Low priority of obesity education leads to lack of medical students\u2019 preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study

W Scott Butsch,Robert F Kushner,Susan Alford,B Gabriel Smolarz

doi:10.1186/s12909-020-1925-z

Abstract

BackgroundPhysicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States. This study sought to evaluate the current status of obesity education among U.S. medical schools, benchmarking the degree to which medical school curricula address competencies proposed by the Obesity Medicine Education Collaborative (OMEC).MethodsInvitations to complete an online survey were sent via postal mail to 141 U.S. medical schools compiled from Association of American Medical Colleges. Medical school deans and curriculum staff knowledgeable about their medical school curriculum completed online surveys in the summer of 2018. Descriptive analyses were performed.ResultsForty of 141 medical schools responded (28.4%) and completed the survey. Only 10.0% of respondents believe their students were “very prepared” to manage patients with obesity and one-third reported that their medical school had no obesity education program in place and no plans to develop one. Half of the medical schools surveyed reported that expanding obesity education was a low priority or not a priority. An average of 10 h was reported as dedicated to obesity education, but less than 40% of schools reported that any obesity-related topic was well covered (i.e., to a “great extent”). Medical students received an adequate education (defined as covered to at least “some extent”) on the topics of biology, physiology, epidemiology of obesity, obesity-related comorbidities, and evidence-based behavior change models to assess patient readiness for counseling (range: 79.5 to 94.9%). However, in approximately 30% of the schools surveyed, there was little or no education in nutrition and behavioral obesity interventions, on appropriate communication with patients with obesity, or pharmacotherapy. Lack of room in the curriculum was reported as the greatest barrier to incorporating obesity education.ConclusionsCurrently, U.S. medical schools are not adequately preparing their students to manage patients with obesity. Despite the obesity epidemic and high cost burden, medical schools are not prioritizing obesity in their curricula.

Highlights

Physicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States
The 2007 Association of American Medical Colleges (AAMC) call to action report, which concluded that “medical education must assure that future physicians will be better prepared to provide respectful, effective care of overweight and obese patients” and that education on preventing and treating obesity should be included in medical school curricula, has not led to any meaningful change in medical education and training [9]
The aim of this study is to report how obesity is currently addressed in the curricula of U.S allopathic medical schools and provide a benchmark from which we can assess progress toward as well as understand barriers to implementing core competencies in obesity

Summary

Introduction

Physicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States. A recent survey of medical students found that understanding genetic and biological factors related to obesity correlated with better counseling skills for patients with obesity [5]. This underscores the need to educate medical students on the disease of obesity to reduce bias and improve patient care. Little progress has been made to incorporate obesity education into undergraduate medical curricula despite studies describing insufficient medical student training in obesity counseling and medical management of obesity [6,7,8]. A recent study found a limited number of references to obesity in the United States Medical Licensing Examinations (USMLE). The USMLE focuses on weightrelated complications of obesity such as type 2 diabetes rather than the disease of obesity itself [12]

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