The Perceptions of Medical School Students and Faculty Toward Obesity Medicine Education: Survey and Needs Analysis

Addressing the Urgent Need for Clinical Nutrition Education in PostGraduate Medical Training: New Programs and Credentialing

The importance of nutrition in the development of disease, and in the recovery from illness, is among the most fundamental tenets in human biology and optimal health. Nutrition was fundamental in many traditional forms of medicine until its role in medical care experienced a rapid decline over the last century. We believe a key cause of the decline in nutrition's essential role in healthcare and preventative medicine is the escalating crisis of inadequate nutrition education in medical training. Recent data show 75% of United States medical schools have no required clinical nutrition classes and only 14% of residency programs have a required nutrition curriculum. More troubling, only 14% of current healthcare providers feel comfortable discussing nutrition with their patients. The purpose of this paper is to present the evidence illustrating the distinct lack of nutrition education in medical training. Further, we present key examples of existing formal nutrition curricula to incorporate nutritional science into all healthcare providers' education and practices. We discuss existing nutrition fellowships and training programs, including the new Duke Online Clinical Nutrition Fellowship. We also cover a physician nutrition certification allowing physicians to pursue clinical nutrition as a career path. Finally, recent financial incentives and quality measures incentivizing healthcare provider nutrition education is discussed. Thus, in conclusion, we advocate the inclusion of nutrition education curricula as a priority in medical schools, graduate medical education, and continuing medical education. Formal clinical nutrition training should be a requirement for hospital leadership and administrators for all Parenteral Nutrition and Nutrition Team Physician Directors in hospitals worldwide, and this key clinical role must become an essential position in all hospitals. In addition, we immediately need to address the critical shortage of physician nutrition specialists who will serve as the next generation of leaders in clinical nutrition care and research.

Nutrition and Physical Activity Education in Medical School: A Narrative Review

This review explores the diverse landscape of integrating nutrition and physical activity education into medical school curricula, focusing on the imperative role of physicians in promoting health through lifestyle changes. By examining global medical education structures, we uncovered disparities in nutrition and physical activity training, and highlighted the need for a shared framework to address international and regional challenges. Despite acknowledging the importance of both nutrition and physical activity, studies have consistently uncovered deficiencies in medical school curricula, especially in skills related to providing lifestyle advice and behavioral counseling. Survey studies among medical students have illuminated various perceptions and knowledge gaps, emphasizing the need for more comprehensive and mandatory nutrition and physical activity training. While acknowledging progress, challenges, such as time constraints, resource availability, and faculty expertise, persist. Integrating lifestyle education results in resistance, a demand for strategic communication, and faculty buy-ins. These findings underscore the importance of a holistic approach that balances theoretical knowledge, practical skills, and confidence that medical students need to promote effective nutrition and physical activity in healthcare.

Preclinical obesity curriculum: audit, implementation, and evaluation

BACKGROUND

This study aimed to (1) evaluate the current status of obesity education at Case Western Reserve University School of Medicine (CWRU) (2), introduce a comprehensive first-year curriculum on obesity, and (3) assess the impact of the curriculum on self-reported attitudes and knowledge regarding obesity among first-year medical students.

METHODS

The preclinical curriculum at CWRU was reviewed to determine the degree of coverage of Obesity Medicine Education Collaborative (OMEC) competencies for healthcare professionals, and recommendations were provided for revising the curriculum to better adhere to these evidence-based competencies. A survey on obesity attitudes and knowledge was given before and after the implementation of the new curriculum to measure intervention-related changes. Changes in obesity attitudes and knowledge were compared (1) before and after the intervention for the class of 2025 and (2) after the intervention for the class of 2025 to a historical cohort that did not receive the intervention.

RESULTS

Among the 27 competencies examined in the audit, 55% were unmet and 41% were partially met. Of 186 first-year medical students (M1s), 29 (16%) completed the baseline survey and 26 (14%) completed the post-intervention survey. Following the intervention, there was a notable improvement in attitudes and knowledge regarding obesity. Specifically, there was a significant decrease in the belief that obesity is caused by poor personal choices, and knowledge of obesity in fourteen out of fifteen areas showed significant improvement from pre- to post-intervention. Additionally, obesity attitudes and knowledge were significantly better post-intervention when compared to the historical cohort.

