Keck School of Medicine of USC ramps up diet and exercise training for primary care medical students

Diet and exercise have always been important for maintaining good health, but doctors have historically received little training in medical school to give their patients solid, evidence-based counsel about nutrition or exercise. 

The Keck School of Medicine of USC Primary Care Initiative set out to change that, launching a new curriculum focused on nutrition and exercise for medical students in the primary care pipeline track. The training is designed to give medical students the tools they need to guide patients on dietary and exercise changes that would help them reach their target health goals. 

“We recognized that counseling people around diet and exercise to prevent illness was a real educational gap and we are trying to fill that gap, especially in primary care,” said Jo Marie Reilly, MD, professor of clinical family medicine at the Keck School of Medicine and director of the Primary Care Initiative. “With chronic disease at record highs, we believed that we needed to train students in evidence-based nutrition and exercise and are pleased to see that students improved their confidence and skill set after participation in the program.”

Hands-on education

Students in the primary care program complete exercise and nutrition training modules during their first year of medical school. After their training, they put their new knowledge to work, providing 15 distinct nutrition and exercise classes to patients from Los Angeles General Medical Center and the surrounding community at The Wellness Center.  The classes, scheduled every Tuesday during the fall and spring semesters, are offered in a hybrid fashion so that patients who cannot come in person can participate via Zoom.

At The Wellness Center, the bilingual Spanish and English nutrition classes focus on reading food labels, teaching patients about healthy carbohydrates and proteins versus fatty foods and sugary beverages, and the difference food choices can make to the health of people living with diabetes, hypertension and high cholesterol. They also cook alongside participants during a demonstration provided by a bilingual chef focusing on culturally sensitive foods. Students teach exercise classes to participants focusing on strength training, gait, balance, stretching and cardiovascular health. 

To evaluate the impact of the program, students were given knowledge and confidence surveys before and after their experiences. The surveys showed that overall, students felt far more confident after their training using evidence-based information to counsel their patients about how diet and exercise can help them improve their health. Furthermore, the data demonstrated that the students improved their own nutrition and exercise habits as a result of their nutrition and diet training program. 

“The students like the idea that they are learning practical skills and that they are learning about the types of questions their patients want to ask their doctors about diet and exercise,” said Isabel Edge, MD, assistant professor of family medicine and assistant director of the Keck School of Medicine Primary Care Initiative. 

Descriptions of the nutrition and exercise curriculums, along with survey results, and the program’s impact were published in the American Journal of Lifestyle Medicine.  

Modernizing medical education

The Primary Care Program at the Keck School of Medicine has been going through some significant curriculum changes in in recent years to better prepare primary care providers to meet the health and medical needs of people in the 21st century. Recent new electives also prepare students to work with vulnerable communities by offering training in street medicine, substance use, elder care and the care of patients with disabilities.  

In the nutrition and exercise program, students also learn about the real issues facing people in the community who want to improve their health through diet and exercise – challenges such as living in neighborhoods that are unsafe for outdoor exercise or that lack access to healthy food, also known as food deserts. Many patients at The Wellness Center come from diverse, immigrant backgrounds and deal with social factors that impact their health. Working with these patients gives students the opportunity to learn how to help them navigate these challenges in accessing care that is equitable and inclusive in the community that surrounds the Keck School of Medicine.  

“We are trying to provide cutting-edge teaching for our medical students, “said Reilly. “By responding to the holistic health needs of the community at large, we provide our graduates with skill sets to meet the needs of contemporary America.”