What Competencies Should Medical Students Attain in Nutritional
Medicine?
Sierpina VS
1*
, Welch K
1
, Devries S
2
, Eisenberg DM
3
, Levine L
4
, McKee J
1
, Dalal M
5
, Mendoza P
6
, Gutierrez J
7
, Robertson S
7
, Rosales D
7
1
UTMB-Health, Department of Family Medicine, USA.
2
Gaples Institute for Integrative Cardiology, USA.
3
Harvard T.H. Chan School of Public Health, USA.
4
UTMB-Health, Department of Obstetrics and Gynecology, USA.
5
UTMB-Health, School of Medicine, USA.
6
Galveston Community College, Institute of Culinary Arts, USA.
7
UTMB-Health, School of Health Professions, Department of Nutrition and Metabolism, USA.
*
Corresponding author: Sierpina VS, UTMB-Health, Department of Family Medicine, USA, Tel: 14097722166; E-mail: vssierpi@UTMB.EDU
Rec Date: Nov 12, 2015; Acc Date: Nov 13, 2015; Pub Date: Nov 19, 2015
Copyright: © 2015 Sierpina VS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Commentary
A sizable gap exists between the nutrition education ofered in
medical school and the dietary knowledge needed for patient care.
Despite the centrality of nutrition to a healthy lifestyle and the pressing
obesity epidemic, medical students receive limited training in
nutrition. Ofen this instruction is focused on basic science and rare
nutritional defciency states rather than on the foundations of nutrition
science needed to prepare physicians to address patient questions and
nutritional needs.
As a result graduating medical students lack the knowledge and
skills required to efectively promote behavior change in their patients.
University instructors and graduating medical students agree that the
approximately 25 contact hours of nutrition education provided to
medical students is inadequate and even this low standard of hours is
ofen not achieved.
Furthermore, such instruction is focused on pathogenesis rather
than the real world nutrition-related challenges of their patients, e.g.,
metabolic syndrome, cardiovascular disease, nutrition in cancer,
obesity, and hospital malnutrition. Additionally, most medical schools
do not provide nutrition education outside of the classroom, so most
medical students do not get the opportunity to learn how to integrate
nutrition knowledge into clinical practice [1].
We propose an alternative to a narrowly focused basic science and
nutritional training based on pathogenesis. Rather, teach nutrition as a
key factor in autogenesis, the generation of health and wellness. In
parallel with this, teach students key skills to foster behavioral change
[2].
Te authors are working to make changes in evolving medical
school nutrition curricula and propose a list of core competencies.
Nutrition education in medical school should empower new
physicians to:
• Take a diet history, perform an appropriate nutrition-oriented
exam, and converse in an informed way with patients about their
food choices [3].
• Discuss and empower patients to shop, cook, and prepare a healthy
diet within a variety of budgetary levels.
• Student should learn to prepare food themselves so they can be
adequately informed as they teach patients.
• Demonstrate knowledge of optimal evidence-based diets, such as
the Mediterranean diet, as well as culturally acceptable alternative
diets that provide healthy proportions of carbohydrates, protein,
fats, antioxidants, fber, and essential micronutrients [4].
• Demonstrate understanding of the epidemiology of obesity in the
US and worldwide and its impact on health, healthcare budgets,
and medical care.
• Evaluate the evidence for popular diets, supplements, and
pharmacological agents for obesity and to develop practical and
credible counseling skills for patients about these.
• Work in inter professional team that includes experts in nutrition,
exercise physiologists, psychologists, health coaches, trainers,
community health educators, and others.
• Learn, apply, and engage in motivational interviewing-helping
patients understand their goals, motives, readiness to change, as
well as barriers to change.
• Find and interpret policy documents informing national nutrition
programs identifying major food consumption trends.
• Connect patients to existing resources for healthful foods and
nutrition education in the community including food banks and
pantries [5].
• Identify patients requiring intensive behavioral therapy and refer
such patients to an appropriate practitioner, e.g. licensed counselor,
psychologist, registered dietitian.
• Describe the role of whole foods and food based-nutrients for
optimal nutrition compared and contrasted with the role of specifc
dietary supplements [6].
At the end of their training, medical students need these skills to
help patients avoid lifestyle related disease and move the needle on the
obesity epidemic. Cursory knowledge of nutrition, especially training
that is focused primarily on biochemistry, is inadequate for helping
patients to make meaningful change [7].
We propose including the skills above as scafolding for preparing
the physicians of the future as well as other healthcare providers to
optimize their patients’ health through nutrition. In a future article, we
plan to expand the details of these competencies by providing a map of
learning objectives and activities, experiential cooking and shopping,
and educational evaluation methods.
Sierpina VS, et al., J Nutr Food Sci 2015, 5:6
DOI: 10.4172/2155-9600.1000431
Commentry Open Access
J Nutr Food Sci
ISSN:2155-9600 JNFS, open Access Journal
Volume 5 • Issue 6 • 431
Journal of Nutrition & Food Sciences
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ISSN: 2155-9600