Medical students say they currently learn almost nothing about the way diet and lifestyle affect health – and they should be taught more.
They say what they are taught is not practical or relevant to most of the medical problems they see in GP surgeries, clinics and hospitals.
A leading GP estimated that up to 80% of his patients had conditions linked to lifestyle and diet.
These included obesity, type 2 diabetes and depression.
Why does this lack of training matter?
This year the NHS will spend more than £11bn on diabetes alone – social care costs, time off work etc, will almost double that bill.
Type 2 diabetes – the most common kind – is linked to obesity. And right now Britain is the fat man of Europe.
Training too traditional
But doctors are not being trained to deal with what medics call non-communicable diseases – and it’s those kind of illnesses that are threatening to bankrupt our health system, so a new kind of training is crucial.
Speaking to BBC Radio 4’s The Food Programme, Dr Rangan Chatterjee, author and podcast host, told me: “The health landscape of the UK has dramatically changed over the last 30 or 40 years and I think the bulk of what I see as a GP now – almost 80% – is in some way driven by our collective lifestyles.”
The ball started rolling at the end of 2016 when cardiologist Dr Aseem Malhotra and a number of other leading doctors including Rangan Chatterjee wrote to the General Medical Council, the health secretary and the Medical Schools Council calling for all medical students and practising doctors to be trained in “evidence based lifestyle interventions”.
Dr Michael Mosley, presenter of BBC One’s Trust Me I’m A Doctor, said, “Unfortunately it’s not part of the traditional training. At medical school I learnt almost nothing about nutrition. And I have a son at medical school and it’s again not part of his key curriculum.
“So I don’t get the sense that there are lots of doctors out there who feel empowered to tell patients much about nutrition.”
A hotbed of the new revolution is Bristol University where, in 2017, third year medical students Ally Jaffee and Iain Broadley founded Nutritank.
It’s an online organisation created for and by medical students to share nutrition science research and organises events and lectures on campus.
This summer, it will welcome GP, author and podcast host Dr Rupy Aujla to Bristol to lead the first UK course in culinary medicine for medical students.
From one society in Bristol, Nutritank has now spread to 15 other student-led groups at universities across the country.
Ally Jaffee said: “There’s just about a society at medical school in everything from sexual health to orthopaedics to dermatology. But there just wasn’t a nutrition and lifestyle or a preventative medicine society.
“We’re taught about 10 to 24 hours over five to six years in medical school on nutrition.”
This month, the British Medical Journal announced it will launch a journal on the science and politics of nutrition in June 2018.
Dr Fiona Godlee, editor-in-chief of the BMJ, told me, “It’s time we recognised that food and nutrition are core to health. There is a growing body of research out there that needs to be published – and we want to contribute to that effort.”
She said the same levels of quality and scrutiny should be applied to food science that are applied to other areas of health research.
The BMJ’s announcement follows an opinion piece it published in October 2017 written by two University of Cambridge graduate medical students, Kate Womersley and Katherine Ripullone.
Kate said: “I was in an obesity clinic as part of my medical shadowing.
“A patient came in and said very frankly to the doctor, the consultant in charge, ‘Why am I so fat?’.
“The patient was asking a very straightforward question and I think was expecting a straightforward answer. But often that’s a question where doctors seem to clam up a bit.
“We were interested to write this piece for the BMJ, because we didn’t feel prepared to be receiving that question.”
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Medical schools in the UK are responsible for setting their own curriculum with guidance and standards published by the General Medical Council.
The GMC is now reviewing that guidance but so far it’s been very general. It told us that it recognises the significance of the impact of diet and nutrition on health and wellbeing and has sought to express this more explicitly in its revised “outcomes” that will be released this summer.
Things are also beginning to change at medical schools. University of Cambridge told us it plans to double the amount of core course content on nutrition and has asked Kate and Katherine to help.
Similarly, Bristol medical school has sought input from students to redesign its curriculum.
Meanwhile, Prof Sumantra Ray of NNedPro Global Centre for Nutrition and Health told us his organisation is involved in rolling out training in diet and nutrition for student doctors by 2020.
Kate said: “Students need to see nutrition as something at the cutting edge of scientific discovery.
“I think there needs to be an image change of how doctors perceive nutrition, but also how it’s presented to students.”
You can hear more about this story on The Food Programme on Radio 4 at 12:32 BST on Sunday or on iPlayer afterwards.