Theses Master's

Neglected Nutrition: A Call to Action for the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) to Update the United States Medical Licensing Examination (USMLE)

Goulding, Samantha Gabrielle

With more than 93 million US adults already living with obesity (Centers for Disease Control and Prevention, 2018), it is unsurprising that obesity-related diseases like type II diabetes, coronary heart disease, stroke, and several types of cancer are becoming the most prevalent health concerns physicians are presented with. Accordingly, nutrition is now a recognized determinant in three of the top four leading causes of death in the United States and subsequently has been validated extensively as an effective preventative health measure through experimental, observational, and controlled clinical trials (Kris-Etherton et al, 2014). Despite evidence supporting nutrition as a cost-effective and low-risk treatment for chronic disease, fewer than thirty percent of medical schools meet the minimum hours of nutrition education recommended by the National Research Council (Bradley et al, 2017). Therefore, medical schools are not adequately training their students in nutrition, which results in lack of confidence in both student and physicians to counsel patients about healthy dietary behaviors. Medical schools prioritize their students’ performance on the USMLE Step exams, and thus shape their curricula around what competencies are present on those exams. By using an ecological model as the framework for intervention, a two-part literature review encompassing the community, organizational, and policy levels was conducted. Upon analysis of the most prevalent nutrition-related treatment recommendations published by professional medical organizations, six specific, evidence-based, nutrition-related competencies were outlined. These recommended competencies are put forward as essential additions to the USMLE Step exams.


More About This Work

Academic Units
Sociomedical Sciences
Thesis Advisors
Van Wye, Gretchen
M.P.H., Mailman School of Public Health, Columbia University
Published Here
May 13, 2020