Medical School Nutrition Education

Medical School Nutrition Education
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Most medical schools in the United States fail to provide even a bare minimum of nutrition training.

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While bad nutrition advice from federal authorities has been chalked up to corporate influence, bad advice from the medical profession more likely arises out of ignorance. What is the status of nutrition education in medical schools?

Back in 1980, less than a quarter of medical schools required a single course on nutrition. By 1981, though, we were up to 32%, then 37%, then slipping to 35%, and back down to 27% by 1984. That was a quarter-century ago, though—back in the dark ages. What about 20 years later, in 2004?

In a survey sent to all U.S. medical schools, we went from 27% in 1984 all the way up to—30%. There was more nutrition education in 1982! On average, out of thousands of hours of preclinical instruction, doctors get about 24 hours of nutrition, with most getting only 11 to 20.

Last year, we got an update: “Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey.” In 2004, we were at 30%, and now we’re at 25%—nearly the lowest ever recorded. Only a quarter of medical schools require a single course on nutrition.

They conclude in their 2010 paper: “The teaching of nutrition in U.S. medical schools still appears to be in a precarious position, lacking a firm, secure place in the medical curriculum of most medical schools.” They advocate for, at a minimum, “the 25 hours of nutrition education needed to properly train physicians.”

Currently, only a small fraction reach even that trifling standard. And even if they did, that means you could learn everything a “properly trained” doctor knows about nutrition in one long weekend.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Peter Mellor.

Please consider volunteering to help out on the site.

While bad nutrition advice from federal authorities has been chalked up to corporate influence, bad advice from the medical profession more likely arises out of ignorance. What is the status of nutrition education in medical schools?

Back in 1980, less than a quarter of medical schools required a single course on nutrition. By 1981, though, we were up to 32%, then 37%, then slipping to 35%, and back down to 27% by 1984. That was a quarter-century ago, though—back in the dark ages. What about 20 years later, in 2004?

In a survey sent to all U.S. medical schools, we went from 27% in 1984 all the way up to—30%. There was more nutrition education in 1982! On average, out of thousands of hours of preclinical instruction, doctors get about 24 hours of nutrition, with most getting only 11 to 20.

Last year, we got an update: “Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey.” In 2004, we were at 30%, and now we’re at 25%—nearly the lowest ever recorded. Only a quarter of medical schools require a single course on nutrition.

They conclude in their 2010 paper: “The teaching of nutrition in U.S. medical schools still appears to be in a precarious position, lacking a firm, secure place in the medical curriculum of most medical schools.” They advocate for, at a minimum, “the 25 hours of nutrition education needed to properly train physicians.”

Currently, only a small fraction reach even that trifling standard. And even if they did, that means you could learn everything a “properly trained” doctor knows about nutrition in one long weekend.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Peter Mellor.

Please consider volunteering to help out on the site.

Doctor's Note

 Be sure to check out all my other videos on the medical profession.

Also be sure to check out my associated blog posts for additional context: Health Food Store Advice: Often Worthless or WorstNutrition Education in Medicine: a Doctor a Day Keeps the Apples AwayTreating Breast Pain with Flax Seeds; and Is Coconut Oil Bad For You?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

28 responses to “Medical School Nutrition Education

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    1. Hello,
      Thanks for your years of help in helping us to understand nutrition. Im new to your Nutritionist facts . Org have registered and read or watch your mini videos.
      Is rye bread good for dieabetic patients? Since December of 2016 i am new to diabetes my A1C levels started at 14, to 7.4 now it 6.2 and i still can improve all in 5 months period. My medical MD is stunned at my progress and i do not even take his medicine every day just as needed depending on meals ill eat due to time or dinner at friends who eat badly.
      The life style changes has taken a while to implement so thats it is not a hassle to handle under lifes changing daily circumstances.
      Do you think a liver cleanse will help if so how many times to apply? Reading about Coffee enima.
      Sincerely Vernon.

      1. Hi Vernon: Congrats on your progress! We’re excited to hear about the improvement in your lab values. Keep up the great work! I’d be careful with rye breads. Most rye breads are not made entirely of whole grains. Avoid rye breads that include refined flours and try to find one that lists a whole grain at the top of the ingredient list. I would not recommend a coffee enema liver cleanse – just continue to nourish and fuel your body with whole, plant-based foods. Your liver is capable of doing it’s own detox when you’re eating the good stuff. :)

    2. Dear Dr G,

      I am over in Melbourne Australia and I would like to study nutrition. Is there an online course/s that you could suggest?

