When I was working on the book, I used a number of studies as references to cite from. I thought I would post some of them, along with what I took away as the important points from them for those who aren’t interested in reading the entire study, or just don’t have the time. I’ll post the entire abstract, then my thoughts, and, of course, a link to the entire study at the end for those interested.

Keep in mind there are LOTS of numbers, figures, etc. involved even in my bullet points as I break it down. LOTS. If you want it broken down very, very simply, here you go:

Contacts at 106 med schools in the US (most of which were the nutrition instructors themselves) filled out a 12-question survey about nutrition training in their school in 2004. The average number of hours spent in nutritional instruction is 23.9 hours, most hours are taught in the first two years of medical school, 3/4 of nutritional instruction occurs outside of a dedicated nutrition course, and most instructors feel the instruction in nutrition is inadequate.

If you want the specifics, keep reading.

 

This first study is a study from The American Journal of Clinical Nutrition published in 2006.

 

Status of nutrition education in medical schools
Kelly M Adams, Karen C Lindell, Martin Kohlmeier, and Steven H Zeisel

ABSTRACT
Background: Numerous entreaties have been made over the past 2 decades to improve the nutrition knowledge and skills of medical students and physicians. However, most graduating medical students continue to rate their nutrition preparation as inadequate.
Objective: The objective was to determine the amount and type of nutrition instruction of US medical schools, especially including the instruction that occurs outside designated nutrition courses.
Design: A 12-item survey asked nutrition educators to characterize nutrition instruction at their medical schools (required, optional, or not offered) and to quantify nutrition contact hours occurring both inside and outside designated nutrition courses. During 2004, we surveyed all 126 US medical schools accredited at the time.
Results: A total of 106 surveys were returned for a response rate of 84%. Ninety-nine of the 106 schools responding required some form of nutrition education; however, only 32 schools (30%) required a separate nutrition course. On average, students received 23.9 contact hours of nutrition instruction during medical school (range: 2-70 h). Only 4 schools required the minimum 25 h recommended by the National Academy of Sciences. Most instructors (88%) expressed the need for additional nutrition instruction at their institutions.
Conclusion: With the move to a more integrated curriculum and problem-based learning at many medical schools, a substantial portion of the total nutrition instruction is occurring outside courses specifically dedicated to nutrition. The amount of nutrition education in medical schools remains inadequate.       Am J Clin Nutr

Key points from my perspective in reading the entire article -

  • This survey was sent out in 2004, and published in 2006. The question beckons – is there any more recent data?
  • In 1985, the National Academy of Sciences (NAS) found that the average required nutrition instruction in med schools was 21 hours; however, only 34 schools (27%) actually had a separate course. This led the NAS to create a recommendation of a minimum of 25 contact hours of nutrition to be taught in med schools.
  • Practicing physicians continually rate their nutrition knowledge and skills as inadequate.
  • 1/2 of graduating medical students report that the time dedicated to nutrition instruction is inadequate.
  • Survey was sent in 2004 to all 126 accredited medical schools and contained 12 questions:
    • Estimate number of contact hours of required nutrition education of their medical school
    • Which years (1st-2nd or 3rd-4th)
    • What type of course was nutrition taught in (nutrition, physiology, biochemistry, etc.)
    • Specific information about course titles, instructors, hours, and year in curriculum
    • Opinion as to whether students needed more nutrition instruction
  • 106/126 responded (84% response rate); 103 filled out by person directly responsible for the nutrition education of medical students at the time time of the survey

Survey Results:

  • 99/106 provided required nutrition instruction
  • 5/106 offered optional instruction only
  • 2/106 did not offer any instruction in nutrition
  • schools requiring nutrition instruction averaged 23.9 hours (range 2-70 h)
  • less than 1/2 (41%) of the 106 schools provided minimum 25 h or more recommended by the NAS in 1985
  • 17/106 (18%) required only ≤10 h; 37/106 required 11-20 h; 21/106 required 21-30 h; 8/106 required 31-40 h; and 14/106 required ≥ 41 hours of required nutrition information
  • 18.9 ± 1.2 h taught in years 1&2: 5.1 ± 0.7 h in years 3&4
  • 32 schools indicated that, at least in part, instruction occurred in a required nutrition course; these students received an average of 17.7 ± 1.8  contact hours of nutrition instruction taught in a dedicated nutrition course; 36 (schools indicated nutrition information was taught in a physiology, pathophysiology, pathology course with an average of 6.9 ± 1.0 h; 44 schools taught nutrition in biochemistry with 6.8 ± 0.7 h; 58 schools taught an integrated curriculum with 13.1 ± 1.4 h; 42 schools taught nutrition during clinical practice with 8.0 ± 1.0 h; 13 schools indicated “other” for their nutrition curriculum with 8.4 ± 1.9 h. 97 schools of the 106 surveyed responded.
  • 3/4 of nutrition information in medical schools is not specifically identified as nutrition in the curriculum
  • The breakdown of hours taught are as follows: 32% are taught in an Integrated Curriculum; 25% in a dedicated Nutrition course; 14% in Clinical Practice; 13% in Biochemistry; 11% in Physiology; Pathophysiology; Pathology; and 5% in Other
  • 106 (88%) of instructors indicated that students at their schools need more nutrition instruction; 8/106 said they did not (6 of these were at schools offering much more than the average number of nutrition hours); 4% did not know whether their students needed more nutrition instruction

 

Discussion Points by Authors:

  • The question of what constitutes “adequate” comes to mind
  • Nutrition education typically occurs during the first 2y of medical school when the basic sciences are being emphasized: nutrition does not appear to get much emphasis during the clinical years when nutrition concepts and skill sould be applied more directly to clinical problem-solving
  • Surveys show that practicing physicians feel inappropriately prepared to address the growing problem of obesity, particularly in children

 

Andrea’s points:

  • As I’ve always said, surgeons are great at cutting (or at least we hope they are – that’s what we pay them for) but they are not trained in nutrition.
  • It should be noted that surgeons get their surgical training way past med school — so if they are getting their nutritional training in the 1st or 2nd year, then they have 3rd and 4th year of Clinical Rounds, then residency, possible fellowships, etc. All possible without additional nutritional training.

The full study can be read here. It’s enlightening.

Related Posts with Thumbnails

1 Response » to “Study: Status of nutrition education in medical schools”

  1. Leza says:

    23.9 hours is NOTHING in the journey of a med student! Even one of the docs I used to work for said that! That’s less than a full day (not by much), but considering the number of YEARS spent in undergrad, post-grad, medical/specialties, residency…that’s a grain of salt. Insane.

Leave a Reply