Reports on Why So Many Medical Doctors Lack Knowledge about Nutrition – of How Healthy Food & Lifestyles can Prevent, Treat & Reverse Disease – for they receive only little education during college; reports from Science Journals & News Media regards the USA, UK, Europe, Australia, Japan.
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A 2008 report in the American Journal for Clinical Nutrition concludes: “The amount of nutrition education in medical schools remains inadequate.”
The results section states: “Ninety-nine of the 106 schools responding required some form of nutrition education; however, only 32 schools (30%) required a separate nutrition course. On average, students received 23.9 contact hours of nutrition instruction during medical school (range: 2–70 h). Only 40 schools [38%] required the minimum 25 h recommended by the National Academy of Sciences. Most instructors (88%) expressed the need for additional nutrition instruction at their institutions.”
Reference: “Status of nutrition education in medical schools”, Am J Clin Nutr., 2008 Jun 18; at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430660/
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A 2016 report on the status of nutrition education among recent medical graduates concluded: “Incoming residents to a pediatric residency program appear to be DEFICIENT IN BASIC NUTRITIONAL KNOWLEDGE… The incoming interns averaged answering 52% of the questions correctly…”
Some notes about the study: “Medical and osteopathic school graduates entering a pediatric residency program completed an 18-question nutrition survey…
With the ever increasing burden of obesity and its associated co-morbidities on society, it is imperative that medical education focuses on preparing physicians to appropriately counsel all populations on proper nutrition.” (capitalised emphasis added)
Reference: “Basic nutrition knowledge of recent medical graduates entering a pediatric residency program”, in the International Journal of Adolescent Medicine and Health, 2016 Nov 1;28(4):357-361; at https://www.ncbi.nlm.nih.gov/pubmed/26234947
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“Medical School Nutrition Education” is a short presentation by Dr Michael Greger MD at https://www.youtube.com/watch?v=5ZbQvTxYYf8
Summary: “Most medical schools in the United States fail to provide even a bare minimum of nutrition training.”
Text is at https://nutritionfacts.org/video/medical-school-nutrition-education/
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A 2015 report “surveyed all 133 US medical schools with a four-year curriculum about the extent and type of required nutrition education during the 2012/13 academic year… Responses came from 121 institutions… Most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition education; 43 (36%) provide less than half that much…”
The authors of the report concluded: “Many US medical schools still fail to prepare future physicians for everyday nutrition challenges in clinical practice. It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school and residency training how to recognize and treat the nutritional root causes.”
Reference: “The State of Nutrition Education at US Medical Schools”, Journal of Biomedical Education, Volume 2015, Article ID 357627; at https://www.hindawi.com/journals/jbe/2015/357627/
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A 2010 report in the journal of the Association of American Medical Colleges concludes: “The amount of nutrition education that medical students receive continues to be inadequate.”
The authors sent their survey to “all 127 accredited U.S. medical schools (that were matriculating students at the time of this study)…”
The results: “Respondents from 109 (86%) of the targeted medical schools completed some part of the survey. Most schools (103/109) required some form of nutrition education. Of the 105 schools answering questions about courses and contact hours, only 26 (25%) required a dedicated nutrition course; in 2004, 32 (30%) of 106 schools did. Overall, medical students received 19.6 contact hours of nutrition instruction during their medical school careers (range: 0-70 hours); the average in 2004 was 22.3 hours. Only 28 (27%) of the 105 schools met the minimum 25 required hours set by the National Academy of Sciences; in 2004, 40 (38%) of 104 schools did so.”
Reference: “Nutrition education in U.S. medical schools: latest update of a national survey”, Academic Medicine, 2010 Sep;85(9):1537-2; at https://www.ncbi.nlm.nih.gov/pubmed/20736683
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A 1999 analysis on the “current level of nutrition course offerings for 128 U.S. accredited medical schools” found that for 1997-98 “25% of medical schools provide NO nutrition instruction, or they cannot quantify the amount of nutrition education offered”; only 25.8% of medical schools “reported a required nutrition course”; while another 47.7% “reported an elective nutrition course.”
