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Doctors Do Not Know Much About Obesity Because They Are Not Expected To



sharma-obesity-medical-students1Despite recognition of obesity by the American Medical Association as a chronic medical disease not unlike hypertension or diabetes, do not expect doctors in the US to know much about it.

If you’re wondering why, the answer is rather simple.

According to a paper by Robert Kushner and colleagues published in the journal Teaching And Learning In Medicine, competencies in obesity prevention, assessment, and treatment are apparently not really required, at least not based on the questions that young doctors can expect to be asked in licensing exams.

The researchers examined the coverage and distribution of obesity-related items on the three step United States Medical Licensing Examination (USMLE), which every practicing US physician (irrespective of the specialty or discipline) has to pass to qualify for licensing.

Although the USMLE question panel did include over 80o multiple-choice items containing obesity-related keywords, 58% of these items were represented by only 4 of 17 organ systems, and 80% of coded items were represented by only 6 of the 107 American Board of Obesity Medicine subdomains.

While the majority of obesity-coded items pertained to the diagnosis and management of obesity-related comorbid conditions, they did not directly address the prevention, diagnosis, or management of obesity itself.

In medicine (as in any other discipline), students focus on topics that they can expect to encounter in their exams – clearly, diagnosing obesity and managing it, is not one of them.

Although this analysis was performed in the US, I would be surprised if any licensing body in the world actually requires of medical graduates to have a good working knowledge of preventing, diagnosing, and managing obesity (rather than just the related comorbidities).
Till this changes, people living with obesity should not be surprised to encounter physicians who may know less about obesity, its causes, and treatments than they might expect.
@DrSharma
Edmonton, AB

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