow in memory clinics, falls clinics, or inpatient consults.
  • Build a foundation in internal medicine and add skills in rehab, psychiatry, and palliative approaches.
  • Learn Ontario’s community resources and Specialized Geriatric Services so you can connect patients to the right supports.
  • Develop communication and leadership skills—geriatricians often coordinate care across settings.
  • Consider academic involvement: teaching and quality improvement can amplify your impact.
  • Think regional: excellent opportunities exist beyond the largest cities, with strong community need across Ontario.

FAQ

What is the difference between a Geriatrician, a Care of the Elderly Family Physician, and a Geriatric Psychiatrist in Ontario?

  • A Geriatrician is an Internal Medicine subspecialist (MD + Internal Medicine residency + Geriatric Medicine fellowship + Royal College certification). Focus: complex medical issues of aging, CGAs, frailty, polypharmacy, falls, delirium, and dementia from a medical perspective.
  • A Care of the Elderly (COE) family physician completes Family Medicine plus an extra year of enhanced skills in elder care. They are not Internal Medicine subspecialists but have advanced geriatric training suitable for primary care settings and geriatrics-focused clinics.
  • A Geriatric Psychiatrist is a Psychiatry subspecialist focused on mental health in older adults (e.g., depression, anxiety, psychosis, behavioural and psychological symptoms of dementia).

All three work together frequently in Ontario.

Do Geriatricians in Ontario do home visits or only clinic/hospital work?

Many Ontario geriatricians work mainly in clinics and hospitals; however, some participate in home-based assessments through specialized programs or team-based outreach, especially for frail patients with mobility limitations. Availability varies by region and program (see Regional Geriatric Programs: https://www.rgpo.ca).

How competitive is Geriatric Medicine training in Ontario?

Competitiveness varies by year and school. Because the field is relatively small and demand is high, there are usually good opportunities for motivated candidates with strong Internal Medicine foundations and demonstrated interest in geriatrics (electives, research, quality improvement, or community engagement). For application details, visit CaRMS: https://www.carms.ca

Can International Medical Graduates (IMGs) become Geriatricians in Ontario?

Yes, but the pathway can be challenging. IMGs typically need to:

  • Secure a residency position in Internal Medicine via CaRMS and then match to Geriatric Medicine, or
  • Pursue CPSO registration through routes available at the time (requirements change).
    IMGs should consult HealthForceOntario for guidance and current options: https://www.healthforceontario.ca and verify licensing requirements with CPSO: https://www.cpso.on.ca

What kinds of research can I do as a Geriatrician in Ontario?

Common areas include dementia care, delirium Prevention, falls and fracture prevention, polypharmacy/deprescribing, frailty measurement, transitions of care, and health System Design for aging populations. Academic centres at U of T, McMaster, Western, Queen’s, Ottawa, and NOSM support clinical research, implementation science, and quality improvement. Look for local research institutes and interprofessional teams to collaborate with, and check university faculty pages:

H3 headings intentionally omitted in FAQ to maintain the requested structure with H4 questions.

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