epidemic and are influencing educa- tional changes. “Students are coming in armed with
everything that’s shifted in society and with more experience and interest in [nutrition education] than we’ve ever seen. So we [medical schools] can parlay that and kick it up to the pro- fessional level,” said Mary L. Brandt, MD, senior associate dean for student affairs at Baylor College of Medicine in Houston. In week three of her embryology
course, the pediatric surgeon lectures students on the importance of per- sonal nutrition not only to survive medical school but also to attain a vo- cabulary to guide their patients. Bay- lor’s curriculum also incorporates a nutrition module into other courses on disease and preventive health. But it was Baylor medical students themselves who three years ago de- signed an elective course that com- bines didactic discussions and hands- on culinary instruction to enhance the
school’s nutritional curriculum. The Baylor CHEF (Choosing Healthy, Eat- ing Fresh) course targets second-year students as they transition from their preclinical training to working with patients, and teaches them to cook while learning from physician faculty like Dr. Brandt and nutritionists about personal health, nutrition basics, and impacts on maternal and cardiovascu- lar health, for instance. “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,” Dr. Brandt said. Natalie Uy, a fourth-year Baylor
medical student, leads the Baylor CHEF course, which has since ex- panded to include community out- reach projects such as a cooking pro- gram geared for bariatric patients and their families and a campus farmers market to offer better access to fresh foods. The added experience, she says, allows her to better empathize with
her patients and demonstrate what healthy behaviors actually look like so they participate in their own care. “This class grew out of a need for
students to be examples of how to lead a good, well-balanced, healthy life- style. It’s almost hypocritical to tell a patient you need to lose weight when you yourself eat poorly and don’t ex- ercise. And it’s also nice to explain to patients this can be done even on a budget and even on a busy schedule,” Ms. Uy said. One of her class projects, for ex-
ample, involved living and cooking on a food-stamp budget for three weeks. “It brought me closer to my patients because a lot of them are underserved and they don’t have a lot of money, so eating fruits and veggies and gluten- free can be expensive, and it takes time and planning,” Ms. Uy said. “So many patients tell me, ‘This isn’t fair for you to tell me this.’ I feel for them because they have to do this for their whole life. I just did it for three weeks.
DIFFERENT INGREDIENTS
U.S. medical schools take different approaches to incorporating nutrition instruction. Those that do so provide nutrition education in more than one type of course or context.
Average Hours of
Course/ Context
Nutrition Integrated Biochemistry Physiology Clinical practice
Number of Schools*
22 82 45 35 55
Nutrition Instruction in This Context
13.8 12.6 6.4 4.2 6.4
Average Total Four-Year Curriculum Hours at Schools Using Nutrition Instruction in This Form
22.2 22.1 21.7
23.1 24.2
Average Percent of Total Nutrition
Instruction Provided in This Course/Context
66.7 60.3 31.8 24.3 25.1
*121 schools responded to a survey of 141 U.S. medical schools fully or provisionally accredited during the 2012–13 academic year. Source: The State of Nutrition Education at U.S. Medical Schools, Journal of Biomedical Education, Jan. 11, 2015.
November 2015 TEXAS MEDICINE 39
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