Exercise Medicine In Residency Training

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Physical activity (PA) is a key intervention for chronic disease, yet few physicians prescribe exercise. Determining factors associated with physicians who have the greatest conviction to prescribe exercise in their practice may help inform future training. PURPOSE: To determine residents’: (1) perceived importance of exercise prescription, (2) personal PA levels, (3) attitudes/beliefs about PA (4) exercise counselling and prescription practices, (5) knowledge of the PA Guidelines, (6) competence in exercise prescription and (7) perspectives of training in exercise medicine. METHODS: 396 University of British Columbia family medicine residents were eligible to complete the 49-item cross-sectional survey. All variables were evaluated on a 7-point Likert scale, and assessed in relation to the importance of exercise prescription, with significance set conservatively to p=0.01. RESULTS: The response rate was 80.6% (319/396). Exercise prescription was important to residents (95.6%), with 37.5% strongly agreeing (termed “prescribers”). Both groups reported strong beliefs of the importance of PA in health (97.3% vs. 90.0%, p<0.001), physician responsibility advising patients in PA (96.3% vs. 90.7%, p<0.001), with prescribers higher across each (of 5) variable assessed. The level of exercise counseling (57.8% vs. 38.3%, p=0.001), prescription (36.7% vs. 18.0%, p=0.001) and self-reported competence prescribing exercise (48.5% vs. 56.6%, p<0.001) was greater for prescribers. Both groups had low knowledge of the PA guidelines (42.5%, p =1.0). Neither group is sufficiently PA, with few meeting the guidelines (51.9% aerobic, 24.5% strength). Both groups valued their exercise (94.2% vs. 87.5%, p<0.001), perceived lower control over it (68.5% vs. 67.3%, p=0.72) and desired program support in being active (96.3% vs. 90.7%, p<0.001). Few Residents’ perceived their training in exercise medicine as adequate (24.6% vs. 15.3% p=0.25) and both groups desired additional training in exercise prescription (94.2% vs. 89.1% p=0.004). CONCLUSIONS: Current training is not preparing physicians to prescribe exercise, nor to be suitable PA role models for their patients. Program reform should include curriculum in exercise medicine, support residents’ personal exercise and foster a culture of physical activity.