Geriatric medicine
Falls, delirium, dementia, polypharmacy, frailty and aged care. AMC stations often involve an elderly patient living alone and a worried family.
High-yield points
Delirium is acute, fluctuating inattention; screen with the 4AT or CAM and look for causes (infection, drugs, retention, constipation, hypoxia, pain).
Hypoactive delirium is common and often missed.
Falls: review medications (sedatives, antihypertensives), postural BP, vision, feet, gait and home hazards; consider osteoporosis.
Deprescribing: review anticholinergics, benzodiazepines and antipsychotics; use Beers or STOPP/START criteria.
Minimal-trauma fracture in an older adult means osteoporosis until proven otherwise; treat to prevent the next fracture.
Advance care planning: discuss goals of care early; respect advance care directives and substitute decision-makers.
Pressure injury prevention: regular repositioning, nutrition and skin checks.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Who provides care | Family is usually the main carer; formal aged care is limited. | Most older people live independently. Government-funded home or residential care is accessed through My Aged Care and an aged care assessment. |
| Advance care planning | Rarely formalised; family often decides. | Advance care directives and appointed substitute decision-makers are expected. Titles and forms vary by state. |
| Medication review | Polypharmacy often not systematically reviewed. | Deprescribing is emphasised; GP can arrange a pharmacist Home Medicines Review. Falls risk assessment is routine. |
| Elder abuse | Recognised but rarely acted on formally. | Screen for and act on elder abuse; serious incidents in residential aged care must be reported under a national scheme. |
Who provides care
India (MBBS)
Family is usually the main carer; formal aged care is limited.
Australia (AMC): what the exam expects
Most older people live independently. Government-funded home or residential care is accessed through My Aged Care and an aged care assessment.
Advance care planning
India (MBBS)
Rarely formalised; family often decides.
Australia (AMC): what the exam expects
Advance care directives and appointed substitute decision-makers are expected. Titles and forms vary by state.
Medication review
India (MBBS)
Polypharmacy often not systematically reviewed.
Australia (AMC): what the exam expects
Deprescribing is emphasised; GP can arrange a pharmacist Home Medicines Review. Falls risk assessment is routine.
Elder abuse
India (MBBS)
Recognised but rarely acted on formally.
Australia (AMC): what the exam expects
Screen for and act on elder abuse; serious incidents in residential aged care must be reported under a national scheme.
The Australian context
Access to government-funded aged care (home care or residential) starts through My Aged Care, which arranges an aged care assessment. Most older Australians live independently, and families often expect the medical team to discuss options openly. Substitute decision-maker titles (enduring guardian, medical treatment decision maker) differ by state.