“The more sophisticated the soon-to-be doctors would be around preparing healthy meals, the better they would be able to help their patients.”
Students on the culinary and lifestyle medicine track can obtain board certification, similar to being certified in family medicine, internal medicine, or another specialty. At WVU, these students work with a chef in a teaching kitchen, which Marsh said gives them real-world, hands-on experience to better support patients.
Inside the teaching kitchens, students learn to explain different steps of meal preparation, from choosing the right oil to deciding on a sugar substitute, depending on a patient’s health status and desired outcome.
WVU students have a particular passion for nutrition, Marsh said, given the health challenges in the state. West Virginia consistently has one of the highest obesity rates in the country, along with high mortality rates from heart and vascular diseases.
“There’s so many different illnesses and diseases—we know that nutrition is a part of a holistic set of solutions,” Marsh said.
The school also has relationships with local farmers and emphasizes ways to support local markets, Marsh said. The teaching kitchens provide a buyer for farm produce, and the classes encourage patients to choose and eat local foods.
Establishing the infrastructure for more hands-on learning, like teaching kitchens, can be expensive. WVU’s culinary medicine track is centered around a regional campus with access to farms, Marsh said, while other campuses use community resources, including kitchens that feed schools and recovery houses.
Medical students absorb a large amount of information throughout their studies. But the hope is that students will take away a sense of what foods may be appropriate for specific patients and conditions, as well as an understanding of the available data and science, Marsh said.
George Washington University (GW) is another school with a long focus on nutrition; it too signed onto the administration’s agreement. In the years following the COVID-19 pandemic, during heightened conversations about diet-related conditions, the medical school examined its nutrition curriculum, looking to revamp it.
“When you walk the walk, you can talk the talk a little better when you are making those recommendations for your patients in the future.”
Currently, GW’s medical-school curriculum averages about 40 hours of nutrition content. The nutrition curriculum spans all four years of medical school. It gives students a foundation in the basics before helping them incorporate nutrition into clinical work, said Terry Kind, the associate dean for clinical education at GW’s School of Medicine and Health Sciences.
With the agreement, GW is not necessarily looking to boost its nutritional offerings. Instead, the school is taking the time to evaluate its existing curriculum to make sure it is up to date, evidence based, and culturally sensitive.
GW also has a teaching-kitchen elective for medical students where they can apply foundational knowledge from the first two years of school. Students work with patients who have diet-related conditions like iron deficiency or diabetes, identifying what’s happening inside the body at a microscopic level and then learning how diet can help.
“When you walk the walk, you can talk the talk a little better when you are making those recommendations for your patients in the future,” said Alicia Tucker, director of culinary medicine education at GW.
Tucker said the goal is to also encourage graduates to be lifelong learners and keep up with nutrition science as it evolves, so they can help patients make “realistic and healthy” nutrition choices.
Fourth-year medical students reach for their Match Day envelopes at Boston University’s Chobanian and Avedisian School of Medicine in March. Health experts say soon-to-be doctors benefit by understanding the nutritional aspects of medicine. (Photo by Erin Clark/The Boston Globe via Getty Images)
It’s unclear exactly how the MAHA movement’s focus on nutrition education for doctors will change the historic barriers to that education. Thus far, HHS has offered $5 million to support medical schools, nursing, residency, and dietician programs that integrate nutrition education through a National Institutes of Health nutrition education challenge. The administration has also focused on food and nutrition in the medical space by pushing hospitals to align their patient meals with the updated Dietary Guidelines for Americans.
But there are historic challenges that can make harder to for doctors to adopt the role of nutrition counselor overnight.
Nutrition education has long been under-recognized, Kind said. The biggest challenge is simply finding the space for it in an already jam-packed curriculum.
These time constraints are also present in the exam room, when medical students go on to clinical work. If a doctor has limited time with a patient, it can be difficult to touch on nutrition and diet on top of other topics.
Another element of modernizing medical-school curriculum is teaching students how to have culturally competent conversations about nutrition with patients in a short time frame. One technique students learn is how to create a “SMART goal” with patients. The motivational interview techniques—resulting in goals that are specific, measurable, attainable, relevant, and time-bound (ie with target dates)—are easy for future physicians to work into their practices.
“I would love to wave a wand and make everyone’s visits be able to last 45 minutes and do really robust nutrition counseling,” Tucker said. “But we know that’s probably not in the cards right now.”