“When students start focusing on what they need to do for their own health, that becomes internalized and makes them a very different kind of doctor.”
“Vitamin D is actually a steroid
we now know is responsible for over 1,000 DNA-driven activities in our body. So it doesn’t make sense not to include that in areas where steroids are being taught,” he said. Medical students also interact with
trainees at the other health profes- sional schools on UNTHSC’s campus, where nutrition comes up in the con- text of learning collaborative practice skills. Last spring, TCOM introduced
an elective culinary medicine course that not only links cooking to nutri- tion science but also teaches team- work. Students trade their white coats for aprons and learn to cook healthy dishes for chronically ill patients with poor diets. TCOM physician faculty members
partner with dietitians from Texas Christian University’s Department of Nutritional Sciences to put on the course, modeled after a program at the Goldring Center for Culinary Medi- cine at Tulane University’s School of Medicine in New Orleans. Roughly 10 medical schools collaborate with Tulane in what has grown into a na- tional research project to track how the course affects students’ practice once they become physicians. Not only do medical students learn
how to cook for themselves, but they also learn alongside other trainees to substitute ingredients to fit the differ- ent types of diets their patients may eat, whether they are diabetic, hyper- tensive, or hospitalized. “We all — physicians specifically —
know that taking care of a person is a team sport now. There are so many aspects of health care that a single person can’t manage it. And that’s par- tially why you run into some problems [teaching nutrition] as a single topic,” Dr. D’Agostino said. “What physi- cians need is a working knowledge of nutrition, and where the physician comes in is when we are dealing with the actual disease and taking care of those aspects that can affect change. And the patient-centered approach
38 TEXAS MEDICINE November 2015
involves being able to put that treat- ment into place. So making sure medi- cal students, physician assistants, and pharmacy students are all in the same classroom with dietitians, learning the exact same thing at the exact same time, creates a powerful model.” That theme carries over into resi-
dency training at Texas Tech Univer- sity Health Sciences Center’s (TTUH- SC’s) Family Medicine Residency Program, which has a nutritionist on board as part of the department fac- ulty. Residents spend time learning what it feels like to get and record fin- ger sticks using a glucometer, and un- derstanding and eating different diets their patients might get in the hospital. Like medical school, residency
program accreditation guidelines set no specific obligation or criteria for nutrition education. “We put that in there because that’s all part of how we manage and monitor disease,” said Ronald L. Cook, DO, chair of TTUH- SC’s Department of Family and Com- munity Medicine in Lubbock and a member of the Texas Medical Asso- ciation Council on Medical Education. Nutrition has always been a natural
part of certain specialties like family medicine, pediatrics, and obstetrics, he says. But the movement toward ac- countable care and patient-centered medical care largely drives an in- creased emphasis on tracking diseases like diabetes, with help from nutrition experts like dietitians, diabetic educa- tors, and case managers, to keep pa- tients out of the hospital. The idea is not to force students to
spend a month rotating with a dieti- tian. “It’s about having access to him or her as part of the team. And when residents train that way and see the need, they are more likely to have ac- cess to those individuals in their pri- vate practice when they go out,” Dr. Cook said.
STUDENT-DRIVEN These days, educators say medical stu- dents also are entering medical school more personally aware of the obesity
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68