Nutrition competencies for the prevention and treatment of disease in Australian medical courses

To the Editor: In Australia, cancer, heart disease, stroke and diabetes mellitus contribute to 56% of all deaths,1 and have a significant nutrition-related lifestyle component. In 2008, 68% of men and 55% women were classified as overweight or obese,1 and of those in residential aged care, 50% were moderately or severely malnourished.2 Accreditation standards for medical schools (currently under review) specify that medical graduates have the ability to apply nutrition knowledge in practice.3 Nutrition has been integrated into medical education in the United Kingdom, the United States and Canada since 2001, and the medical profession has adopted nutrition competencies.4 However, no nutrition competencies have been included in Australian medical courses.

We assessed nutrition education using published material and telephone interviews with key staff from all 18 Australian medical schools. We found that there is no integration of nutrition knowledge and skills across medical courses; assessment of nutrition knowledge and skills varies significantly between courses, and nutrition education is highly dependent on individual staff interest. Practical skills, including how to take a dietary history, were taught in only 44% of courses; nutrition-related knowledge and skills were developed on clinical rotations in 56% of courses, but content and detail varied considerably. Only one university specified a graduate attribute linked to nutritional management of common conditions.

A symposium held 24 years ago, reaffirmed by the Dietitians Association of Australia, recommended that medical schools demonstrate a commitment to teaching nutrition, and adequately resource nutrition education, with a clearly identified person or department responsible for nutrition education.5 In 2010–2011, none of the medical courses in Australia had an academic appointment for a nutrition coordinator, although in 1992, two universities employed staff to undertake a review of nutrition in their medical courses.5

We have developed a nutrition competency framework that can easily be integrated into the medical curriculum, derived from UK and US nutrition competencies. This framework is aligned with the Framework of competencies for medical graduate outcomes developed by Medical Deans Australia and New Zealand.3

Adoption of nutrition competencies in Australian medical courses will ultimately lead to improvements in the treatment and prevention of nutrition-related diseases. We urge medical schools to adopt this framework to ensure development of nutrition competencies in medical graduates.