For centuries, medical students learned the basics of their profession the same way. First, they were taught the basics of anatomy, physiology and biochemistry. Then, in clinical rounds they learned to identify diseases as patients presented — lung cancer, heart attack, stroke — and what treatment options might cure the condition or at least slow it down.
The pattern of study for other health professionals was pretty much the same. But with the increasing emphasis on preventive medicine comes a new approach to education. UAB was one of the first medical schools in the country to focus on nutrition as a part of the curriculum. Now wellness is at the forefront of a major change in how medicine is taught.
Teaching in Context
Saving Lives 20 Years in Advance
Preventing clogged arteries may not be as dramatic as a quadruple bypass, but it can be a very effective way to save lives, with less risk, less pain and lower costs to patients, their families and society.
“As we teach organ systems, we talk about the impact of disease on society and the public health implications,” said Berkow. “Over time, as students learn about the body’s systems and how they work together, they begin to see a clearer picture of how they can help to prevent diseases and begin to apply that knowledge in their clinical training.”
“We place an emphasis on prevention,” said Berkow. “It’s much like well baby care in pediatrics, where we monitor a baby’s nutrition and how it’s growing, what immunizations it needs to protect it from illnesses, and we watch for problems that need to be corrected so it can achieve optimal health. Family history, early detection and considering the patient in the context of his family and social environment are also an important part of preventive medicine.”
Changing Behaviors, Changing Lives
In other areas of health education, wellness is also a central theme.
“Students today are being taught prevention, prevention and prevention, including health education, behavior change, and specifics of nutrition and exercise,” said Charles D. Sands, PhD, associate dean, Education and Professional Studies at Samford University, who works with students in exercise science and sports medicine.
“A student graduating today begins a conversation with the idea that preventing a disease is a much better way to approach health. In addition, the students are taught to recognize that wellness has to be tailored to the individual. There is enough evidence-based support for individuals to recognize the benefit, value and importance of regular exercise and a sound diet; however, the transition of the information to application is the main focus at this point. Thus, more and more students need training in behavior change models and theories to assist individuals to begin to move forward.”
Leading by Example
“One of the first things we have new medical students do is to start with their own health,” said Dr. Douglas Heimburger, professor of Nutrition Sciences and Medicine at UAB.
“We have them assess their own nutrition, fitness and how they manage stress. What they learn in taking care of themselves they can pass along to their patients. We teach students how to detect nutritional problems and therapeutic measures. Students in internal medicine and physician nutrition specialists receive additional training in nutrition, but what we want all our medical students to understand is the link between diet and chronic diseases. There are so many nuances. Everything is related. We want them to understand the changes in nutritional requirements through the life cycle — pregnancy, birth and aging.”
Today, malnutrition in developed countries is usually a result of illness. But in fast-food America, there is another type of malnutrition that comes from foods that can overfill the stomach and fail to nourish the body.
One of the most powerful tools physicians have in teaching patients to make wellness a way of life is their own example in making it part of theirs.
January 2008
