Medical student nutrition
I’ve been asking my medical students how much teaching they get in nutrition and lifestyle advice at medical school. I wondered if things have moved on since my days at UCL where these topics did not feature much in any part of my curriculum. I spend so much time as a GP seeing lifestyle related problems and over half of medical students will probably end up as GPs. I wanted to find out what today’s medical students know about giving their patients practical sound advice.
Most of the students have told me they get about 5 hours of general teaching about nutrition and lifestyle. So I asked them what they remembered about it. The main messages that they seemed to have picked up were to tell patients to eat more low fat food, eat more fruit and vegetables and cut down on smoking and alcohol. Other messages they remembered were to get more exercise, mainly to suggest patients go for a run. They remembered being told to direct patients to stress management techniques but didn’t get taught anything specific. They didn’t get told about any specific resources of where to direct their patients to.
They had some contact with the NHS dieticians but this was hospital-based teaching. It mainly centred on special feeding regimes and supplements for hospitalised and sick patients. None of the students I spoke to have spent time looking at diet and nutrition as preventative strategies or in the community.
About half of medical students will end up in general practice in the future and will be seeing patients with symptoms where lifestyle intervention will be the important first step before bringing out the big guns of drugs and surgery. I think it is so essential for young doctors to know about effective lifestyle advice and patient motivation. Doctors need colleagues such as lifestyle advisors to help educate and motivate the patients and empower them to make healthier choices. These can have positive improvements on health. It sounds pretty simple but a long way from what is actually happening in the NHS.
One of my students had developed raised blood pressure and heart palpitations. He volunteered this information to me in my teaching session on angina at my surgery He was worried and had been referred to a specialist. He wanted to know what else he could to help himself. We had a basic discussion about his diet and lifestyle that he had not considered before. One of the things he was doing was having extremely high levels of caffeine to get through his studies and workload. One of the cafes in the med school was serving up quadruple shots of espresso that had become popular the students. This had not been picked up on before and we realised it was pretty relevant to his own case.
Being a student of DrQ he had been exposed to herbal teas offers in my surgery and discovered that he quite enjoyed them. He decided to swap out the coffees for some camomile tea. He introduced some green juices into the student house he shared. He decided to walk more and adopt a few other lifestyle changes we discussed. Two months later when I saw him again he was feeling so much better in himself, lost weight and had no palpitations. He told me about the big cheap bags of kale he was getting hold of for the juicing which didn’t break his student budget. I was really proud of his changes and it was all pretty basic stuff.
I think we need to give medical students a flavour of what making small interventions in diet and lifestyle can do. Start by getting them to look at their own habits and lifestyles. I certainly wish someone had done that for me back in the day. These doctors of the future will often be the first port of call for patients dealing with chronic disease and lifestyle related ill health. If they can learn about themselves they will be able to teach others.
The current model is not working and chronic diseases and obesity are rising. We need to get our medical students on board and educate them so they can pass on what they have learned, it will also probably save a lot of hospital time and money too.