Medical Schools Exclude Exercise From Curriculum, Leaving Future Doctors Ill-Equipped

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Physicians may be unprepared to give patients advice on working out, given so few learn the basics in school. See-ming Lee, CC BY-SA 2.0

They might learn the intricacies of microbiology and bedside care, but budding doctors seldom learn the first thing about the simple act of exercise, a new study finds. Without a proper foundation for advising patients on personal health, these physicians could be leaving out important information on how to avoid major diseases.

Together with diet, moderate physical activity has been well-established to lower people’s risks for most diseases, delay aging, and promote cognitive function. Unfortunately, as more than two-thirds of the U.S. population is currently overweight, sedentary lifestyles have largely taken hold. Too often, physical fitness falls to hectic schedules and rationalized excuses to stay seated.

That might change if doctors are armed with knowledge to pass on to patients. Lead author of the new study Brad Cardinal, professor of exercise and sport science at Oregon State University, says the effect of regular exercise is so powerful, it might as well be considered medicinal. “I was surprised that medical schools didn't spend more time on it,” Cardinal said.

He and several of his colleagues collected data on 118 accredited medical schools out of the available 170, focusing only on those that had a listed curriculum online. They screened the schools for language pointing toward exercise-related classes. In total, 51 percent of schools offered no coursework related to physical activity, and 21 percent offered only one. Of those that had classes available, only 18 percent made them mandatory.

While some schools may indeed teach students about exercise without spelling out the lessons in the curriculum, from what Cardinal and his team can see, the rate should still be much higher. “I'm an outsider looking in,” he said, “and I was expecting to see more than what we did.”

For many people, physicians serve as the primary point of contact in learning about staying healthy. People may carry the general understanding that exercise is “good for you,” but which exercises to perform, with what frequency, and for how long can still loom as major question marks. “Understanding why and how to exercise, and knowing how to help people who are struggling to make it a habit, is really important,” Cardinal said. It may be the only way to institutionalize exercise as a public health habit, not just a behavior of the select few.

Fortunately, people who graduate medical school and enter the workforce as physicians already tend to carry an increased passion and knowledge for personal health. What they may be missing is a way to relate to their patients’ specific needs. A teenage boy looking to lift weights has different goals and restrictions than an elderly woman looking to alleviate her arthritis. A formal education that outlines these criteria may help reduce widespread injury and improve overall health.

“We really need to see something happen to address this,” Cardinal said. “How do we get it more institutionalized into medical school curriculum? This is a question researchers have been asking for 40 years now. It is about time we figured it out.”

Source: Cardinal B, Park E, Kim M, Cardinal M. If Exercise is Medicine, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content. Journal of Physical Activity and Health. 2015.

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