Nutrition in Medical School -- Do Doctors Learn Enough?

Nutrition in Medical School — Do Doctors Learn Enough?

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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 panel.
Read the show notes.
Check out the resources.
Leave a comment.

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This episode is brought to you by US Wellness Meats. I use their liverwurst as a convenient way to make a sustainable habit of eating a diversity of organ meats. They also have a milder braunschweiger and an even milder head cheese that gives you similar benefits, as well as a wide array of other meat products, all from animals raised on pasture. Head to grasslandbeef.com and enter promo code “Chris” at checkout to get a 15% discount on any order that is at least 7 pounds and is at least $75 after applying the discount but under 40 pounds (it can be 39.99 lbs, but not 40). You can use this discount code not once, but twice!

Meet the “Nutrition in Medical School” Panel

Rob Abbot on the Mastering Nutrition podcast.
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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 on the Mastering Nutrition podcast.
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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 on the Mastering Nutrition podcast.
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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?

2:02:05 How you can find the panel members.

Resources Mentioned in “Nutrition in Medical School”


The Ultimate Functional and Integrative Medicine Education Resource

The Foodwise Mobile App

My Masterclass with Masterjohn classes

My new energy metabolism class

My Chris Masterjohn Lite videos

My podcast series on measuring and managing nutritional status

The Kresser Institute's clinician training programs

Chris Kresser's web site

Re-Find Health (formerly Primal Docs)

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12 Comments

  1. Hello. I’m first time here and it’s very interesting article, really it is. I would like to express my dissatisfaction with the current level of education and especially about medical education. Many students are using medical school application essay help and eventually become unqualified specialists. So I would like to see current doctors really know enough.

  2. So I would like a verdict: would I still be all-that necessary to want to be a sports medicine practitioner (know all about diet, and physiology (human and exercise), sports performance etc) and still go through medical school today? (Because I have learnt a lot from reading your website and a few others (wapf, drlwilson (mainly these two), mercola and chriskresser)

  3. I’ve only listened to a handful of your podcasts, but they never fail to be both intriguing and informative. I want to say thank you for continuing to create quality media! I can’t wait to dig into your new Masterclasses, and check out all of the resources linked in this episode’s show notes.

    The main purpose of my comment though, is to suggest another topic, or at least seek further discussion. I am a senior undergraduate nutrition major, heading to Boston University this fall for my master’s degree/ dietetic internship. I loved hearing from the panel of people involved with medical education about how to address the issue of doctors and their responsibilities regarding nutrition. However, I was certainly one of those listeners thinking, “Pick me, pick me!” (around 1:10). I would love to hear more of what people in nutrition education think about whether or not we should be changing our approach to teaching nutrition, as well as challenging the system of how doctors learn it. While concepts of biochemistry are impenetrable for most patients, concepts of basic nutrition are not. Dietitians work closely with basic nutrition. Physicians tend to work closely with the concept of biochemistry. Yet many dietitians I have personally known did not have a good grasp on the biochemistry of bodily interactions with food, and some physicians have missed the mark when making food recommendations to patients. I want to know how can we improve nutrition education to start bridging that gap. I don’t see why it should be a one-directional approach, with only the medical field education system being held at fault when we already have people in place to specialize in the food AND biochemistry, with room to grow in physiology.

    Along that same line of bridging gaps and increasing cross-discipline teamwork, I would also be curious to hear more about why physicians don’t send many patients to dietitians. The members of the panel specifically seemed to want to avoid this option. I am young, and probably biased, given that being a dietitian is what I want to spend the rest of my life doing. I would like to understand why so few physicians trust me to do it, so that I may also dedicate my time and energies to narrowing that divide.

    Again, thank you for this podcast. It gave me a lot to think about, but also a sense of hope for the future of health care in general.

  4. Even if all doctors/dentists were ONLY taught about Weston A Price and the foundation (especially about the pre-, post- and during pregnancy diets for moms and babies), his travels, his thoughts about CLO and K2 (the forgotten vitamin), organic food, grass fed proteins and good fat, medical doctors would be doing A LOT better in the area of nutrition. Unfortunately, this probably won’t ever happen in my lifetime. So I’ll continue doctoring myself, taking my mega doses of vitamin C, taking supplements — especially fat soluble vitamins and astaxanthin, eating organic and grass fed.

  5. Hey Chris,
    I’m a big fan of your work. I’ve listened to all of your podcasts, but this is the only one that is not available for direct download. Will you use only itunes and stitcher from now on? Please don’t. 🙂

  6. Once again, I am in your debt. You continue to outdo yourself. This podcast was very serendipitous. I have a niece who is in her second year as a Nurse Practitioner. We get into serious conversations regarding disease centered medicine vs Functional Medicine. I would love to see her complete her education by pursuing a functional approach. Last week we had a conversation about Magnesium in which I stated an oft heard analysis regarding the magnesium status of the general population. She had not even heard of magnesium depleted soils and by extension the status of people relying on food alone. This podcast is so timely and I will definitely share it with her in hopes it will expand her horizons. For some reason she thinks MD’s are the experts in nutrition??? You alone are doing so much to educate. I would be lost without you…enjoyed meeting these new forward looking docs and appreciate the new link to like minded practioners. Thank you again and looking forward to the Transcript. 🙂

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