Episode 39 is a panel discussion between me and three panel members who are either finishing medical school now or are recent graduates of medical school. We discuss the current state of nutrition in medical school, whether and how it should change, what doctors and future doctors should do to obtain a deep understanding of nutrition, and what patients should do to obtain high-quality, nutritionally focused medical care.
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Meet the “Nutrition in Medical School” Panel
Rob Abbott is a fourth year medical student at the University of Virginia (U.Va.) in Charlottesville, Virginia. He graduated with Summa Cum Laude Designation from the College of William and Mary with a B.S. in Chemistry in 2011. He approaches medicine from an evolutionary and functional perspective and sees mindfulness and unified spirituality as his way of being. He will be starting a family medicine residency with VCU-Shenandoah Valley in Front Royal, Virginia in June 2017 with visions for practicing spiritually focused functional medicine in central Virginia. He currently works with holistic and functional clinicians at Downtown Family Health Care in Charlottesville, Virginia and is completing clinician training with Chris Kresser through his functional and evolutionary focused ADAPT clinician training program. You can find more about him on his web site, A Medicinal Mind. Rob created a “The Ultimate Functional and Integrative Medicine Education Resource.”
Clayton Dalton, MD grew up in Texas, attended medical school at Columbia University in New York, and is now a resident physician in emergency medicine at Massachusetts General Hospital in Boston. He discovered nutrition through competitive cycling, and discovered medicine through nutrition.
Leland Stillman, MD studied environmental health and biology at Connecticut College, received his medical doctorate at the University of Virginia, and will complete his residency in internal medicine at Maine Medical Center in July of 2017. He became interested in nutrition as a result of first hand experiences in his adolescent and teenage years. In addition to nutrition, he is interested in Traditional Chinese Medicine, Indigenous and Narrative Medicine, and mobile technology to empower people to achieve good health. He is the designer of Foodwise Mobile, a mobile app for people with food allergies or intolerances. He will be pursuing a career in integrative primary care. You can find out more about him at stillmanmd.com and more about Foodwise Mobile at foodwisemobile.com.
Show Notes for “Nutrition in Medical School”
In this episode, you will find all of the following and more:
00:38 I introduce the panel to you in my own words.
07:39 The panel members introduce themselves to you in their words and tell you how they got interested in nutrition.
14:35 Everything in our body is made from our food. So is there a difference between learning “nutrition” and learning how everything in the body works? Does the biochemistry, physiology, and molecular biology learned in medical school count as learning nutrition?
17:13 Triage theory: you can learn every pathway, but if you don’t learn how they’re prioritized in suboptimal nutrient status, you haven’t learned useful nutrition.
24:34 The deficiency of clinical relevance and connections between clinical and basic science material.
26:58 Is teaching less the key to teaching deeper?
30:50 Is the purpose of the medical prerequisites and curricula to sort people rather than teach useful information?
32:12 It’s just harder to teach in a way that connects the dots.
36:03 My upcoming class on energy metabolism.
37:23 Are rare metabolic diseases (inborn errors of metabolism) really irrelevant?
39:29 Is the medical diagnostic paradigm too binary? Should we be looking at disease and health on a continuum instead?
47:56 Wildly misaligned economic incentives take the focus off nutrition.
53:15 In order to avoid burdening patients with unnecessary worry, we often withhold information. But this often hurts our collective pool of knowledge by hampering critical research and impairs our ability to help people.
1:06:38 Nutrition in medical school is abysmal, but do we need more and better nutrition education in medical school, a separate type of medical degree for primary care that focuses on nutrition, or more collaboration between physicians and others (for example, dietitians) who specialize in nutrition?
1:14:57 Empowering patients with mobile apps and other digital technology, providing real-time information in the context of a backlogged medical system.
1:24:14 What should a medical doctor, medical student, or future medical student do now to gain a practically useful understanding of nutrition?
1:34:08 Disciplines are fragmented and isolated, and desperately need to be connected.
1:38:36 Social media will be the next game-changer in medical education.
1:42:00 How to think about a patient’s nutritional status.
1:44:22 Selenium as an example of where testing can help you navigate equal probabilities of help and harm with supplementation.
1:45:03 Testing nutritional status is valuable because knowledge that a choice is necessary makes the choice more sustainable.
1:48:02 What should patients be doing to get good nutritionally focused medical care?
Resources Mentioned in “Nutrition in Medical School”
My new energy metabolism class
My podcast series on measuring and managing nutritional status
The Kresser Institute's clinician training programs
Re-Find Health (formerly Primal Docs)