Written by: Makayla Schuchardt MS, RDN
Despite the critical role nutrition plays in preventing and managing chronic diseases, nutrition education remains significantly underrepresented in U.S. medical school curricula. In a 2023 survey of over 1,000 U.S. medical students by Duggen and colleagues, around 58% reported receiving no formal nutrition education during their four years of medical school, with those who did averaging about three hours per year. This is far below the 1985 goal set by the U.S. Committee on Nutrition in Medical Education, which recommends 25 hours of nutrition education, or a little over six hours per year. A 2015 study showed only 29% of medical schools met this goal, and a 2023 study indicated the situation had worsened, with just 7.8% of medical students reporting 20 or more hours of nutrition education throughout their entire medical school experience. A majority (93.3%) of students surveyed either somewhat or strongly agreed that understanding the effects of nutrition and eating decisions on the human body is critical to maximizing patient care. Consequently, there is a growing call for medical schools to enhance their nutrition education to better equip doctors to address the nutrition needs of their patients effectively.
In March of 2023, the Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine met to identify nutrition competencies for medical education. This was in response to the U.S. House of Representatives passing a bipartisan resolution (Resolution 1118) in 2022, which called for “meaningful nutrition education for medical trainees.” The resolution aimed to address the increased health care spending and prevalence of nutrition-related chronic diseases in the U.S. healthcare system. Three example nutrition competencies that received over 97% agreement among panel experts include the following:
- Providing evidence-based, culturally sensitive nutrition and food recommendations to patients for the prevention and treatment of disease.
- Assessing the nutritional status of a patient with a brief diet and food history or questionnaire, anthropometric measurements, and appropriate laboratory tests.
- Demonstrating knowledge of the nutritional content of foods, including the major dietary sources of macronutrients and micronutrients.
The lack of nutrition education in medical schools has been attributed to a lack of qualified instructors for nutrition courses, as most physicians do not understand nutrition well enough themselves to teach it. However, one solution to this barrier is encouraging collaboration between medical students and other healthcare professionals, such as dietitians and nutritionists, which can enhance learning and application of nutrition knowledge in clinical practice. Registered Dietitian Nutritionists (RDNs) are highly qualified to teach within medical school education due to their extensive training and expertise in nutrition and dietetics. They hold at least a graduate degree from an accredited dietetics program, have completed a rigorous supervised practice requirement of at least 1,000 hours, and passed a national examination. RDNs are well-versed in translating complex nutritional science into practical dietary advice, making them adept at educating future physicians on the critical role of nutrition in patient care and addressing the proposed nutrition competencies listed above.
Given this renewed interest in addressing nutrition education among medical students, the Department of Nutritional Sciences (DNS) was eager to partner with the School of Medicine and Public Health (SMPH) to collaborate on the instruction of the Food, Fasting, and Fitness Block in the SMPH ForWard Curriculum. Dr. Tara LaRowe, Assistant Teaching Professor and registered dietitian nutritionist in the DNS, was appointed the role of assistant block leader starting with the 2024-2025 academic school year. Dr. LaRowe is responsible for coordinating the design, implementation, and continuous quality improvement of the curriculum related to areas of nutrition. In this first academic year, Dr. LaRowe, along with her DNS colleague, Dr. Amber Haroldson, Teaching Faculty and RDN, provided lectures on the Dietary Guidelines for Americans, macronutrients, water- and fat-soluble vitamins, and minerals. This lecture content was then applied in Case-Based Learning (CBL) sessions, which included patient case studies on malnutrition, pediatric micronutrient deficiencies, and medical nutrition therapy for cardiovascular disease. During the CBL sessions, first-year medical students were split into classrooms with approximately 30 students. Each classroom had a facilitator that led the small groups through case studies. The facilitators were organized by another DNS teaching faculty, Makayla Schuchardt, RDN, and included practicing RDNs from UW Health’s Clinical Nutrition Department and MS Clinical Nutrition graduate students from the DNS. Isabel Koplien, MS Clinical Nutrition graduate student, thought, “Working with Megan Roquet, an inpatient RDN, as well as a class of medical students was super fun as I was able to learn their thought processes and different approaches to addressing nutrition-related issues. This experience really highlighted the importance of interdisciplinary collaboration in optimizing patient care, and how dietitians are an amazing resource to lean on.”
MS Clinical Nutrition graduate student Grace Griffin thought, “It was also interesting to gain a deeper understanding of their educational journey and how nutrition fits into that framework. Being part of this process gave a valuable perspective on how future healthcare professionals are trained and how nutrition can play a critical role in their clinical decisions.” DNS tenured faculty, Dr. Brian Parks and Joseph Pierre, also participated in the Case-Based Learning sessions. Their background in nutritional biochemistry and metabolism was applied in case studies related to metabolic adaptation during starvation and intermittent fasting.
Adequate nutrition education enables doctors to provide evidence-based dietary advice, fostering better patient outcomes and reducing healthcare costs. By embarking on this partnership with SMPH and integrating more nutrition into medical curricula, we can ensure that new generations of doctors are well-prepared to support their patients’ overall health and well-being through informed dietary guidance and collaboration with clinical dietitians.
References:
Duggan, Michael P.; Kodali, Anahita T.; Panton, Zach A.; Smith, Shannon M.; Riew, Grant J.; Donaghue, Jack F.; Leya, Gregory A.; and Briggs, Logan G. (2023) “Survey of Nutrition Education Among Medical Students,” Journal of Wellness: Vol. 4 : Iss. 2 , Article 11.
DOI: https://doi.org/10.55504/2578-9333.1167
Eisenberg DM, Cole A, Maile EJ, et al. Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement. JAMA Netw Open. 2024;7(9):e2435425. doi:10.1001/jamanetworkopen.2024.35425