What Competencies Should Medical Students Attain in Nutritional M
Journal of Nutrition & Food Sciences

Journal of Nutrition & Food Sciences
Open Access

ISSN: 2155-9600

Commentary - (2015) Volume 5, Issue 6

What Competencies Should Medical Students Attain in Nutritional Medicine?

Sierpina VS1*, Welch K1, Devries S2, Eisenberg DM3, Levine L4, McKee J1, Dalal M5, Mendoza P6, Gutierrez J7, Robertson S7 and Rosales D7
1UTMB-Health, Department of Family Medicine, USA, E-mail:
2Gaples Institute for Integrative Cardiology, USA, E-mail:
3Harvard T.H. Chan School of Public Health, USA, E-mail:
4UTMB-Health, Department of Obstetrics and Gynecology, USA, E-mail:
5UTMB-Health, School of Medicine, USA, E-mail:
6Galveston Community College, Institute of Culinary Arts, USA, E-mail:
7UTMB-Health, School of Health Professions, Department of Nutrition and Metabolism, USA, E-mail:
*Corresponding Author: Sierpina VS, UTMB-Health, Department of Family Medicine, USA, Tel: 14097722166


A sizable gap exists between the nutrition education offered in medical school and the dietary knowledge needed for patient care. Despite the centrality of nutrition to a healthy lifestyle and the pressing obesity epidemic, medical students receive limited training in nutrition. Often this instruction is focused on basic science and rare nutritional deficiency states rather than on the foundations of nutrition science needed to prepare physicians to address patient questions and nutritional needs.

As a result graduating medical students lack the knowledge and skills required to effectively promote behavior change in their patients. University instructors and graduating medical students agree that the approximately 25 contact hours of nutrition education provided to medical students is inadequate and even this low standard of hours is often not achieved.

Furthermore, such instruction is focused on pathogenesis rather than the real world nutrition-related challenges of their patients, e.g., metabolic syndrome, cardiovascular disease, nutrition in cancer, obesity, and hospital malnutrition. Additionally, most medical schools do not provide nutrition education outside of the classroom, so most medical students do not get the opportunity to learn how to integrate nutrition knowledge into clinical practice [1].

We propose an alternative to a narrowly focused basic science and nutritional training based on pathogenesis. Rather, teach nutrition as a key factor in autogenesis, the generation of health and wellness. In parallel with this, teach students key skills to foster behavioral change [2].

The authors are working to make changes in evolving medical school nutrition curricula and propose a list of core competencies.

Nutrition education in medical school should empower new physicians to:

• Take a diet history, perform an appropriate nutrition-oriented exam, and converse in an informed way with patients about their food choices [3].

• Discuss and empower patients to shop, cook, and prepare a healthy diet within a variety of budgetary levels.

• Student should learn to prepare food themselves so they can be adequately informed as they teach patients.

• Demonstrate knowledge of optimal evidence-based diets, such as the Mediterranean diet, as well as culturally acceptable alternative diets that provide healthy proportions of carbohydrates, protein, fats, antioxidants, fiber, and essential micronutrients [4].

• Demonstrate understanding of the epidemiology of obesity in the US and worldwide and its impact on health, healthcare budgets, and medical care.

• Evaluate the evidence for popular diets, supplements, and pharmacological agents for obesity and to develop practical and credible counseling skills for patients about these.

• Work in inter professional team that includes experts in nutrition, exercise physiologists, psychologists, health coaches, trainers, community health educators, and others.

• Learn, apply, and engage in motivational interviewing-helping patients understand their goals, motives, readiness to change, as well as barriers to change.

• Find and interpret policy documents informing national nutrition programs identifying major food consumption trends.

• Connect patients to existing resources for healthful foods and nutrition education in the community including food banks and pantries [5].

• Identify patients requiring intensive behavioral therapy and refer such patients to an appropriate practitioner, e.g. licensed counselor, psychologist, registered dietitian.

• Describe the role of whole foods and food based-nutrients for optimal nutrition compared and contrasted with the role of specific dietary supplements [6].

At the end of their training, medical students need these skills to help patients avoid lifestyle related disease and move the needle on the obesity epidemic. Cursory knowledge of nutrition, especially training that is focused primarily on biochemistry, is inadequate for helping patients to make meaningful change [7].

We propose including the skills above as scaffolding for preparing the physicians of the future as well as other healthcare providers to optimize their patients’ health through nutrition. In a future article, we plan to expand the details of these competencies by providing a map of learning objectives and activities, experiential cooking and shopping, and educational evaluation methods.


  1. Adams KM, Butsch SW, Kohlmeier M (2015) The State of Nutrition Education at US Medical Schools, Journal of Biomedical Education.
  2. Sierpina V, Levine L, McKee J, Campbell C, Lian S, et al. (2015) Nutrition, Metabolism, and Integrative Approaches in Cancer Survivors. SON 31: 42-52.
  3. Devries S, Dalen J, Eisenberg D, Maizes V, Ornish D, et al. (2014) A Deficiency Of Nutrition Education in Medical Training. AJM 127: 804-806.
  4. Sierpina V, Devries S, Prasad A, Eisenberg D, McKee J et al. (2013) Nutritional Deficiency In Healthcare Education, Explore 9: 192-195.
  5. Eisenberg DM, Myrdal Miller A, McManus K, Bugress J, Bernstein AM (2013) Enhancing medical education to address obesity: “See one. Taste one. Cook one. Teach one.” JAMA Intern Med 173: 470-472.
  6. Adams KM, Kohlmeier M, Powell M, Zeisel SH (2010) Nutrition in medicine: nutrition education for medical students and residents. Nutr Clin Pract 25:471-480.
  7. Adams KM, Lindell KC, Kohlmeier M, Zeisel SH (2006) Status of nutrition education in medical schools, Am J Clin Nutr 83: 941S-944S.
Citation: Sierpina VS, Welch K, Devries S, Eisenberg DM, Levine L, et al. (2015) What Competencies Should Medical Students Attain in Nutritional Medicine?. J Nutr Food Sci 5:431.

Copyright: © 2015 Sierpina VS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.