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The University of Alabama at Birmingham, 1675 University Boulevard, Webb 222, Birmingham, AL 35294-3360. E-mail: doug.heimburger{at}uab.edu.
Through its Group on Nutrition, the Society of Teachers of Family Medicine has long taken leadership in defining desirable medical nutrition education goals for residents in family medicine, complete with a recommended curriculum that includes suggested methods for implementation. Its Physician’s Curriculum in Clinical Nutrition: Primary Care, a monograph first published in 1995, was revised in 2001. It is intended for directors of residency programs in family medicine but is also substantially applicable to residency programs in other primary care specialties such as internal medicine and pediatrics.
In publishing this monograph, the intention of the Society is not to provide another textbook or handbook in clinical nutrition; there are ample numbers of those. Rather, its aims are to articulate comprehensive goals for medical nutrition education, catalog methods for achieving them, showcase residency programs that could be considered models, and point to resources that are available for free or for purchase to provide more detailed information.
In articulating teaching objectives, the Curriculum is similar to the curricula recently produced by the Nutrition Academic Award institutions (www.nhlbi.nih.gov/funding/training/naa), which are supported by the National Institutes of Health, and the Intersociety Professional Nutrition Education Consortium (www.ipnec.org). The difference is that the objectives of the Curriculum are aimed at residents, whereas those of the curricula of the Nutrition Academic Award and the Intersociety Professional Nutrition Education Consortium are primarily directed toward undergraduate medical students and physician nutrition specialists, respectively. The objectives are divided into fundamental skills (nutrition assessment and counseling), nutrition issues at different stages of the life cycle (infants through the elderly), nutrition care skills for prevention and treatment of disease (including the major nutrition-related conditions common in the United States), and issues of secondary malnutrition caused by systemic diseases. The goals are largely comprehensive, although they differ in depth (eg, for cancer prevention, the reader is simply referred to 3 websites, and the obesity section does not mention waist circumference or waist-to-hip ratio).
The recommended methods for implementing medical nutrition education are quite robust. These methods include elements of successful programs; ways to use the residency orientation as a teaching tool; teaching opportunities in inpatient settings, nursing homes, home visits, the ambulatory care setting, and didactic settings; suggestions for independent study; and evaluation tools and strategies.
To highlight "best practices," the third section of the monograph contains a list of 13 family medicine residency programs that have incorporated substantial nutrition education; the list includes contact information for those programs. The third section also contains a list of 24 family practice faculty members who have volunteered to help others develop successful teaching programs, and the list includes each faculty member’s areas of expertise.
The final section lists multiple resources that should help directors of residency programs cover the many topics involved in medical nutrition education. These resources include textbooks, handbooks, cookbooks, web-based dietary analysis tools, journals, newsletters, journal articles, organizations, CD-ROMs, and websites for physician education, patient education, evidence-based medicine, geriatrics, and handheld computer software. The extensive list of websites, which are cited throughout the Curriculum and compiled at the end, is one of the publication’s most helpful features. An appendix also supplies forms for developing and evaluating nutrition teaching programs.
The Curriculum is a useful resource for anyone attempting to develop a nutrition education program for residents in primary care fields. Although it has a few limitations, including a faulty table of contents and paragraph-numbering irregularities, it is very well thought out and comprehensive.