Obesity is barely covered in medical students' licensing exam

[Northerner]

Obesity is one of the most significant threats to health in the U.S. and is responsible for the development of multiple serious medical problems such as diabetes, heart disease and some forms of cancer. Yet obesity is barely covered in medical training, according to a new Northwestern Medicine study.

The licensing exams for graduating medical students have a surprisingly limited number of test items about obesity prevention and treatment.

"It's a trickle-down effect," said lead study author Dr. Robert Kushner. "If it's not being tested, it won't be taught as robustly as it should be."

https://www.sciencedaily.com/releases/2017/01/170119163200.htm

 

[mikeyB]

It was never taught in my medical training either, so that's no surprise at all.

 

[Copepod]

Not so surprising that your medical training in 1970s or 80s (I'm guessing) didn't cover obesity, MikeyB. Less understandable why it's not covered these days.

 

[mikeyB]

Early 1970s, Copepod. No need to be coy😉

I agree with your point, though.

 

[Hazel]

Alan knows my thoughts on this subject - obesity/T2.

All we (UK) do is to put a plaster over it - yes it has improved since my diagnosis, but we need more education, education, education.

I have been overweight wll my adult life - at no point was it ever mentioned that I could develop T2. I understand that has improved.

Years ago there were huge campaigns to save lives in the weariig of seatbelts and the dangers of smoking..

I think obesity and the dangers, should be taught in school. Also home economic (cooking), which was stopped in my school days.

I dispair when I see young kids eating Greggs sausage rolls and burgers and the like - seldom do you see kids eating fruit.

I learned more about diabetes from my reseach on line and on this forum that I was ever told by my GP or anyone in the surgery. I had to wait for over two years to see the Diabetic clinic at the local hospital (after I kicked up a stooshie - 9 months). Then only 1 DSN and 1 consultant for the whole county. Now 4 DSNs, 2 consultants, 1 dietician, plus others, so a huge improvement.

But I come back to knowledge, education - so yes it should be part of any medical training and not just obesity, also Diabetes. I saw how badly my Dad (T2) was treated in his 8 months in hospital.

Sorry for the rant

 

[Dave W]

Good report from the Scottish parliament today. It looks like there'll maybe some progress on action to tackle obesity. Time though will tell, as there's a whole thicket of nettles to be grasped and politicians are not noted for grasping nettles.
Stats for Scotland : Adults - 65% overweight, 29% obese. Children - 28% at risk of being overweight and 15% at risk of being obese.
http://www.bbc.co.uk/news/uk-scotland-scotland-politics-38716754

 

[Deleted member 16779]

I've heard that GPs will generally not have had any study time on nutrition at all during their training.

 

[mikeyB]

You're right. That's why we have dieticians. GPs can't know everything. They also can't remove tonsils in the surgery, but nobody complains.

 

[Dave W]

You're right. That's why we have dieticians. GPs can't know everything. They also can't remove tonsils in the surgery, but nobody complains.

Yes Mike, GPs are generalists and can't possibly be expected to have the specialist knowledge to cover ALL health issues, that's where referral to a consultant comes in.
It's a bit like the field of I.T. where the complexities have grown over the past 20 or 30 years or so. Once upon a time the knowlege base and problems were small but it is now so large that one person can't encompass it all.
Doctor Finlay inTannoch Brae belong to the past when GPs knew everything there was to be known. Maybe Dr Snoddie didn't though!

 

[mikeyB]

Aye, there's the rub, Dave. There is so much more to be known now that it simply impossible for a single person to know it all, though so many people are expecting their GPs to do it. How vets cope I have no idea, but I bet they consult the books when you take in your torpid pet tarantula.

 

[Owen]

When it comes to PHEM there are not too many doctors that are trained outside of the voluntary sector. Then there is a clear difference between in hospital critical care and pre-hospital critical care. The pit crew method is practiced by some ambulance trusts but not by all. One trust near operates a scoop and run policy, whereas another is more stay and play. There is an assumption that all ambulance staff are paramedics, but the amount of crews that are double tech or even one tech plus an ECA is much higher than you would think. This is just one tiny aspect of medicine, so how the hell is a GP supposed to know all this. Plus with the modern attitude to litigation, I am often called to GP surgeries to deal with patients due to this aspect.
Is this the correct way?

 

[Deleted member 16779]

When it comes to PHEM there are not too many doctors that are trained outside of the voluntary sector. Then there is a clear difference between in hospital critical care and pre-hospital critical care. The pit crew method is practiced by some ambulance trusts but not by all. One trust near operates a scoop and run policy, whereas another is more stay and play. There is an assumption that all ambulance staff are paramedics, but the amount of crews that are double tech or even one tech plus an ECA is much higher than you would think. This is just one tiny aspect of medicine, so how the hell is a GP supposed to know all this. Plus with the modern attitude to litigation, I am often called to GP surgeries to deal with patients due to this aspect.
Is this the correct way?

