Medical Education Shortcomings

The elephant in the room is what people see, but for whatever reason, don’t want to talk about. To switch metaphors, a lot of people avoid acknowledging the lacuna in the midst of the typical doctor’s knowledge base.

Guess how many hours of nutrition education the average medical student partakes of? Journalist Rachel Cernansky wrote,

In a 2015 survey of 121 four-year medical schools, [University of North Carolina research professor Martin] Kohlmeier and colleagues found that 71 percent did not require at least 25 hours of nutrition education and that fewer than 20 percent required a nutrition course — fewer even than 15 years before.

Only last year, Dr. David Eisenberg of Harvard’s T.H. Chan School of Public Health said,

Today, most medical schools in the United States teach less than 25 hours of nutrition over four years. The fact that less than 20 percent of medical schools have a single required course in nutrition, it’s a scandal. It’s outrageous. It’s obscene.

Healing has two parts: fixing the broken, and preventing the breakage. Here is Dr. Mark Hyman:

Most chronic diseases (heart disease, type 2 diabetes, cancer, dementia, autoimmune disease, and more) are caused by food, and can be prevented, treated, and often reversed by food.

But chronic diseases are non-communicable diseases, and it is said that often, the educational establishment deals much more with communicable diseases. Looked at from an epidemiological standpoint, that is a paradox, because the non-communicable ones are much more prevalent, and much more likely to bankrupt a nation. Every illness named by Dr. Hyman is expensive as hell.

As always, quality of life matters, and there seems to be good evidence that surgical patients do better when their nutritional status is enhanced both pre- and post-op. Embryos who don’t imbibe the right chemicals and nutrients will start out at a disadvantage, as in the sad Pink Floyd lyric, “No one told you when to run/ You missed the starting gun.”

Revolution needed

Why is the vital importance of diet not apparent to everyone? Stepping back for an all-encompassing view, what is a physician’s purpose in life? To assimilate and utilize knowledge about the human body and/or one of its particular parts or systems. We don’t often conceptualize it this way, but indirectly and indubitably, the human body is made from food. Not one of those parts and systems, not even a single living cell, would exist without the components supplied by the ingestion of edible substances.

When, as with diabetes and hypertension, the first-line treatment is lifestyle change, for most people that mainly requires a revolution in their eating habits. Surely it behooves the professionals in charge of taking care of bodies, to have a rudimentary grasp of nutrition and related areas of knowledge.

What could be improved?

Often, what nutritional content appears in the curriculum is described as informal, fragmented, and other uncomplimentary adjectives. Students need an awareness that the nutritional needs of people vary, over time and space, and that each individual reacts differently to the multiplicity of causative factors acting on that person.

One step toward becoming a doctor is passing the “Boards,” or grueling written exams created by the licensing authority. To the school administrator’s mind, the priority is helping the candidates pass the test, and if there are no nutrition questions on the test, why bother?

Within this paradigm, everyone’s time could be put to better use. Of course, the obvious solution here is to add some nutrition questions, and require more credit hours of it in the classrooms.

Your responses and feedback are welcome!

Source: “Your doctor may not be the best source of nutrition advice,” WashingtonPost.com, 07/08/18
Source: “Doctors need more nutrition education,” Harvard.edu, 05/08/17
Source: “Why don’t they teach nutrition in medical school?,” DrHyman.com, 09/07/18
Photo credit: David Blackwell. on Foter.com/CC BY-ND

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Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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