In the UK, malnutrition is common and The Royal College of Physicians states that doctors have a responsibility to address nutrition-related issues in healthcare, and The National Health Service (NHS) highlights nutrition training in their action plan for the prevention of ill health and health inequalities. This is important considering many patients cite their physicians as trusted information sources regarding healthful food choices and weight loss.
However, several studies have found clinicians are under-prepared to facilitate nutrition discussion with patients. A recent study of 853 medical students and doctors found that over 70% had received less than two hours nutrition training while at medical school.
A number of task forces have highlighted the importance of nutrition-related education for doctors in training, including the Nutrition Task Force which was established in 1994 to develop a core nutrition curriculum for undergraduate medical students. It created 18 generic nutrition objectives for medical training, focusing on principles of nutritional science, public health, and clinical nutrition. But there has been inconsistent uptake of these objectives in both undergraduate and postgraduate curriculum.
The authors of the current study note there is no published data on the current outcomes of nutrition-related education in UK postgraduate training programmes. The aim of this study therefore was to carry out a quantitative, critical synthesis of nutrition-related education in current postgraduate curricula by identifying nutrition-related learning objectives (NLOs) and their designation within the The Generic Professional Capabilities and Good Medical Practice Domain frameworks.
Between August and October 2020, Laura Ganis, from Barts Health NHS Trust, independently reviewed the published curricula of 43 UK postgraduate medical training programmes. Six Core training pathways were included: the Foundation Programme, Acute Care Common Stem (ACCS), Core Medical Training (CMT), Core Psychiatry Training, Core Surgical Training (CST), and Internal Medical Training (IMT) Stage 1.
The study concludes that all 43 curricula had at least one NLO, with a median of 15 NLOs (mean 24) per curriculum. There was considerable variation (range of 176) between curricula in the number of NLOs identified, with a maximum of 177 (Gastroenterology) and a minimum of one (Aviation and Space medicine).
Overall, 51% of medical training programmes failed to incorporate a minimum of 18 objectives and a quarter had fewer than five NLOs.
Those programmes with five or less NLOs were: Occupational Health, Core Psychiatry, Medical Ophthalmology, Public Health Medicine, Rheumatology, Dermatology, Palliative Medicine, General Practice, Neurology, Haematology, and Aviation and Space Medicine.
A mere seven NLOs were identified within Paediatrics and just 10 in Respiratory Medicine.
Surgical curriculums (n = 11) had a higher number of identified NLOs (median 30, mean 35 objectives) compared with medical curriculums (median 8.5 objectives, mean 20)
Those that ranked in the top quarter of all those analysed were: General Surgery, Intensive Care Medicine, Geriatric Medicine, Oral and Maxillofacial Surgery, and Core Medical Training.