The report further states “With nearly 20% of deaths in the U.S. attributed to improper diet and lack of exercise... Nutrition interventions can decrease morbidity, mortality, human suffering, and medical costs, yet only recently have U.S. medical schools begun to integrate nutrition into bedside and case-based teaching.” (capitalised emphasis added)
Reference: “Nutrition Education in Medical Schools: Trends and Implications for Health Educators”, Medical Education Online, Volume 4, 1999 – Issue 1; at http://www.tandfonline.com/doi/abs/10.3402/meo.v4i.4307
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“Doctors Know Less than They Think about Nutrition” is a short presentation by Dr Michael Greger MD at https://www.youtube.com/watch?v=JyhWhr73VnI
Summary: “Doctors found to be overconfident in their knowledge and ability to counsel patients about lifestyle modification for chronic disease prevention.”
Text is at https://nutritionfacts.org/video/doctors-know-less-than-they-think-about-nutrition/
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A 2014 report in the European Journal of Clinical Nutrition (2014) concludes: “We substantiate the increasing concern over the inadequate amounts of nutrition education provided to medical students in Europe.”
Details: “we distributed a survey on required and/or optional nutrition contact hours to medical education directors of all accredited medical schools (N=217) in Western European Union countries (N=14). In total, respondents from 32 medical schools (14.7%) from 10 countries indicated that nutrition education, in some form, was required in 68.8% of schools where, on average, 23.68 h of required nutrition education was provided. The results from this small-scale survey are comparable to a 2010 US study…”
Reference: “Nutrition education in European medical schools: results of an international survey”, European Journal of Clinical Nutrition, 2014 Jul;68(7):844-6; at
https://www.ncbi.nlm.nih.gov/pubmed/24781690 and https://www.nature.com/articles/ejcn201475
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Likewise regards the UK (Great Britain) – doctors are not adequately trained in nutrition matters. The BBC (2010) reports “Nutrition training for doctors ‘must be improved'” Excerpt: “The introduction of nutrition in the first year of junior doctor training has only been rolled out in recent years…
Nutrition is a core element in the first year of a junior doctor course, but it is not a mandatory part of medical school curriculums or many specialist training courses in the latter part of the junior doctor training programme…
Gastroenterologist Dr Penny Neild, who works at London’s St George’s Hospital, said training on how to spot and tackle malnutrition was “patchy”…”
A 2017 article on the site of the British Medical Journal states: “In 2008 and 2009, more than 75% of American junior physicians felt inadequately trained to counsel patients on diet and physical activity. The picture is reportedly similar in the UK… Internationally, this knowledge is lacking in medical training. Just 27% of US medical schools indicated that they provided the agreed minimum 25 hours of nutrition education in 2008. A recent study of European medical schools was slightly more optimistic, suggesting that nutrition education was a requirement in 68.8% of institutions surveyed, with an average of 23.68 hours of teaching…
This, however, has not been our experience at medical school in the UK, where nutrition education has been notably lacking. It is not that students don’t want to learn this material. If individual universities had the courage to lead the way in preventative nutrition, the majority of medical students would be only too keen to learn more about this subject…
Medical students are routinely presented with evidence for pharmaceutical decision-making, but rarely empirical data about the impacts of nutrition or exercise…
The UK should be prioritising nutrition and lifestyle education…”
Reference: “Medical schools should be prioritising nutrition and lifestyle education”, September 7, 2017; http://blogs.bmj.com/bmj/2017/09/07/medical-schools-should-be-prioritising-nutrition-and-lifestyle-education/
The Guardian (2016) reports: “Doctors ‘know too little about nutrition and exercise’” Excerpts: “Most doctors are ill-equipped to tackle Britain’s increasing frequency of lifestyle-related diseases because they know worryingly little about how nutrition and exercise can improve health, a group of prominent medics has claimed.
“There is a lack of knowledge and understanding of the basic evidence for the impact of nutrition and physical activity on health among the overwhelming majority of doctors. This has its roots in the lack of early formal training,” they state in a letter to the Medical Schools Council (MSC) and General Medical Council (GMC)…
Oliver said that, in a recent study of Edinburgh University medical students, just 14.9% knew how much exercise the UK chief medical officers recommended that adults should take in order to boost their health. Fewer than 10% felt adequately trained to give patients advice on physical activity and more than 90% said they would like more training on it…”
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“Medical Associations Oppose Bill to Mandate Nutrition Training” is a short presentation by Dr Michael Greger MD at https://www.youtube.com/watch?v=ADlY8CYllhU
Summary: “Physician trade groups such as the California Medical Association came out in opposition of a bill requiring doctors to get 7 hours of nutrition training anytime before 2017.”