CONCLUSIONS

The improvements made to the preclinical curriculum through this project improved obesity attitudes and knowledge among first-year medical students. This method provides a practical approach for evaluating and enhancing obesity education in medical school curricula.

Approaches to teaching about mechanisms of obesity in undergraduate pathophysiology courses

Views of obesity as a consequence of "lack of willpower" or other behavioral choices, rather than a complex array of biological and other factors, are quite common among undergraduate students. Many undergraduates in prenursing or biology programs have little exposure to the physiology and pathophysiology of obesity, including learning about leptin and other hormones involved in appetite control. I developed materials for teaching about the pathophysiology of obesity in two different pathophysiology courses: one designed as a survey of pathophysiology topics for prenursing majors, and the other designed as an in-depth exploration of the molecular and cellular basis of selected diseases for upper-division biology majors. In the molecular basis of disease course, obesity is covered as part of a unit organized around metabolic syndrome. The discussion includes molecular and cellular mechanisms that link obesity to several other diseases, including type 2 diabetes and atherosclerosis. This article briefly describes the approaches I have taken for teaching obesity to two different undergraduate student populations and lists several resources that may be useful tools for teaching about obesity.NEW & NOTEWORTHY This article describes approaches for teaching obesity in an allied health major pathophysiology course, and, additionally, in an upper-division biology major course on the cellular and molecular basis of disease.

A Multi-Modality Intervention Improves Obesity Bias among Medical Students

Background: Obesity is linked to chronic diseases in adults and children. Its prevalence continues to grow in the United States, necessitating the need for healthcare provider training and presenting an opportunity for the education of future medical providers. Despite this need, effectively implementing obesity education into medical school curricula has been challenging. Anti-obesity bias amongst healthcare providers and trainees represents a significant obstacle to the care of patients with obesity. Obesity bias may affect up to 1/3 of medical students. Methods: This study describes the development and preliminary testing of a brief, 2.5 h multi-modality teaching intervention consisting of online, interactive, and independent learning modules for first-year medical students and a patient panel focused on obesity, obesity bias, and motivational interviewing. The participants took Crandall's anti-fat attitude (AFA) questionnaire before and after an online independent learning module on motivational interviewing and obesity bias. The AFA consists of three subscales ("dislike", "fear of fat", and "willpower"). Individual responses were measured using a nine-point Likert-type response format (0 = very strongly disagree; 9 = very strongly agree). An average composite score was calculated for each subscale. Results: Data were analyzed from 103 first-year medical students enrolled at a college of medicine in the southwestern United States in 2022. The AFA mean composite scores decreased significantly, indicating a decrease in explicit anti-obesity attitude bias after completing the online module. This decrease was present in all three domains of fear (4.63 vs. 3.72, p < 0.001), dislike (1.25 vs. 0.88, p < 0.001) and willpower (3.23 vs. 2.31, p < 0.001). Conclusions: Relatively brief educational interventions can positively impact students' anti-obesity attitudes.

The implications of defining obesity as a disease: a report from the Association for the Study of Obesity 2021 annual conference

Unlike various countries and organisations, including the World Health Organisation and the European Parliament, the United Kingdom does not formally recognise obesity as a disease. This report presents the discussion on the potential impact of defining obesity as a disease on the patient, the healthcare system, the economy, and the wider society. A group of speakers from a wide range of disciplines came together to debate the topic bringing their knowledge and expertise from backgrounds in medicine, psychology, economics, and politics as well as the experience of people living with obesity. The aim of their debate was not to decide whether obesity should be classified as a disease but rather to explore what the implications of doing so would be, what the gaps in the available data are, as well as to provide up-to-date information on the topic from experts in the field. There were four topics where speakers presented their viewpoints, each one including a question-and-answer section for debate. The first one focused on the impact that the recognition of obesity could have on people living with obesity regarding the change in their behaviour, either positive and empowering or more stigmatising. During the second one, the impact of defining obesity as a disease on the National Health Service and the wider economy was discussed. The primary outcome was the need for more robust data as the one available does not represent the actual cost of obesity. The third topic was related to the policy implications regarding treatment provision, focusing on the public's power to influence policy. Finally, the last issue discussed, included the implications of public health actions, highlighting the importance of the government's actions and private stakeholders. The speakers agreed that no matter where they stand on this debate, the goal is common: to provide a healthcare system that supports and protects the patients, strategies that protect the economy and broader society, and policies that reduce stigma and promote health equity. Many questions are left to be answered regarding how these goals can be achieved. However, this discussion has set a good foundation providing evidence that can be used by the public, clinicians, and policymakers to make that happen.

