Nutrition-Competency and Attitude towards Nutrition Counseling among Graduating Medical Students ^†

Abstract

Background and objectives: Diet is a leading modifiable factor for the development of non-communicable diseases. The effective use of dietary interventions and advice should be an integral part of clinical care and medical doctors should be the most reliable and trusted source of nutrition information. The adequacy of nutrition training in medical education remains an issue of concern and most graduating medical students rate their nutrition competency as inadequate. There is no minimum standard of compulsory hours designated for nutrition in Bulgarian medical universities, nutrition classes are elective, and total assigned academic hours vary from 15 to 30. The aim of the current survey was to assess the self-perceived confidence in nutrition knowledge and skills of medical interns, obtained during medical training. Methods: A cross-sectional survey was conducted in February–March 2023. A total of 15 survey questions were formulated to assess the comprehensive medical training, nutrition knowledge and practical skills in dietary assessment, and preparedness to provide nutrition guidelines and dietary counselling. A five-point Likert scale was applied to assess the level of confidence. Results and discussion: A total of 53 interns responded to the survey with a response rate of 44%. Most participants were well confident about the diet-non-communicable disease relationship (64%), body composition and chronic diseases (76%), and the effect of diet on type-2-diabetes (68%), but fewer were familiar with food-drug interactions (8%) and were not prepared to provide food-based dietary guidelines to patients (12%). The interns were confident when interpreting laboratory nutrition tests (68%) and were ready to use anthropometric measurements (60%). About one-third of interns fully agreed that evaluation of nutritional status (36%) and dietary intake (28%) should be a part of every patient’s routine examination and 28% thought that nutrition counselling was not a part of their duties. Only 12% of the respondents were confident in their capacity to provide nutritional consultations. The strengthening of the medical curriculum with more mandatory nutrition classes will benefit physicians’ capacity in diet therapy counselling.