Text is at https://nutritionfacts.org/video/medical-associations-oppose-bill-to-mandate-nutrition-training/
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Regards Australia – The Conversation (2015) website reports: “Many doctors may not feel confident about giving nutrition advice because they are not well educated on the subject. Indeed, the amount of nutrition education provided to medical students and doctors has traditionally been viewed by educators and government bodies alike as inadequate. But attempts to change medical education by incorporating nutrition knowledge are happening both in Australia and abroad…”
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“Physicians May Be Missing their Most Important Tool” is a short presentation by Dr Michael Greger MD at https://www.youtube.com/watch?v=3IkwWhXX5gU
Summary: “What might happen if nutritional excellence was taught in medical school? Most deaths in the United States are preventable, and related to nutrition. Given that the #1 cause of death and the #1 cause of disability is diet in this country, surely nutrition is the #1 thing taught in medical school. Sadly, that is not the case.
Nutrition receives little attention in medical practice… ”
Text is at https://nutritionfacts.org/video/physicians-may-be-missing-their-most-important-tool/
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Regards Japan the Asia Pacific Journal of Clinical Nutrition reported in 2013: “In conclusion, the status of nutrition education in Japan has improved slightly but is still inadequate.”
Details of the survey: “The current questionnaire was sent to the directors of Centers for Medical Education of 80 medical schools, who represented all medical schools in Japan. Sixty-seven medical schools (83.8%) responded, of which 25 schools (37.3%) offered dedicated nutrition courses and 36 schools (53.7%) did not offer dedicated nutrition courses but offered something related to nutrition in other courses; six schools (9.0%) did not offer any nutrition education. Overall, 61 schools (91.0%) offered at least some nutritional topics in their undergraduate education.
Nevertheless, only 11 schools (16.4%) seem to dedicate more than 5 hours to substantial nutrition education as judged by their syllabi. Although the mean length of the course was 11 hours, substantial nutrition education accounted for only 4.2 hours. Of the 25 medical schools that offered dedicated nutrition courses, seven schools offered the nutrition course as a stand-alone course and 18 schools offered it as an integrated course.”
Reference: “Nutrition education in Japanese medical schools: a follow-up survey”, Asia Pac J Clin Nutr. 2013;22(1):144-9; at https://www.ncbi.nlm.nih.gov/pubmed/23353622
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A 2017 article by Dr Greger MD “How Much Nutrition Education Do Doctors Get?”
Excerpt: “In the United States, most deaths are preventable and related to nutrition. Given that the number-one cause of death and the number-one cause of disability in this country is diet, surely nutrition is the number-one subject taught in medical school, right? Sadly, that is not the case.
As shown in my video, Physicians May Be Missing Their Most Important Tool, a group of prominent physicians wrote in 2014 that “nutrition receives little attention in medical practice” and “the reason stems, in large part, from the severe deficiency of nutrition education at all levels of medical training.” They note this is particularly shocking since it has been proven that a whole foods, plant-based diet low in animal products and refined carbohydrates can reverse coronary heart disease—our number-one killer—and provide potent protection against other leading causes of death, such as cancer and type 2 diabetes.
So, how has medical education been affected by this knowledge? Medical students are still getting less than 20 hours of nutrition education over 4 years, and even most of that has limited clinical relevance. Thirty years ago, only 37 percent of medical schools had a single course in nutrition. According to the most recent national survey, that number has since dropped to 27 percent. And, it gets even worse after students graduate.
According to the official list of all the requirements for those specializing in cardiology, fellows must perform at least 50 stress tests, participate in at least 100 catheterizations, and so on. But nowhere in the 34-page list of requirements is there any mention of nutrition. Maybe they leave that to the primary care physicians? No. In the official 35-page list of requirements for internal medicine doctors, once again, nutrition doesn’t get even a single mention.
There are no requirements for nutrition before medical school either. Instead, aspiring doctors need to take courses like calculus, organic chemistry, and physics. Most of these common pre-med requirements are irrelevant to the practice of medicine and are primarily used to “weed out” students. Shouldn’t we be weeding out based on skills a physician actually uses? …
Despite the neglect of nutrition in medical education, physicians are considered by the public to be among the most trusted sources for information related to nutrition. But, if doctors don’t know what they’re talking about, they could actually be contributing to diet-related disease…”
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Video Clip: “WHY DOCTORS DON’T RECOMMEND VEGANISM #5: Dr. Michael Klaper & Dr. Pam Popper” at https://www.youtube.com/watch?v=XTriuK3N3gg
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More to Come!
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This set of articles were compiled for
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