Nutrition Education in U.S. Medical Schools: An Assessment of Nutrition Content in USMLE STEP Preparation Materials

Abstract

In the U.S., the numbers of obese individuals and of obesity-related health conditions are rising. While physicians understand the need to improve patient health by promoting a healthy lifestyle, the advancement of nutrition education in medical school and residency is not keeping pace. This is evident in the inadequate time dedicated to nutrition education by medical schools and in the dissatisfaction of medical students and residents with their medical nutrition training. The aim of the current study was to investigate how food, diet, nutrition, and obesity are represented in the U.S. medical school licensing examinations (USMLE) as a potential incentive to better match medical nutrition curricula to the modern societal needs. We semi-quantitatively analyzed nutrition-related information of the USMLE Step 1, 2, and 3 Content Description documents and two test preparation books, using QRS NVivo 10. The software's coding comparison query was used as reliability statistics. We found an adequate amount of nutrition references. However, the content of the references was inadequate in that there was minimal information in regards to chronic diseases and no content related to disease prevention. Moreover, there was a lack of specifics in regards to food and nutritional science. We propose a content adjustment to the medical licensing exams to ensure that future physicians are more skilled and comfortable in fulfilling their roles as health care providers and advisors for an increasingly obese patient clientele.

Implementation of an Interprofessional Nutrition Workshop to Integrate Nutrition Education into a Preclinical Medical School Curriculum

“…A gap also exists if we consider "assessment drives learning" (11). Preparation material for the U.S. Medical Licensing Exam (USMLE) references nutrition in almost one-third of its question stems (12). However, few of these questions are related to critical topics including prevention of disease, obesity, or nutrition's impact on chronic diseases, and instead focus on vitamin and mineral deficiencies (12).…”

Physician Nutrition Advice and Referrals to Registered Dietitians

“…1,3,11 Indeed, a wide variety of healthcare providers understand that proper nutrition plays an essential role in disease prevention 5,12,13 and that poor diet quality, increased BMI, and low health-related quality of life have specifically been shown to be associated with increased mortality in adults. 14 While providers recognize the importance of nutrition in disease progression, [15][16][17] nutrition education has been historically underrepresented in health professional curricula, 18 with noted absences at medical schools and residency programs, 15 nursing schools, 5 and physician assistant programs. 2,13 Due to a lack of targeted nutrition education in these educational models and ongoing integration of care between specialties, one behavioral counseling strategy being widely recommended in clinical guidelines 3,6,7,19 is to refer patients to registered dietitian nutritionists (RDN), who are specifically trained to deliver both medical and individual nutrition therapy in acute and chronic care.…”

Beyond Competence: Efficiency in American Biomedicine

“…Students often purchase one or more independently (Burk-Rafel, Santen, and Purkiss 2017), raising concerns about student debt (Bhatnagar, Diaz, and Bucur 2019;Prober et al 2016) and its role in racial disparities in that debt and in medical student enrollment (Bhatnagar, Diaz, and Bucur 2019). While many educators are concerned that the parallel curriculum may replace the more holistic and in-depth content of the broader curriculum (including classroom learning and faculty-assigned readings) with more surface-level content (Bhatnagar, Diaz, and Bucur 2019;Patel et al 2015;Prober et al 2016), some medical schools enter into contracts to provide one or more products to their students as a supplement to the curriculum (Quick of Chumley 2018) and students report their usefulness in increasing integration and cohesion of information across the curriculum (Coda 2019). Even textbooks may be used in ways other than in-depth reading due to digital access that previous generations of learners did not have: digital textbooks can serve as reference texts, with a collection of textbooks treated as a repository to search for key sections, definitions, figures, and tables (Ugaz and Resnick 2008).…”