Medical students lack basic knowledge on nutrition: Research

‘It’s a concern.’
 
That is Mark Harris, Professor of General Practice at the University of New South Wales and main author of the RACGP’s Smoking, nutrition, alcohol and physical activity (SNAP) guide.
 
He is talking to newsGP about his thoughts on new research that found medical students are not being taught enough about nutrition.
 
The research, from Queensland’s Griffith University and the University of Auckland, was published in The Lancet Planetary Health. It was a systematic review of 24 studies, seven of which analysed Australian curriculum, from the years 2012–18.
 
The findings show that nutrition was insufficiently incorporated into medical education, regardless of country, setting or year of medical education.
 
‘I think the general level of nutrition education in medical training is quite limited, and I think that’s probably true across Australia,’ Professor Harris said.
 
Dr Lauren Ball from Griffith University was the study’s lead author. She said, in many cases, medical students received little or no education on nutrition.
 
‘The studies we looked at in our review found medical students definitely think it is their role to support patients to eat well,’ Dr Ball said.
 
‘We know that patients go to doctors as their first port of call if they have a question about diet, so it’s definitely part of a doctor’s role to support patients to eat well.’
 
Previous research from 2013 supports that notion.
 
That research found that, when asked who their preferred provider of nutrition care was, most participants nominated their GPs first, followed by dietitians.
 
And yet, as the new research found, there is a deficit of knowledge among medical professionals in relation to this field.
 
While it may seem the obvious answer is to include more nutrition education for medical students, the solution might not be so straightforward.
 
‘We know that medical training is just so crowded. There are all sorts of things that medical students are learning about, and quite rightly so, and we know a lot of medical training institutions are trying to find space for it,’ Dr Ball said.
 
‘But finding how to do that is the key challenge.’
 
Professor Harris agreed medical students are not receiving adequate education on nutrition. He also agrees that the answer does not necessarily lie in simply increasing the amount of nutrition education.
 
Instead, he said it is important for GPs to understand the role of a dietitian and to become comfortable explaining that to patients and referring when needed.
 
‘There’s no way that a GP is going to be providing detailed diabetes advice and support to patients in the same way as a dietitian would, and nor would they want to,’ he said.
 
‘GPs shouldn’t be trying to replace dieticians; they don’t have the skill or time.’
 
That said, Professor Harris believes GPs need a good understanding of basic nutrition.
 
‘Obviously, as GPs we need to be able to give patients general advice about their diet, and also reinforce appropriate messages they might get from other places,’ he said.
 
That does not mean, however, GPs need to take a detailed dietary assessment, nor offer complex advice.
 
‘It’s about being able to say to patients, “Well, what’s important is the overall pattern of your diet”,’ Professor Harris said.
 
‘It’s not rocket science, but [it’s important for GPs to have some] basic understanding so they can give patients general advice.’
 
Professor Harris believes an optimal time for doctors to acquire knowledge on nutrition is when they are treating patients professionally. He said this can be done through continuing education.
 
But he does concede that this is easier said than done, as there is often a dearth of interest among doctors when it comes to education on nutrition. 
 
‘It’s not necessarily the topic that GPs queue up for,’ Professor Harris said.
 
‘If you run a course on nutrition, you’ll get a few very interested doctors. But the majority of GPs will opt for the things that are more clinically oriented, like how to manage diabetes or cardiovascular disease, so we’ve got to try and incorporate nutrition into other education.
 
‘That’s the challenge.’
 
To ensure doctors receive necessary postgraduate education, Professor Harris believes other approaches may be needed.
 
‘It’s better incorporated into case-based discussion, role-plays, interactive education that might occur online. We need to think about trying to incorporate nutrition into that,’ he said.
 
‘That requires a shift in the way we think about education, too.’

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