      I was lectured yesterday by a pharmacist that australia’s TGA (thereapeutic goods administration) is so rigorous that our products are above and beyond. Then I went to the TGA website only to discover that Aust L for “listed” means that complementary medicines are randomly tested. Not the high standard I want for the fish oils I want to buy. The IFOS in canada appears legitimate. What do you think. ?
      I want to know more about the chemistry of the substances touted as biologically available when I buy supplements. What courses are recommended for a non science student. ?

  1. 25 hrs of nutrition training…sad. If I just watch your short videos each day I will get approximately 10 hrs across the year. And I’m not in it for the money. But, maybe that’s the problem. They are.

    1. Unfortunately part of the problem dates back to early in the 20th century when public health schools were separated from medical schools. Many instructors in med schools are involved in research not related to nutrition. The clinical faculty don’t know the studies. So even if nutrition was added to the curriculum it would not necessarily be taught well. Of course the reimbursement aspect of medicine as you mention is an issue but it doesn’t explain why prepaid health care isn’t doing more in this area… it is complex. You can help by making health care professionals aware of this website and you might even give them printed copies of abstracts of articles cited by Dr. Greger which are related to your questions or concerns.

      1.  Hey Dr. Dons. I was thinking that talking about this to doctors could offend them. What’s your experience with your colleges concerning this issue? I’m guessing it won’t be so bad coming from a fellow doctor, but what if a patient brings it up?

  2. That is criminal! So instead of telling a patient to lower cholesterol via a plant based diet because they never learned about nutrition, they will prescribe stains instead.
    I have asked 3 doctors in the last 3 months what they think about the China Study. All 3 said they had never heard of it!!
    Thank goodness for people like Dr. Greger, Dr. Barnard, Dr. Furhman, Dr. Campbell, etc. that are educating not just the masses, but doctors as well.
    Thank you!
    Louise F.

  3. I’m afraid I’m one of those guilty docs who never filled in the nutrition knowledge gap that medical school left me with. NutritionFacts.org has been such an eye-opener, and I am already seeing some quasi-miraculous changes in some of my more motivated patients. Where else would you suggest I go to supplement my training in nutrition?

      1. Dr. Greger, can you share with us your medical career path in nutrition?
        You consider yourself a Clinical nutrition specialist and became a respectable public speaker.
        But how do doctors who are starting in this field could pursue nutrition in Medicine in such deficient schools when it comes to train medical doctors in nutrition? I am rethinking all my medical career but finding good education seems to be harder in formal education scenario. How can doctors regain patient’s confidence when it comes to lifestyle education? How would patients trust more the doctor than health gurus or magazines? The ample source of information that internet has become can make it more confusing than helpful. Finding doctors like you brings hope to us in offering guidelines based on real science!! Thanks for your job!

        1. Hi Natalia-
          What a great question! While I can’t answer for Dr. Greger, I’ll tell you how I became a physician (pediatrician and Adolescent Medicine specialist) who’s practice has a strong emphasis on nutrition. I obtained a Master’s in Nutrition Science during my fellowship training. While unfortunately, it was fairly traditional nutrition training (i.e. food pyramid, emphasis on protein/meat/dairy, no talk of WFPB diet), the training in biochemistry, vitamin and mineral metabolism and research methodology was extremely valuable. With that sort of knowledge it is much easier to evaluate scientific nutrition articles for yourself. In terms of training in a WFPB diet, you do have to search it out for yourself. There are some good resources out there. The College for Lifestyle Medicine and the Physicians Committee for Responsible Medicine are great for CME and conferences. I can’t recommend the International Plant-Based Nutrition Conference ( http://pbnhc.com/) enough. Worth saving up to attend as it is an excellent opportunity to network with a huge variety of healthcare providers who advocate a WFPB lifestyle.

          In terms of getting patients to trust you…that’s the art of medicine. You learn how to speak with patients without seeming to lecture or shame them. You give them the evidence for what you’re recommending in words they can understand (this website helps). You follow the lifestyle yourself and show them your health and vitality. You absolutely cannot underestimate the power of the healthcare provider-patient relationship.

          You can find out a bit more about Dr. Greger’s career at http://www.drgreger.org.

          Good luck, Natalia! The more young doctors, nurses, dietitians, PA’s, etc, etc, etc that advocate for training in PB nutrition the more word will spread.
          Best,
          Cathleen

    1. I like GreenMedInfo.com because they have the science/research information they base their articles on at the end of each article. It is one of my “go to” websites as well as LEF.org.

    2. develop a close professional relationship with a top clinical RD – registered dietitian in your area!

