How many hours would you say you’ve spent learning about nutrition in medical school? When you have the case of the young immigrant child with night blindness, do you have a vitamin deficiency on your differential? When you check a CBC on your alcoholic patient, do you know why they most likely have macrocytic anemia? Some of you may be saying, “of course, I know the answers to those questions.” And that’s great, but I’d say it’s just a start. These types of scenarios are popular for Step 1/2 review questions, but what about when you’re in clinical practice and you’ve got a patient who is pre-diabetic and wants to avoid going on medications, can you help really help them with this goal? Although many practitioners can utilize fantastic resources like patient educators and nutritionists, not all have access to these resources. Furthermore, some of our patients may not have the time or means to participate in these types of interventions. So it’s up to you, the doctor, to try to fill this role.
When you look back on your medical school career, do you think you can handle this responsibility? To go back to the first question, how many hours to you really think you’ve received… What do you think you should get? I’ll admit, very little nutrition is tested on the USMLE exams, but it is extremely valuable to your patients and may affect how you practice medicine. If you feel comfortable counseling your patients with diet and lifestyle changes, I would propose that you’ll be more likely to try this first rather than just starting a patient on a medication that they may not like to take or could have side effects from.
It took me about 10 minutes of googling, but I eventually found the National Academy of Science’s 2004 recommendations for nutritional education in medical school. And the magic number? 25 hours.
A study published in 2014 surveyed all 127 US accredited medical schools, 106 of which responded, and found that only 27% achieved the 25+ hours of nutritional education goal (surveyed 2008-2009) with an average of 19.6 hrs.