Proposed Nutrition Competencies for Medical Students and Physician Trainees
Authors: Eisenberg David M. , Cole Alexis , Maile Edward J. , Salt Matthew , Armstrong Elizabeth , Broad Leib Emily , Findley Trevor , Massa Jennifer , Albin Jaclyn , Alston Meredith , Barkoukis Hope , Buckhold Fred , Danoff Robert , Delichatsios Helen , Devries Stephen , Dewar Stephanie , Di Rocco Jennifer , Duggan Christopher P. , Essel Kofi , Frates Beth , Hansen Pamela , Haramati Aviad , Harlan Timothy S. , Hauser Michelle E. , Leopold David , Lewis Joanna , Locke Amy , Mann Joshua R. , McClure Auden , McWhorter John Wesley , Misra Saroj , Murano Tiffany , Oxentenko Amy , Pierce-Talsma Stacey , Potts Stacy , Reilly Jo Marie , Ring Melinda , Sampang Suzanne , Shafto Kate , Shiue Linda , Slusser Wendelin , Stone Terri , Studer Karen , Thomas Olivia , Trilk Jennifer , Edgar Laura 
Published: September 2024

Importance

In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education.

Objective

To recommend nutrition competencies for inclusion in medical education to improve patient and population health.

Evidence Review

The research team conducted a rapid literature review to identify existing nutrition-related competencies published between July 2013 and July 2023. Additional competencies were identified from learning objectives in selected nutrition, culinary medicine, and teaching kitchen curricula; dietetic core competencies; and research team–generated de novo competencies. An expert panel of 22 nutrition subject matter experts and 15 residency program directors participated in a modified Delphi process and completed 4 rounds of voting to reach consensus on recommended nutrition competencies, the level of medical education at which they should be included, and recommendations for monitoring implementation and evaluation of these competencies.

Findings

A total of 15 articles met inclusion criteria for competency extraction and yielded 187 competencies. Through review of gray literature and other sources, researchers identified 167 additional competencies for a total of 354 competencies. These competencies were compiled and refined prior to voting. After 4 rounds of voting, 36 competencies were identified for recommendation: 30 at both undergraduate and graduate levels, 2 at the undergraduate level only, and 4 at the graduate level only. Competencies fell into the following nutrition-related themes: foundational nutrition knowledge, assessment and diagnosis, communication skills, public health, collaborative support and treatment for specific conditions, and indications for referral. A total of 36 panelists (97%) recommended nutrition competencies be assessed as part of licensing and board certification examinations.

Conclusions and Relevance

These competencies represent a US-based effort to use a modified Delphi process to establish consensus on nutrition competencies for medical students and physician trainees. These competencies will require an iterative process of institutional prioritization, refinement, and inclusion in current and future educational curricula as well as licensure and certification examinations.