Nutrition education intervention improves medical students' dietary habits and their competency and self-efficacy in providing nutrition care: A pre, post and follow-up quasi-experimental study

Objective

Most doctors and medical students report inadequate competencies in nutrition care. We evaluated the impact of a nutrition education intervention on medical students' lifestyle habits, dietary diversity, nutrition care knowledge, attitude toward nutrition care, and their level of self-efficacy in the provision of nutrition care.

Methods

All 2nd-year medical students were enrolled into a 5 week, 24-h nutrition education intervention that involved both deductive and practical sessions. Pre-, post and 4 weeks follow-up assessments were conducted.

Results

At post- and 4-weeks post-intervention the number of days participants consumed vegetables and engaged in moderate-to-vigorous physical activity significantly (p = 0.003 and 0.002) improved respectively from baseline. Mean nutrition care knowledge scores of participants increased by 3.27 points (95% Cl: 1.98-4.56, p < 0.001) from 19.49 at baseline through to 24.78 post- and 22.76 4 weeks follow-up. No significant [X ( 2 ) 2 = 1.568, p = 0.457] change in mean attitude toward nutrition care score was recorded. Mean level of self-efficacy in the provision of nutrition care improved significantly by 1.73 (95% Cl: 1.17-2.28, p < 0.001) at post-intervention and 4 weeks follow-up compared to the baseline scores.

Conclusion

The intervention improved the nutrition care knowledge, self-efficacy in the provision of nutrition care as well as medical students' own consumption of vegetables, dietary diversity and their engagement in moderate-to-vigorous physical activity. However, continuous implementation of nutrition education interventions is needed to sustain these outcomes and further improve the nutrition education experience of medical students.

Impact of bariatric and metabolic surgery education program on the knowledge and attitude of medical students

Objectives

Bariatric and metabolic surgery (BMS) is the most effective treatment method of morbid obesity. Optimum education of medical students regarding BMS is important for proper assessment of morbidly obese patients in the future.

Material and Methods

Medical students from five and six years were determined as the targeted study population. A survey including 17 questions was applied through a web-based survey platform. Students who replied the survey were classified into two groups: distinct bariatric and metabolic surgery education program (BMSEP) (+) and (-). The answers of two groups were compared using Chi-square test.

Results

In total, 845 students replied the survey. Surgery referral rates were higher (33.4% vs. 26.5%, p <0.05), referring to alternative treatment methods were low (4.9% vs. 11.9%, p <0.05), the answer rate of "absolutely agree" was higher and "have no idea" was lower in questions regarding the indications of BMS for the sample patient with body mass index (BMI)> 40 kg/m² and the sample patient with BMI between 35-40 kg/m² in the BMSEP (+) group (p <0.05). However, the two groups were comparable for the answers given for the sample patient of BMI 30-35 kg/m² with uncontrolled diabetes. The rate of first-degree relative referral to BMS when indicated was higher in the BMSEP (+) group. Effectiveness of surgery, cost and risk perception were comparable between the two groups.

Conclusion

This study showed that medical students who have a distinct BMSEP in their medical school have better level of knowledge and comparable risk perception regarding BMS. Structured education programs in BMS may directly improve knowledge, perception, and attitude of medical students and indirectly increase the role of primary care physicians in patient referral to BMS and long-term follow-up.

Nutrition Education in Medical Schools: What do Medical Students Think?

Objective

To examine medical students' perceptions of the nutrition education received and their ability to apply that knowledge in clinical settings.

Methods

This is a qualitative study using a structured survey with free responses to solicit the perspective of US medical students regarding their nutrition education. A national online survey was distributed by the American Academy of Pediatrics, Section on Pediatric Trainees. An expert committee in nutrition education evaluated and conducted a thematic analysis of the survey responses.

Results

Twenty-four surveys were completed (10 medical students and 14 pediatric interns). The survey revealed students were not satisfied with the nutrition education they received in several areas including nutritional recommendations for obesity and prediabetes/diabetes; nutritional needs during pregnancy, childhood, and adolescent age-related dietary recommendations; cultural influences on diet and eating habits; and food insecurity. Students also reported a lack of confidence in providing healthful nutrition counseling to adolescent patients and delivering culturally appropriate nutrition advice.

