A research paper published by authors from the University of Arizona Center for Integrative Medicine, University of Arizona College of Medicine in Tucson looked into the efficacy of an online, multi site residency program for training physicians in integrative medicine. Residents from eight family medicine programs took the 200 hour online program. The researchers measured the medical knowledge of those completing the program and concluded that the online delivery of the curriculum was a viable way to expand the dissemination of this sort of knowledge to family doctors in training.
The Arizona Center for Integrative Medicine defines integrative medicine as “healing oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies,” according to the research paper.
Questions from patients
The need for this kind of training comes not just from a judgement about the efficacy of alternative therapies but from the market itself. Physicians need to be able to offer input to questions coming from their patients.
“According to the Centers for Disease Control, 40% to 45% of adults in the US use CAM [Complementary and Alternative Medicine]. The Institute of Medicine (IOM) recommends that ‘health profession schools (e.g. schools of medicine, nursing, pharmacy, and allied health) incorporate sufficient information about CAM into the standard curriculum at the undergraduate, graduate, and postgraduate levels to enable licensed professionals to competently advise their patients about CAM,’” the authors wrote.
The paper notes that this type of curriculum is now offered in 60 family medicine residencies in the US and Canada. But that is still a small subset of the overall market for physicians. According to data from the National Resident Match Program, there were 28,849 PGY-1 (Post Graduate Year 1) positions offered in the US in all specialties in 2017, of which 3,237 were in family medicine.
Dr Victoria Maizes, MD, of the Arizona center and one of the authors of the program, said that there is a crying need for more training of this sort for physicians. More evidence is available all the time about the effects of nutrition and specific bioactive substances in supporting health and ameliorating underlying disease conditions, but medical school curricula haven’t kept up.
“Twenty-five hours of nutrition [education] are recommended in medical school, but many schools do not achieve that number of hours.And, until recently little of the nutrition education prepared physicians to answer practical questions that patients commonly ask,” Dr Maizes told NutraIngredients-USA.
“As physicians move deeper into their training this situation gets worse. There is no required education in nutrition for cardiologists despite heart disease being largely preventable with dietary interventions. There are no requirements to teach about the use of dietary supplements in conventional training,” she said.
Program started in 2007
The Arizona curriculum has been under development since 2007. The online delivery, which was vetted in the present study, could help expand this training in residency programs where there is little on site expertise in nutrition, dietary supplementation and other aspects of CAM.
“Our curriculum provides physicians in training with the evidence for the use of nutrition as a preventive and primary treatment tool.It also teaches trainees how to appropriately recommend supplements.The education covers general principles of prescribing as well as dietary and supplement recommendations for a wide range of conditions that are commonly encountered in primary care,” Dr Maizes said.
Source: Family Medicine
Integrative Medicine in Residency: Feasibility and Effectiveness of an Online Program.
2017 Jul;49(7):514-521.
Authors: Lebensohn P, et al.