insights
Clinician Spotlight: Elizabeth Boham, MD, on Nutrition Education
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As a core tenet of functional medicine, much emphasis is placed on the role of nutrition as a key modulator of health. In most standardized medical school curriculum, however, the focus is often on acute care versus preventive medicine, and nutrition education is either limited, lacking, or nonexistent. A systematic review of nutrition learning experiences in the US reported disproportionate teaching and assessment methods of nutrition education.1 The heterogeneity of articles analyzed in this study suggests that no standardized objectives for nutrition education are currently applied when teaching students how to transfer this knowledge into clinical practice.1
A lack of focus on nutrition training isn’t limited to the US; research on nutrition in medical education finds that this training is also suboptimal in countries like Australia,2 the Czech Republic,3 Ghana,4 and the UK.5 Qualitative analyses reveal that medical school students recognize their duty as physicians to counsel patients on adequate nutrition but feel that nutrition education is not sufficient or emphasized enough in the curriculum.3,4 Another systematic review of curriculum in global regions reported similar results to the US study mentioned above, suggesting that deficits in nutrition education affect students’ confidence and competence in implementing nutrition-based care and may limit the therapeutic options available to patients.2
For many clinicians, discovering the functional medicine approach helps them return to why they initially wanted to do medicine. For Elizabeth Boham, MD, MS, RD, IFM’s foundational course, Applying Functional Medicine in Clinical Practice, provided the framework to integrate her passion for nutrition with preventive medicine. Watch her explain her journey to functional medicine.
TRANSCRIPT:
My undergraduate and graduate degree was in the field of nutrition. So when I went back to medical school and was in my medical school training and residency, there were many times where I got frustrated because we were so focused on acute care medicine, and I really wanted to focus more on prevention and really see how food can impact our health and how food is medicine.
When I got out of residency, I was trying to find my way, and how I was going to practice medicine—and how I was going to incorporate my nutrition training and my medical school practice.
It was in 2004 that I went to AFMCP [Applying Functional Medicine in Clinical Practice], and it was amazing. I remember I went up and gave David Jones a big hug afterward with tears in my eyes because I was like, “This is amazing. This is exactly what I wanted.”
IFM gave me the tools, the map.
The way to incorporate my nutrition background with my medical school training and be able to incorporate the two to really have a very patient-focused practice. To focus on the individual and do some personalized medicine, and really just bring a big science-based approach.
Just do the best of medicine.
References
- Bassin SR, Al-Nimr RI, Allen K, Ogrinc G. The state of nutrition in medical education in the United States. Nutr Rev. 2020;78(9):764-780. doi:1093/nutrit/nuz100
- Crowley J, Ball L, Hiddink GJ. Nutrition in medical education: a systematic review. Lancet Planet Health. 2019;3(9):e379-e389. doi:1016/S2542-5196(19)30171-8
- Hawk VH, Kapounová Z, Krobot M, et al. Student and faculty perceptions of nutrition education in medical school. Clin Nutr ESPEN. 2022;47:351-357. doi:1016/j.clnesp.2021.11.011
- Mogre V, Stevens FCJ, Aryee PA, Amalba A, Scherpbier AJJA. Why nutrition education is inadequate in the medical curriculum: a qualitative study of students’ perspectives on barriers and strategies. BMC Med Educ. 2018;18(1):26. doi:1186/s12909-018-1130-5
- Ganis L, Christides T. Are we neglecting nutrition in UK medical training? A quantitative analysis of nutrition-related education in postgraduate medical training curriculums. Nutrients. 2021;13(3):957. doi:3390/nu13030957