Conclusions

Survey responses revealed the need for improvements in several areas of nutrition curricula related to health and chronic disease management and suggest broader social determinants of health such as cultural influences on nutrition practices and food insecurity. The results of this survey provide unique insight into the medical student perspective on nutrition education and can inform the development of future medical school nutrition curriculums.

Medical and Surgical Treatment of Obesity

During the past decade, several effective antiobesity medications and devices have been developed. In addition, new information regarding the mechanism of action, benefits, and long-term efficacy of bariatric surgery continues to emerge. More than 90% of patients who qualify for therapy for obesity remain untreated. This article aims to provide an overview of the indications and efficacy of currently available medical and surgical therapies for obesity, along with a look toward promising therapies on the horizon.

A Canadian survey of medical students and undergraduate deans on the management of patients living with obesity

BACKGROUND

With over 26% of Canadian adults living with obesity, undergraduate medical education (UGME) should prepare medical students to manage this chronic disease. It is currently unknown how the management of patients living with obesity is taught within UGME curricula in Canada. This study (1) examined the knowledge and self-reported competence of final-year medical students in managing patients living with obesity, and (2) explored how this topic is taught within UGME curricula in Canada.

METHODS

We distributed two online surveys: one to final-year medical students, and another to UGME deans at 9 English-speaking medical schools in Canada. The medical student survey assessed students' knowledge and self-reported competence in managing patients living with obesity. The dean's survey assessed how management of patients living with obesity is taught within the UGME curriculum.

RESULTS

One hundred thirty-three (6.9%) and 180 (9.3%) out of 1936 eligible students completed the knowledge and self-reported competence parts of the survey, respectively. Mean knowledge score was 10.5 (2.1) out of 18. Students had greatest knowledge about etiology of obesity and goals of treatment, and poorest knowledge about physiology and maintenance of weight loss. Mean self-reported competence score was 2.5 (0.86) out of 4. Students felt most competent assessing diet for unhealthy behaviors and calculating body mass index. Five (56%) out of 9 deans completed the survey. A mean of 14.6 (5.0) curricular hours were spent on teaching management of patients living with obesity. Nutrition and bariatric surgery were most frequently covered topics, with education delivered most often via large-group sessions and clinical activities.

CONCLUSIONS

Canadian medical students lack adequate knowledge and feel inadequately prepared to manage patients living with obesity. Changes to UGME curricula may help address this gap in education.

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools

OBJECTIVE

To characterize the current landscape of pre-clinical medical endocrine education in United States (U.S.) allopathic medical schools.

METHODS

U.S. endocrine curriculum directors were asked to voluntarily complete a 16-question emailed survey surveying the status of endocrine pre-clinical education at their medical school.

RESULTS

There were 69 of 155 (45%) endocrine block director respondents who completed the online survey between July to Sept 2021. A larger incoming class, a longer duration of an endocrine curriculum, and the offering of a separate endocrine curriculum (i.e. apart from the teaching of other organ systems) were each independently associated with an increased number of faculty teaching the course. Schools that used a gland/organ-based curriculum only and those that used a combination of gland/organ with topic based were differed significantly in their use of large lectures, small groups, and several curriculum components including point of care glucose testing, continuous glucose monitoring, and insulin pumps.

CONCLUSION

This survey study reports the current landscape of preclinical endocrine education in the U.S. and describes opportunities to improve interest in pursuing endocrinology as a career.

Nutrition in medical education in Latin America: Results of a cross-sectional survey

RATIONALE

The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final-year medical students.

METHODS

Eighty-five public and private medical schools from 17 Latin American countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges.

RESULTS

A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). A total of 1530 of 1630 (94%) students from 12 countries responded. Students' average age was 25 ± 3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutrition counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues.

CONCLUSIONS

Positive attitude and interest in nutrition among final-year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition.

Effect of modified physiology laboratory sessions on the awareness and knowledge of obesity of health-related university students

BACKGROUND:

Obesity is a global health problem of immense magnitude. Increased awareness and knowledge about obesity in health-care providers are essential to addressing this global issue. The aim of the present study was to assess the baseline knowledge on obesity of university students in health-related programs and evaluate the effectiveness of modified physiology laboratory (MPL) sessions in enhancing the awareness of obesity of these students by repeated exposure to physiological differences between normal weight (NW) and overweight or obese (OW/OB) individuals.

