Medical Schools Need To Teach More about Obesity and Nutrition
Medikoe HealthTech Expert
80 feet road indira nagar, Bengaluru Feb 9, 2017
If you have been living in a cave and don't read the news, we are in the midst of a global obesity epidemic. Also, obesity can lead to so many different diseases, ranging from diabetes to cardiovascular disease to cancer to many mental health issues. And if you didn't realize it, what you eat affects your health. Oh, and doctors deal with health and disease. Nothing new, right? Why then are many medical schools still failing to teach enough about obesity and nutrition?
Yes, failing. Studies have confirmed that medical students are starved of nutrition and obesity education. For example, a study published in the International Journal of Adolescent Medicine and Health gave a medical or osteopathic school graduates who were just entering a pediatric residency program an 18-item nutrition questionnaire. On average, the new graduates could only answer 52% of the questions. That's a failing grade even with grade inflation.
Although such Twitter polls are not scientific studies, they reaffirm what the aforementioned more formal studies have shown. Why, then, aren't medical schools jumping to change their curricula? Here are some possibilities:
Medical licensing exams haven't changed. Frankly, many medical schools may be teaching their students to score well on these exams. In a study published in Teaching and Learning Medicine, six obesity experts reviewed questions from three recent versions of United States Medical Licensing Examination (USMLE), a series of board exams that all medical students have to pass to eventually practice medicine. They used a rubric from the American Board of Obesity Medicine (ABOM) to evaluate these questions. According to the authors, "the most important concepts of obesity prevention and treatment were not represented on the Step exams" and "the expert review panel identified numerous important obesity-related topics that were insufficiently addressed or entirely absent from the examinations."
Already overcrowded medical school curricula. Medical students need free time to do things like sleep and bathe. The argument is that medical students can't learn everything, so something has to be left behind. However, not teaching about something you put in your mouth every day and one of the biggest health problems in the world makes little sense. Surely obesity and nutrition education can replace many of the minutiae taught in medical school.
Doctors assume that nutritionists and dietitians will always be available to help. This is like a football quarterback saying that there's no need to learn how to run because a running back will always be there. Well, maybe nutritionists or dietitians are available in some hospitals and clinics, but not all. Plus, unless a doctor and a dietitian decide to tether themselves together like in a two-legged race, there will be many times that a doctor will have to make nutrition-related decisions without a dietitian around. A doctor can't be constantly calling a dietitian. Moreover, increased familiarity with nutrition will facilitate conversations with nutritionists and dietitians. In fact, many doctors have become nutrition and diet experts. Shouldn't medical schools help the next generation reach such positions? Finally, obesity goes well beyond nutrition. Diet affects obesity, but so do physical activity and other things such as the environment, economics, metabolism and potentially other things such as the micro biome.
Lack of attention to disease prevention and alternative treatments. Changing your diet could help prevent as well as treat many different diseases.
Lack of funding. Teaching obesity and nutrition is not necessarily more expensive than teaching other existing topics in medical school. Part of it is just shifting resources and priorities. Also, with obesity and nutrition being such important areas that doctors need to have a voice in, isn't a little investment worth it?
Like food and beverages, the education that medical schools feed to medical students will affect them for years down the road. As the American Association of Medical Colleges (AAMC) reports, some schools are developing new obesity curricula, and the recently formed Obesity Medicine Education Collaboration and an education working group within the National Academy of Medicine are planning to develop new educational recommendations. But how many medical schools will actually change? Medical schools have a responsibility to arm their graduates to take on the biggest health problems in the world. The knowledge, experience, expertise and position of doctors can be vital in addressing obesity and nutrition problems, especially with so much misinformation floating around. Medical school education needs to change with the times to make the grade.