Well, I would take issue with 'tiny bit' aspect - surely this is both a modern epidemic - in that obesity is behind a lot of problems patients have and if doctors know nothing about diet or obesity, why do they try to treat it by giving the patients diets and often throwaway advice on doing more exercise? It does seem odd that they don't study nutrition when it's such a fundamental input into the human system with such widely ranging effects.
Or perhaps we need more specialists and each GP should have a dietitian attached to the staff?

 

[Robin]

Or perhaps we need more specialists and each GP should have a dietitian attached to the staff?

Perish the thought! We'd all be eating from the Eatwell Plate .(OK, it's the Eatwell Guide officially now, but same difference).

 

[Owen]

Well, I would take issue with 'tiny bit' aspect - surely this is both a modern epidemic - in that obesity is behind a lot of problems patients have and if doctors know nothing about diet or obesity, why do they try to treat it by giving the patients diets and often throwaway advice on doing more exercise? It does seem odd that they don't study nutrition when it's such a fundamental input into the human system with such widely ranging effects.
Or perhaps we need more specialists and each GP should have a dietitian attached to the staff?

If you must quote and comment then keep it in context. The tiny bit I am referring to is, related to pre-hospital care. Too many people assume that a GP (which is only one aspect of medicine) should have all the answers, in a similar vane these same people get upset that when a medic or paramedic does not diagnose all their illnesses and ailments then they have not been trained well enough. Nutrition is a dietary (education need) not an urgent medical or emergency medical need (unless you are in anaphylaxis or choking). Likewise dieticians don't usually provide ALS. You would not expect your gas engineer to fix your electricity supply, would you? From my limited knowledge of general practice, is it not a system to signpost people to the correct secondary care?

 

[Hazel]

Owen that was exactly my point earlier.
Nutrition needs to be taught early on

 

[Owen]

Owen that was exactly my point earlier.
Nutrition needs to be taught early on

Sadly we often learning from media, this is only set to confuse even more. The only real way to correct this is through government backed education campaigns using all the media available and even then, it would need to be without bias. Very unlikely as every politician seems to have their own agenda. Parents ultimately hold the responsibility, but need the correct information which seems to subjective or certainly subject to constant debate and even then will be different for each persons individual needs.

 

[Deleted member 16779]

If you must quote and comment then keep it in context. The tiny bit I am referring to is, related to pre-hospital care. Too many people assume that a GP (which is only one aspect of medicine) should have all the answers, in a similar vane these same people get upset that when a medic or paramedic does not diagnose all their illnesses and ailments then they have not been trained well enough. Nutrition is a dietary (education need) not an urgent medical or emergency medical need (unless you are in anaphylaxis or choking). Likewise dieticians don't usually provide ALS. You would not expect your gas engineer to fix your electricity supply, would you? From my limited knowledge of general practice, is it not a system to signpost people to the correct secondary care?

I don't wish to get bogged down in the subject of ambulance crews as it's not relevant here - you were making an analogy with your area of expertise I think, but you were saying that 'tiny bit' is like 'diet, nutrition and obesity' being a 'tiny bit' of GPs work. I am disagreeing with that.

 

[Deleted member 16779]

Sadly we often learning from media, this is only set to confuse even more. The only real way to correct this is through government backed education campaigns using all the media available and even then, it would need to be without bias. Very unlikely as every politician seems to have their own agenda. Parents ultimately hold the responsibility, but need the correct information which seems to subjective or certainly subject to constant debate and even then will be different for each persons individual needs.

I don't think it's something you can dump at the door of parents - they're just one of the many influences people have, including friends, other family members, the media, fast food companies and food manufacturers and the government's policies. Government dietary policies definitely have an effect. To take one extreme example - rationing had a massive effect on reducing obesity and the concomitant effects.

 

[Northerner]

Well, the problem is that people have had 30 years of conditioning to believe all fat is evil and you have to eat plenty of carbs for 'energy'. Even healthcare professionals refuse, in many cases, to change their stance

I'm just hoping that, as with things like smoking and drinking that are now in decline in the under-25s, some of the focus on better nutrition and need for exercise is gradually seeping into today's young people and children as they grow up. A much greater emphasis and directed education in schools, better recreation facilities would all help.

 

[Owen]

I stand by my argument that is in the root of education. Medical staff are educated. Children are educated. New ideas and thought processes evolve from education. If you have a child you are there primary source of education. Everything else is secondary or tertiary. It is everyone's responsibility to learn, you can only learn if you want to. Now some will say that fats are good, some will say that fats are evil, others will say that is too simplistic. One thing I will guarantee, is that there are more opinions than there are answers.

If it works for you as an individual, then great keep doing it. But that does not mean that it is the only or best solution.

What I will say is, let people express a thought or opinion without assassinating every typo or potential error. Because doing this will only result in people saying sod it, I cannot be bothered speaking. Feel free to question or debate but don't keep jumping in with an opposing view just to be belligerent.