MATERIALS AND METHODS:

It was a quasi-experimental study in which three regular physiology laboratory exercises were modified (MPL) to address different aspects of obesity. A total of 319 students (181 male and 138 female) from health-related colleges taking the physiology course during academic session 2011–2012 were included in the study. A questionnaire on obesity served as a measure of prior knowledge and improvement of evolution of student knowledge. The questionnaire was administered thrice: Beginning of the first MPL session (pretest), at the end of the second session of the first MPL (posttest-1), and the end of second session of the final MPL (posttest-2). Correct knowledge (CK), perceived knowledge (PK), and accuracy of knowledge (KA) were evaluated. Students gathered and analyzed physiological data in these sessions to explore the differences between NW and OW/OB subjects.

RESULTS:

The students' level of PK on obesity was high, but KA was low in pretest. The three knowledge indices improved significantly (P <0.001) from pretest (PK = 77.2%; KA = 52.8%; CK = 40.5%) to posttest 1 (PK = 93.5%; KA = 70.1%; CK = 65.9%). However, from posttest 1 to posttest 2, only small but significant increments were observed in CK (10.5%) and KA (8.7%).

CONCLUSION:

The awareness and knowledge on obesity of health-related undergraduate university students at baseline were low, but significantly improved after MPLs. The students' knowledge did not only increase but also improved in accuracy. This increase in awareness and knowledge of obesity is expected to directly impact on the students' lifestyles and boost their confidence to counsel others on obesity.

Barriers and Solutions for Prescribing Obesity Pharmacotherapy

There are many valid reasons why health care providers are reluctant to use pharmacotherapy for weight management: the negative track record of weight loss medications has led to numerous safety concerns, and there is lack of formal training in obesity medicine and a general discomfort with using these medications. New medications have improved safety profiles, and their mechanisms are based on recent discoveries of how humans regulate weight. This, combined with a change in American health coverage, has slowly increased the use weight loss medication. This article examines the barriers and changes that are increasing the use of anti-obesity medications.

Low priority of obesity education leads to lack of medical students' preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study

BACKGROUND

Physicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States. This study sought to evaluate the current status of obesity education among U.S. medical schools, benchmarking the degree to which medical school curricula address competencies proposed by the Obesity Medicine Education Collaborative (OMEC).

METHODS

Invitations to complete an online survey were sent via postal mail to 141 U.S. medical schools compiled from Association of American Medical Colleges. Medical school deans and curriculum staff knowledgeable about their medical school curriculum completed online surveys in the summer of 2018. Descriptive analyses were performed.

RESULTS

Forty of 141 medical schools responded (28.4%) and completed the survey. Only 10.0% of respondents believe their students were "very prepared" to manage patients with obesity and one-third reported that their medical school had no obesity education program in place and no plans to develop one. Half of the medical schools surveyed reported that expanding obesity education was a low priority or not a priority. An average of 10 h was reported as dedicated to obesity education, but less than 40% of schools reported that any obesity-related topic was well covered (i.e., to a "great extent"). Medical students received an adequate education (defined as covered to at least "some extent") on the topics of biology, physiology, epidemiology of obesity, obesity-related comorbidities, and evidence-based behavior change models to assess patient readiness for counseling (range: 79.5 to 94.9%). However, in approximately 30% of the schools surveyed, there was little or no education in nutrition and behavioral obesity interventions, on appropriate communication with patients with obesity, or pharmacotherapy. Lack of room in the curriculum was reported as the greatest barrier to incorporating obesity education.

CONCLUSIONS

Currently, U.S. medical schools are not adequately preparing their students to manage patients with obesity. Despite the obesity epidemic and high cost burden, medical schools are not prioritizing obesity in their curricula.

Nutrition in medical education: a systematic review

BACKGROUND

In many countries, doctors are recommended to provide nutrition care to patients to improve the dietary behaviours of individuals and populations. Here, we present a systematic review that aims to critically synthesise literature on nutrition education provided to medical students.

