Nutrition in medical education: Classroom, clinic and community

What is the level of nutritional and dietary training in medical schools? School of Medicine Greenville at the University of South Carolina has a course of study for medical students to learn about culinary medicine and what that means for human health and patients’ situations. Jennifer L. Trilk, PhD, FACSM, DipACLM, a professor of biomedical sciences and director of the Lifestyle Medicine Program, explains the school’s classroom-clinic-community model of nutrition education.

Trilk is a co-author of “Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement,” published in JAMA Network Open. The authors’ goal was to recommend nutrition competencies in medical education to improve patient and population health. She is the co-founder of the Lifestyle Medicine Education Collaborative, which has published free medical education curriculum materials on lifestyle medicine.

Jennifer L. Trilk, PhD, FACSM, DipACLM: Our admissions committee tells me constantly that the vast majority of candidates who apply to our medical school apply because they want to get this training in lifestyle medicine so that they can adequately care for their patients as they become doctors and have those competencies. Because we always think, well, you know, we've heard Richard for years before starting an exercise program, consult your physician. Well, physicians aren't trained in physical activity and movement and the mechanistic pathway of how the heart is improved through exercise. You know, we know that exercise is important for heart health, but exactly what happens to the left ventricular chamber function and how that improves the unit as a pump to become a more efficient pump, to be a healthier heart and to reduce risk of chronic disease. And our students are taught that from day one, day one all the way through to the graduation. We also have a culinary medicine lecture and we also have an elective in the first year and in the fourth year, where students get into a teaching kitchen. And this is a really, really near and dear to our heart, where the students learn how to cook, they learn how to prepare, they understand cultural competent food patterns. They understand it from a chronic disease food pattern. And they also understand that they need to meet their patients where they are in terms of changing dietary patterns. And then they have a capstone. The first years have a capstone and food insecurity. So they're given boxes of foods that you would get maybe at a food pantry or a WIC box or a SNAP box, and they're required to make meals out of those, out of those boxes. And then the fourth years, they bring actual patients into the kitchen, and they teach the patients how to cook and how to improve their cooking habits and their lifestyle habits through nutrition and through cooking. So we've got, we've got what I consider a classroom-clinic-community model, where the students learn it in the classroom, they apply it in the clinic, and then they really work with the community to be those end users to improve population health.