      JuliSu DiMucci-Ward MPH, RD,LD, CDE

  4. Thank you for bringing this issue to light.  As a registered dietitian and Certified Diabetes Educator, I am occasionally in the uncomfortable position of having to tactfully correct well intentioned but erroneous nutrition advice that a physician has given a patient.  Some patients tell me the doc has far more education than the RD, so he/she must know better.  Sigh:(

  5. Does Dr. Greger have any advice for people like us who are willing to eat only extremely healthy foods and practice a moderately healthy lifestyle with regards to the Affordable Care Act (Obamacare)?

    Should we go naked on medical insurance and pay the annual fine or should we buy the plan with the lowest monthly premium with the highest deductible?

    1. Ron,

      If it were me considering those two options, I’d buy the cheapest plan with the highest deduction. I’ve known far too many very healthy people who have had various accidents, were inadvertently exposed to serious diseases, mugged, or just tripped on the sidewalk. By the time they were released from the hospital the ones who were insured were sad they didn’t have more insurance, but the ones without insurance were bankrupt and in debt.

  6. My girflirend is looking into nutrition. Could you please recommend the best plant based nutrition courses/schools? (She has no previous knowledge or medical background, but would like to work in this field someday. We are from Europe, so maybe online courses would be better, although she is open to study abroad). Thank you.

  7. The doctors that I see these days are a joke! They don’t know anything about anything. All they want is give me more prescriptions every day. There’s a huge need for changing the way they teach medicine in this country. What a shame!!! I lost 20 lbs and my bp is back to normal and I don’t need to poisen my body with medicine….They really think that we are stupid!!!!

  8. This is amazing. it’s astounding that people think their doctors are experts on nutrition! It’s interesting that in the 2012/2013 school year, the situation hasn’t changed (71% of medical schools “fail to provide the recommended minimum 25 hours of nutrition education; 36% provide less than half that much. (source-http://www.hindawi.com/journals/jbe/2015/357627/)

  9. What would be the optimal plant-based daily diet for over 50s, in terms of food groups, portion size, supplementation (i.e. B12, vitamin D, fatty acids…)?

    1. Amanda: There are a few different ways to get at this. I think all of them are good. The one that would be right for you would be the one that speaks the best to you. I recommend looking at all of them. Note that all plans recommend a B12 supplement. The link to the NutritionFacts Optimum Nutrition Recommendation page below gives details on how much B12 and how often.
      .
      The very simplest recommendation would be the PCRM (Physician’s Committee For Responsible Medicine) Power Plate which divides foods into 4 simple food groups. Here is the Power Plate: http://www.pcrm.org/sites/default/files/pdfs/health/Dietary-Guidelines-high.pdf. The idea is that if you eat those whole foods in about those proportions by the end of the day–and just eat until you are full–you don’t have to worry about portion size. Your body will eat the right amount. And you will be getting the right amount of various micro and macro nutrients. I found this simple diagram when I was getting started to be very comforting. It doesn’t have to be complicated at all.
      .
      The next level plan that gets into a bit more detail, but is still a very high-level simple overview is Dr. Greger’s general recommendations on this website: http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/ The link says that the recommendations are from 2011 and originally they were. But I believe the page has been slightly updated since then. And once again note that the general idea is that if you eat a variety of those whole plant foods (no oils, no processed foods, no meat, no dairy, no eggs), your body will automatically eat the right amount/portions–assuming you don’t eat past being full. And with the variety, you just won’t have to worry about getting all the nutrients. You will.
      .
      The next level above that is Dr. Greger’s new “Daily Dozen” plan. The Daily Dozen plan is very popular and is explained in detail in Part 2 of Dr. Greger’s new book, How Not To Die. The book is available in libraries (at least my library has it). But if a book is not on your agenda and if you have a smart cell phone, you can download a free ‘app’ for the Daily Dozen. More info about that there: http://nutritionfacts.org/2015/12/31/free-app-for-android-and-iphone-and-top-10-videos-of-2015/. The difference in this plan is that you get a lot more details on how much of each type of food to eat compared to the previous two plans. And the Daily Dozen is very specific to the information presented on this website.
      .
      Finally, I will refer you back to PCRM for a different kind of plan. PCRM’s free 21 Day Kickstart plan is also recommended in Dr. Greger’s book. The program will “hold your hand” for 21 days, including meal plans, recipes, videos, inspirational messages, and a forum (moderated by a very respected RD) where you can ask questions. If you went through the 21 Day Kickstart program, you would have a very good idea of exactly what to eat in terms of an optimal plant-based daily diet.
      http://www.pcrm.org/kickstartHome/
      (Click the green “Register Now” button.)
      .
      Hope that helps!

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