METHODS

In this systematic review, a literature search was done between May 1 and July 1, 2018, for articles on medical students' nutrition knowledge, skills, and confidence to counsel patients, from Nov 1, 2012, to Dec 31, 2018. Search terms related to medical students included "nutrition in medical education", "medical nutrition education", and "undergraduate medical nutrition education". Search terms for topic of interest included "nutrition", "knowledge", "skills", "nutrition counselling", "confidence", "nutrition care", or "nutrition education". Included studies examined any aspect of recently graduated (ie, ≤4 years) or current medical students' nutrition knowledge, attitudes, skills, or confidence (or all three) in nutrition or nutrition counselling; evaluated nutrition curriculum initiatives for medical students; or assessed recently graduated or current medical students' perceptions of nutrition education. Quality assessment appraisal of the studies was done using a Mixed Methods Appraisal Tool. Curriculum initiatives were also appraised.

FINDINGS

66 studies were identified by the search and 24 were eligible for full-text analysis. 16 quantitative studies, three qualitative studies, and five curriculum initiatives from the USA (n=11), Europe (n=4), the Middle East (n=1), Africa (n=1), and Australasia (n=7) met the inclusion criteria. Our analysis of these studies showed that nutrition is insufficiently incorporated into medical education, regardless of country, setting, or year of medical education. Deficits in nutrition education affect students' knowledge, skills, and confidence to implement nutrition care into patient care. A modest positive effect was reported from curriculum initiatives.

INTERPRETATION

Despite the centrality of nutrition to healthy lifestyle, medical students are not supported to provide high-quality, effective nutrition care. Medical education can be enhanced by institutional commitment to make nutrition education compulsory in medical training, establishment of nutrition competencies to provide a benchmark for nutrition knowledge and skills to be included in curricula, and supported by funding for innovative curriculum initiatives. These initiatives will improve nutrition in medical training to support future doctors for the 21st century.

FUNDING

Sir John Logan Campbell Medical Fellowship 2017, and an Australian National Health and Medical Research Council Fellowship.

Clinical Nutrition Education of Doctors and Medical Students: Solving the Catch 22

There is a well-documented pandemic of malnutrition. It has numerous sequelae, including physical and psychological ill health, early death, and socioeconomic burden. The nutrition landscape and dynamics of the nutrition transition are extremely complex, but one significant factor in both is the role of medical management. Doctors have a unique position in society from which to influence this scenario at global, public, and personal levels, but we are failing to do so. There are several reasons for this, including inadequate time; historical educational bias towards disease and therapeutic intervention-rather than diet, lifestyle, and prevention; actual or perceived incompetency in the field of nutrition; confusion or deflection within medicine about whose role(s) it is on a medical team to address nutrition; and public confusion about whom to turn to for advice. But the most fundamental reason is that current doctors (and thus the trainers of medical students) have not received-and future doctors are thus still not receiving-adequate training to render them confident or competent to take on the role. A small number of important educational approaches exist aimed at practicing doctors and medical students, but the most effective methods of teaching are still being evaluated. Without properly trained trainers, we have no one to train the doctors of tomorrow. This is a "catch 22." To break this deadlock, there is an urgent need to make appropriate nutrition training available, internationally, and at all levels of medical education (medical students, doctors-in-training, and practicing doctors). Until this is achieved, the current pandemic of nutrition-related disease will continue to grow. Using important illustrative examples of existing successful nutrition education approaches, we suggest potential approaches to breaking this deadlock.

Reevaluating Biochemistry and Nutrition Education Through Opinions of Clinicians and Educators

Biochemistry is a core component of medical education as it contributes to the fundamental basis and understanding of molecular mechanisms in pathophysiological processes. The convergence of nutritional factors also gives insight to many chronic diseases. Topics of nutrition are often incorporated into biochemistry coursework and must be integrated in a way that makes sense within the overall curriculum. An important issue raised by this structure is determining which topics are most important to a student's understanding and what topics are most relevant to future clinical practice. Previous surveys show medical undergraduates feel that much of current medical biochemistry coursework lacks clinical relevance and pays too much attention to small details. Here we report the results of a survey that aims to determine the biochemical and nutritional topics that physicians and educators feel are most important to teach in medical school. This information is important for medical schools to better prepare their students for what they will see and apply in their future clinical practice. Physicians and medical educators were surveyed, asked demographic questions, and then requested to provide a prioritized list of the top 10 biochemistry and nutrition topics that they believed should be focused on in undergraduate medical education. Topics suggested by participants were normalized for spelling, acronyms, and abbreviations and given a weight from 10 to 1. A prioritized list was then created based on the suggested topics. This list provides insight into the topics that medical educators and physicians consider important to cover in undergraduate medical education.