Medical Students Starved for Nutrition Education

Although the importance of nutrition in preventing obesity and other diseases is universally acknowledged, nutrition education in US medical schools remains inadequate, according to research published in Academic Medicine.

Few medical schools incorporate the 25 minimum hours of nutrition instruction in the undergraduate curriculum that was recommended by the National Academy of Sciences in 1985, said Steven H. Zeisel, MD, PhD, of the University of North Carolina at Chapel Hill (UNC), one of the study’s authors.

"The teaching of nutrition in U.S. medical schools still appears to be in a precarious position, lacking a firm, secure place in the medical curriculum of most medical schools," the authors noted. "Concerns remain that many future physicians will lack adequate preparation in this essential component of modern medical practice."

For the study, which was conducted as part of UNC's Nutrition in Medicine project, nutrition educators at US medical schools completed a two-page online survey between August 2008 and July 2009. A similar survey was conducted by the NIM project in 2004.

Educators were asked about the number of nutrition instruction contact hours that are required for their medical students and whether those hours are accumulated via a designated nutrition course, within another course or during clinical rotations.

Although most of the 109 medical schools that responded to the 2008-2009 survey reported requiring some form of nutrition education, other survey findings were not so promising.

• Only 28 medical schools (27%) met the recommended minimum of 25 hours, compared with 40 schools (38%) in 2004
• Only 26 schools (25%) required a dedicated nutrition course, compared with 32 schools (30%) in 2004
• Medical students received an average of 19.6 contact hours of nutrition instruction; the average in 2004 was 22.3 hours

According to study co-author Martin Kohlmeier, M.D., a research professor in the UNC department of nutrition and the NIM project director, the study results are cause for concern. "It does concern us to see a steeply declining number of dedicated nutrition courses at the medical schools because we also find that schools with such courses offer about a third more hours of nutrition education," Kohlmeier told AAFP News Now. "Something is clearly getting lost with the integration into other courses. We have to continue to push for adequate nutrition education."

According to NIM researchers, more than half of graduating medical students rate their nutrition knowledge as "inadequate," and physicians report they have not received adequate training to counsel their patients. In fact, previous surveys of both groups have found "suboptimal knowledge" regarding nutrition facts.

"This deficit in preparation is rather alarming, considering the importance of nutrition in obesity prevention and the critical role of diet in the energy balance equation," the researchers said.

For more information:

• Academic Medicine—Nutrition education in U.S. medical schools: latest update of a national survey
• American Journal of Clinical Nutrition—Status of nutrition education in medical schools
• Applied Physiology, Nutrition, and Metabolism—Medical students' perceptions of nutrition education in Canadian universities

Do you believe that medical students are not adequately educated on nutrition? If so, what can be done to resolve this issue?