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Most American doctors are not properly trained in this important health topic



Why aren't doctors adequately trained on the nutritional topic during their medical training? With the ever-increasing amount of research that supports the importance of nutrition for overall health, it seems an easy-to-answer question. But it is not.

"Nutrition education in the medical school is, at best, limited and limited to the duration of the master's program for many specialties. Requirements for meaningful business education at all stages of medical training are long," says Stephen Devries, MD, FACC, MD Director, Gaples Institute for Integrative Cardiology, Deerfield, IL and co-authors. They published their comments online in JAMA .

The importance of nutrition in health cannot be overstated. Randomized clinical trials have hammered home the importance of proper diet in the prevention and management of all forms of disease, including but not limited to diabetes and cardiovascular diseases as well as other health benefits. But noted Dr. Devries and colleagues say that "the large amount of evidence supporting the benefits of nutritional intervention is not sufficiently translated into action in medical training or practice."

Measuring the deficit

Consider that courses describing nutrition are limited in the medical school, usually a total of 1

9 hours over 4 years. The focus on these courses remains on biochemistry and vitamin deficiency diseases – which do not often occur in the United States.

In the subsequent 3+ year graduate study, business education is not included.

And despite major updates made in July 2018 to the Accreditation Council for Master's degree program Common program requirements for residence permit and scholarship education, no requirements for nutrition or diet education are included. Such requirements are also lacking in specialized training programs.

In a 2017 study completed by 930 cardiologists and cardiovascular team members performed by Dr. Devries and other researchers reported a full 90% who received minimal or no nutritional training during the scholarship, 59% did not receive any in-house training and 31% reported that no-one received in the medical school. A full 95% felt it was their personal responsibility to advise patients with at least basic nutrition information.

Other researchers led by Kelly M. Adams, MPH, RD, LDN, Department of Nutrition, School of Medicine and Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, conducted a study for to determine the state of nutrition education in American medical schools and compare it with recommended instructional goals. They examined 133 US medical schools with 4-year curricula and received responses from 121.

A full 71% of these schools did not provide the recommended minimum of 25 hours of nutrition education and 36% provided less than 50% of that amount. Furthermore, less than 50% of all schools taught any nutrition in clinical practice.

Responding schools reported giving an average of 19 hours of nutrition education, but 36% required 12 or less hours of education. Of these, 9% required none.

These results led Adams et al to conclude: "Doctors in the United States are largely alone in learning to find signs of nutritional problems, how to explain the importance of nutrition-related conditions and appropriate interventions, and how to refer patients. for nutritional staff. "

Do the doctors even need nutrition training?

"Some may suggest that doctors do not need to be educated on nutrition because other health professionals, including dieticians, are better educated and positioned to make supplements," Dr. Devries and colleagues.

They claimed that dietary counseling for patients should be treated by a team of dieticians, nutritionists, nurses, health professionals, and cooks. It seems intuitive that the patient's doctor is part of this team. Unfortunately, this is not the reality, in most cases.

"The problem is that most doctors currently do not have adequate nutrition training to contribute meaningfully to that team. At least, doctors need adequate training to at least start the nutrition interview with their patients. In addition, clinicians will With a foundation of nutritional knowledge, it is more likely to recognize the importance of diet and make more effective referrals, "they added.

According to Dr. Devries and colleagues are properly trained in nutrition a must for clinicians, and should be a priority in medical training for the following reasons:

  1. Poor diet is the leading cause of death in the United States according to a report from US vulnerability employees in 2018. The incidence of diet-related illness, and the associated health care costs will only continue to increase.
  2. The likelihood of a paradigm shift in healthcare focus from disease management to health promotion and prevention makes it necessary for doctors to have a solid foundation in clinical nutrition.
  3. Media coverage of health and diet bombs patients with new information all the time; Doctors must play a role in helping them interpret and sort through the gluten of stories.
  4. With more focus on well-being and self-care by residents and scholars, clinical nutrition education can improve the physician's self-care as well as the patient's health. This will also allow the physician to more effectively advise patients on nutritional issues.

Involvement of nutrition training in medical training, according to Dr. Devries and colleagues can be successful if business concepts can be integrated into existing content.

"In this way, nutrition can be understood more appropriately as a vital, practical determinant of health rather than as an isolated discipline," they concluded.

Researchers led by Adams agree: "Many American medical schools still fail to prepare future doctors for daily nutritional challenges in clinical practice. Nutrition is a dominant contributor to most chronic diseases and a crucial determinant of poor treatment results. be a realistic expectation for doctors to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition and many other conditions, as long as they are not taught in medical school, how to recognize and treat the nutritional causes. "

Clearing the lack of nutrition education in medical schools is clearly needed.

"It is unacceptable that we continue to find the same systemic instruction errors decade after decade and still just hope for the best. What ultimately counts is the doctors' readiness and ability to recognize and effectively address nutrition-related challenges in their patients "The reported educational deficits of medical education provide a long way to explaining why many doctors lack opportunities to use nutrition as an effective health tool," concluded Adams et al.


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