Obesity Coverage on Medical Licensing Examinations in the United States. What Is Being Tested?

Abstract

There were 802 multiple-choice items containing obesity-related keywords identified by NBME, of which 289 (36%) were identified as being relevant to obesity and were coded into appropriate domains and subdomains. Among the individual domains, the Diagnosis& Evaluation domain comprised most of the items (174) for all 3 Step examinations. Fifty-eight percent of items were represented by 4 of 17 organ systems, and 80% of coded items were represented by 6 ABOM subdomains. The majority of obesity-coded items pertained to the diagnosis and management of obesity-related comorbid conditions rather than addressing the prevention, diagnosis, or management of obesity itself. Insights. The most important concepts of obesity prevention and treatment were not represented on the Step exams. Exam items primarily addressed the diagnosis and treatment of obesity-related comorbid conditions instead of obesity itself. The expert review panel identified numerous important obesity-related topics that were insufficiently addressed or entirely absent from the examinations. The reviewers recommend that the areas identified for improvement may promote a more balanced testing of knowledge in obesity.

Current Knowledge of Obesity Treatment Guidelines by Health Care Professionals

“…Unlike previous surveys , the questions used in this analysis were designed to assess HCP knowledge of various evidence‐based obesity treatment guidelines rather than their attitudes or behaviors. Because knowledge of obesity management is not routinely assessed by medical licensing exams , this analysis provides unique information on where knowledge is most lacking and how understanding of IBT and pharmacotherapy guidelines differs for FPs, internists, OB‐GYNs, and NPs. As an assessment of current HCP knowledge, our findings fill an important evidence gap in recent efforts to explain why widespread provider beliefs about the importance of addressing obesity seldom translate into provision of evidence‐based treatments in clinical practice .…”

Development of Obesity Competencies for Medical Education: A Report from the Obesity Medicine Education Collaborative

“…Education on assessing, preventing and treating overweight and obesity should be included in basic sciences, clinical experiences, and population health sciences” . A recent comprehensive review of the United States Medical Licensing Examination found that there was insufficient coverage of obesity on the Step 1 and 2 examinations, and recommendations for inclusion were provided . Others have voiced similar recommendations for residency and fellowship training .…”

Geographic Availability of Physicians Certified by the American Board of Obesity Medicine Relative to Obesity Prevalence

“…Physicians receive little education or training on how to appropriately address obesity in the clinical setting. Competencies taught in medical school and in internal medicine residency have identified obesity and nutrition as major knowledge gaps . Practicing primary care physicians have repeatedly identified insufficient training about obesity as well as low confidence and self‐efficacy with respect to weight management skills .…”